Research Interests:
Research Interests:
Research Interests:
It is well known that the US is plagued by health inequities: unjust differences in morbidity and mortality rates by sociodemographic factors. A potential method to address such inequities lies in utilizing health information technologies... more
It is well known that the US is plagued by health inequities: unjust differences in morbidity and mortality rates by sociodemographic factors. A potential method to address such inequities lies in utilizing health information technologies (HIT) to reach under-resourced populations and increase their involvement in healthcare. Previous researchers have done just this, using HIT tools to engage under-resourced communities and improve outcomes. However, it is unclear how HIT usage varies by sociodemographic characteristics. This study investigated this question through analysis of the Health Information National Trends Survey (HINTS) and proposed tailored HIT interventions for specific subpopulations. Internet, smartphone, and wearable device usage were analyzed by age, race/ethnicity, educational attainment, and income; purposes of HIT usage were assessed; and logistic regression models were conducted to determine associations between purposes of HIT usage and sociodemographic predict...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
ObjectivesTo determine the probability of discharge from military service among soldiers following an incident diagnosis of ankylosing spondylitis (AS), rheumatoid arthritis (RA), psoriasis or systemic lupus erythematous.MethodsAll... more
ObjectivesTo determine the probability of discharge from military service among soldiers following an incident diagnosis of ankylosing spondylitis (AS), rheumatoid arthritis (RA), psoriasis or systemic lupus erythematous.MethodsAll soldiers on active duty in the US Army between January 2014 and June 2017 were included in a retrospective cohort analysis. Termination from service was ascertained using personnel records. Diagnostic codes were used to identify incident cases of the four musculoskeletal and skin diseases and, for comparison, diabetes mellitus (DM). Time to discharge was modelled using sex stratified multivariate survival analysis.ResultsThe analysis included 657 417 individuals with a total of 1.2 million person-years of observation. An elevated risk of discharge was observed in association with each of the five chronic conditions studied. The increase in adjusted risk of discharge was highest among soldiers with AS (men, HR=2.5, 95% CI 2.1 to 3.0; women, HR=2.1, 95% CI ...
Research Interests:
Research Interests:
Research Interests: Psychology and Cancer
Research Interests:
INTRODUCTION: Exposure to traumatic events could increase post-traumatic stress disorder (PTSD) risk among enlisted U.S. Army drone operators. Published research on PTSD risk in this population is unavailable.METHODS: We used a combined... more
INTRODUCTION: Exposure to traumatic events could increase post-traumatic stress disorder (PTSD) risk among enlisted U.S. Army drone operators. Published research on PTSD risk in this population is unavailable.METHODS: We used a combined medical and administrative longitudinal dataset to examine adjusted associations between drone operator service among U.S. Army enlisted members and three PTSD indicators: whether screened via the PTSD Checklist – Civilian (PCL-C); PCL-C scores; and incident PTSD diagnoses. We compiled summary statistics for and conducted tests of differences in independent variable distributions when comparing drone operators and others. Two multivariable survival regression models and an ordinary least squares model were used to estimate adjusted associations.RESULTS: There were 1.68 million person-years of observed time in the study population (N = 678,548; drone operator N = 2856). Compared to other servicemembers, the adjusted likelihood of undergoing PTSD scree...
Research Interests:
Among active-duty military personnel, lower limb musculoskeletal injuries and related conditions (injuries) frequently arise as unintended consequences of physical training. These injuries are particularly common among women. The... more
Among active-duty military personnel, lower limb musculoskeletal injuries and related conditions (injuries) frequently arise as unintended consequences of physical training. These injuries are particularly common among women. The practical impact of such injuries on temporary military occupational disability has not been estimated with precision on a large scale. To determine the proportion of service time compromised by limited duty days attributable to lower limb injuries, characterize the time affected by these limitations in terms of specific lower limb region and compare the limited duty time between male and female soldiers. Administrative data and individual limited duty assignments (profiles) were obtained for active-duty US Army personnel who served in 2014. Lower limb injury-related profiles were used to calculate the percent of person-time requiring duty limitations by gender and body region. The study group was 568 753 soldiers of whom 14% were women. Nearly 13% of servi...
Research Interests:
The relationships of sickle cell trait (SCT), body mass index (BMI), and physical fitness to venous thromboembolism (VTE) in young adults have received little attention.
