0388 Predictors of Incident Reduced Sleep Efficiency in Community-Dwelling Older Women

Introduction

There is a paucity of longitudinal studies with sleep efficiency (SE) as an outcome measure. Our objective was to examine potential risk factors for incident reduced SE among community-dwelling women in late life.

Methods

We studied 700 women (mean age 82.5 [SD=3.0] years) with a SE ≥70% at the Year 16 (2002-04) visit of the Study of Osteoporotic Fractures with a follow-up measure of SE at the Year 20 (2006-08) visit. SE (percentage of time sleeping while in bed) at both visits was measured using a wrist actigraph with data collected for an average of four 24-hour periods. Women were classified as having incident reduced SE if they had SE <70% at Year 20. Logistic regression was used to estimate the associations between potential risk factors (demographics, lifestyle, use of medications, self-reported medical conditions, functional impairment, frailty, mental and physical health) at Year 16 and reduced SE at Year 20. The association of each candidate risk factor with reduced SE at Year 20 was examined in models adjusted for age, clinical site and continuous SE at Year 16. Candidate risk factors with Benjamin Hochberg false-discovery rate q-values <0.10 were included in a final multivariate model.

Results

Among the 700 eligible women, 62 (8.9%) developed incident reduced SE between the Year 16 and Year 20 visits. After adjusting for age, site and baseline SE, antidepressant use [OR=3.06; 95% CI: 1.50-6.25], benzodiazepine use [OR=2.97; 95% CI: 1.30-6.80] and the presence of hypertension [OR=2.83; 95% CI: 1.47-5.45] at Year 16 were independently associated with a higher odds of having reduced SE at follow-up.

Conclusion

These findings suggest that antidepressant use, benzodiazepine use and hypertension are risk factors or markers for the development of reduced sleep efficiency in older women. Future studies are warranted to examine the underlying mechanisms for these associations.

Support

The Study of Osteoporotic Fractures (SOF) is supported by National Institutes of Health funding. The National Institute on Aging (NIA) provides support under the following grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, and R01 AG027576.

An experimental approach for investigating consumers' evaluation of pharmacist consultation services

The goal of this study was to investigate factors that influence consumers' perceptions of service encounter satisfaction, overall service quality, and trust in the service provider for pharmacist consultation services. We used the Dynamic Process Model of Service Quality as the framework for investigating the formation of these evaluations. Consumers' prior expectations of what should and will transpire during the service episode(s) and the performance level of the actual delivered service during the service encounter(s) were hyphothesized to affect satisfaction, quality, and trust. Two experiments using a 2 x 2 x 2 fully crossed factorial design were used for collecting and analyzing data. The results showed that normative (should) and predictive (will) expectations play differential roles in consumers' evaluation of satisfaction, perception of quality, and trust in the service provider. Also, a particular type of expectation seems to serve different roles depending on the level of service performance. The results can be useful for decisions related to financial planning, marketing, and management of pharmacist consultation services.