Research Interests:
Research Interests: Psychology and Medicine
Research Interests:
Research Interests:
To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake. This retrospective... more
To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake. This retrospective cohort study used the Stanford Military Data Repository, which includes all digitally recorded health encounters for active-duty U.S. Army soldiers from 2011 to 2014. We analyzed data from women aged 18-44 years to assess rates of LARC initiation using medical billing codes. We then evaluated predictors of LARC initiation using multivariable regression. Among 114,661 servicewomen, 14.5% received a LARC method; among those, 60% received an IUD. Intrauterine device insertions decreased over the study period (38.7-35.9 insertions per 1,000 women per year, β=0.14, 95% confidence interval [CI] -0.23 to -0.05, P<.05), whereas LARC uptake increased, driven by an increase in implant insertions (20.3-35.4/1,000 women per year, β=0.41, CI 0.33-0.48, P<.001). Younger age was a positive predictor of LARC uptake: 32.4% of IUD users and 62.6% of implant users were in the youngest age category (18-22 years) compared with 9.6% and 2.0% in the oldest (36-44 years). The likelihood of uptake among the youngest women (compared with oldest) was most marked for implants (adjusted relative risk 7.12, CI 5.92-8.55; P<.001). A total of 26.2% of IUD users had one child compared with 13.2% among non-LARC users (adjusted relative risk 1.94, CI 1.85-2.04, P<.001). The majority (52.2%) of those initiating IUDs were married, which was predictive of uptake over never-married women (adjusted relative risk 1.52, CI 1.44-1.59, P<.001). Among servicewomen, we observed low but rising rates of LARC insertion, driven by increasing implant use. Unmarried and childless soldiers were less likely to initiate LARC. These findings are consistent with potential underutilization and a need for education about LARC safety and reversibility in a population facing unique consequences for unintended pregnancies.
Research Interests:
Background The West African Ebola epidemic of 2013–2016 killed nearly 4,000 Sierra Leoneans and devastated health infrastructure across West Africa. Changes in health seeking behavior (HSB) during the outbreak resulted in dramatic... more
Background The West African Ebola epidemic of 2013–2016 killed nearly 4,000 Sierra Leoneans and devastated health infrastructure across West Africa. Changes in health seeking behavior (HSB) during the outbreak resulted in dramatic underreporting and substantial declines in hospital presentations to public health facilities, resulting in an estimated tens of thousands of additional maternal, infant, and adult deaths per year. Sierra Leone’s Kenema District, a major Ebola hotspot, is also endemic for Lassa fever (LF), another often-fatal hemorrhagic disease. Here we assess the impact of the West African Ebola epidemic on health seeking behaviors with respect to presentations to the Kenema Government Hospital (KGH) Lassa Ward, which serves as the primary health care referral center for suspected Lassa fever cases in the Eastern Province of Sierra Leone. Methodology/Principal findings Presentation frequencies for suspected Lassa fever presenting to KGH or one of its referral centers fro...
Research Interests:
Research Interests:
Introduction Occupational disability among military service members is an important target for preventive screening. The specific aim of this study was to quantify disability risk levels among soldiers with selected risk factors (body... more
Introduction Occupational disability among military service members is an important target for preventive screening. The specific aim of this study was to quantify disability risk levels among soldiers with selected risk factors (body mass index extremes, poor or absent physical fitness scores, and tobacco and opioid use) and combinations thereof, suggesting priorities for preventive actions. Materials and Methods This was a retrospective cohort study of 607,006 active-duty soldiers who served in the U.S. Army during 2011–2014. Official medical and administrative data were combined to produce a person-month-based panel dataset with identifiers removed. The subjects were observed longitudinally for incident disability (termed medical nonreadiness) during 1,305,618 person-years at risk. We employed Weibull parametric survival regression models to determine the adjusted medical nonreadiness hazard for selected variables. We then computed individual adjusted risk scores and the populati...
Research Interests:
OBJECTIVE To determine the incidence of pelvic floor disorders (PFD) among active-duty US Army female soldiers. MATERIALS AND METHODS We studied 102,015 women for incident PFD using the Stanford Military Data Repository, which comprises... more
OBJECTIVE To determine the incidence of pelvic floor disorders (PFD) among active-duty US Army female soldiers. MATERIALS AND METHODS We studied 102,015 women for incident PFD using the Stanford Military Data Repository, which comprises medical, demographic and service-related information on all soldiers on active duty in the US Army during 2011-14. Cox proportional hazards estimated adjusted associations with PFD diagnoses. In the adjusted models, military-specific characteristics and fitness were evaluated alongside known PFD predictors. RESULTS Among 102,015 subjects at risk there was a cumulative incidence of 6.4% over a mean of 27 months (median 29, range 1-42). In adjusted models, obese soldiers were more likely to have a PFD compared to those of normal weight (HR 1.23, CI 1.14-1.34, p<0.001) and those with recent weight gain were more likely to have a PFD compared to those without (HR 1.32, CI 1.24-1.40, p<0.05). Women with the lowest physical fitness scores were more likely to have a PFD (HR 1.14, CI 1.04-1.25) compared to those with the highest scores. CONCLUSION Over a median follow-up time of 29 months, 1 in 15 women in this active-duty cohort was diagnosed with a PFD. Optimizing risk factors including BMI and physical fitness may benefit the pelvic health of female soldiers, independent of age, children, and years of service.
Research Interests:
Stressful life changes may tax people’s adaptive capacity. We sought to determine if and when experiences of stressful life changes were associated with increased odds of adverse nutrition-related health outcomes among US Army soldiers... more
Stressful life changes may tax people’s adaptive capacity. We sought to determine if and when experiences of stressful life changes were associated with increased odds of adverse nutrition-related health outcomes among US Army soldiers relative to those who did not experience the same stressful life change. An additional aim was to determine which stressful life changes had the greatest association with these outcomes and if there were gender differences in the magnitude of the associations. Stressful life changes studied included: changes in marital status, combat deployment or return from deployment, relocation, adding a child, change in rank, change in occupation, and development of a physical limitation to duty. Using longitudinal data from the Stanford Military Data Repository, which represents all active-duty soldiers aged 17–62 between 2011 and 2014 ( n = 827,126), we employed an event history analysis to examine associations between stressful life changes and a subsequent diagnosis of hyperlipidemia, substantial weight gain, and weight-related separation from the Army. Marriage was associated with an increase in the odds of substantial weight gain 3 months later for both men and women. Developing a physical duty limitation was associated with an increase in the odds of a hyperlipidemia diagnosis 2 months later for both men and women, as was substantial weight gain 2 months later. Stressful life changes were also associated with increased odds of nutrition-related health outcomes, although we found gender differences in the magnitude of the associations. Findings could be used to mitigate the effects of stress on health by health professionals.
Research Interests:
Objectives This prospective cohort study aimed to determine if experiencing stressful life changes were associated with an earlier onset of adverse nutrition-related health outcomes among US Army Soldiers. An additional aim was to... more
Objectives This prospective cohort study aimed to determine if experiencing stressful life changes were associated with an earlier onset of adverse nutrition-related health outcomes among US Army Soldiers. An additional aim was to determine which stressful life changes were most associated with these outcomes and if there were gender differences in the magnitude of the associations. Methods Stressful life changes were changes in marital status, combat deployment or returning from deployment, relocation, adding a child, change in rank, change in occupation, or development of a physical limitation to duty. Nutrition-related health outcomes were hyperlipidemia diagnosis, substantial weight gain, or weight-related separation from the Army. Using longitudinal data from the Stanford Military Data Repository representing all active-duty Soldiers who were age 17–62 between 2011 and 2014 (n = 827,126), event history analysis was used to model the association of stressful life changes with nu...
Research Interests:
Research Interests:
With increasing integration of women into combat roles in the United States military, it is critical to determine whether deployment, which entails unique stressors and exposures, is associated with adverse reproductive outcomes. Few... more
With increasing integration of women into combat roles in the United States military, it is critical to determine whether deployment, which entails unique stressors and exposures, is associated with adverse reproductive outcomes. Few studies have examined if deployment increases the risk of preterm birth; no studies have examined a recent cohort of servicewomen. We therefore used linked medical and administrative data from the Stanford Military Data Repository for all United States Army soldiers with deliveries between 2011-2014 to estimate the associations between prior deployment, recency of deployment, posttraumatic stress disorder and spontaneous preterm birth, adjusting for socio-demographic, military-service, and health-related factors. Of 12,877 deliveries, 6.1% were spontaneous preterm births. The prevalence was doubled (11.7%) among soldiers who delivered within 6 months of return from deployment. Multivariable discrete-time logistic regression models indicated that deliver...
Research Interests:
Musculoskeletal (MSK) injuries are a leading cause of morbidity among US Army soldiers, especially among women and the newly enlisted. While extremes of body mass index (BMI), low physical fitness and tobacco use have been identified as... more
Musculoskeletal (MSK) injuries are a leading cause of morbidity among US Army soldiers, especially among women and the newly enlisted. While extremes of body mass index (BMI), low physical fitness and tobacco use have been identified as risk factors, no prior studies have determined the combined effects of these risk factors or tested for gender differences in the associations. We conducted a retrospective cohort study utilising the Stanford Military Data Repository to study all enlisted soldier accessions to the US Army between January 2011 and January 2014, with follow-up through December 2014 (n=238 772). We used discrete-time logistic regression to test for associations between demographic, socioeconomic and health behaviour-related predictors and incident lower extremity injuries. We included interaction terms to test for gender differences. Among men, there were greater adjusted odds of injury among underweight (OR 1.27), overweight (OR 1.14) and obese soldiers (OR 1.54) (all ...
Research Interests:
Research Interests:
Reduction mammaplasty is known for excellent outcomes and patient satisfaction. Although patients report improvements in pain, weight loss, and exercise levels, objective data on physical fitness benefits are limited. Using the Stanford... more
Reduction mammaplasty is known for excellent outcomes and patient satisfaction. Although patients report improvements in pain, weight loss, and exercise levels, objective data on physical fitness benefits are limited. Using the Stanford Military Data Repository, we identified 89 US Army active duty women with at least 1 pre- and postoperative Army Physical Fitness Test (APFT) who underwent reduction mammaplasty during 2011 to 2014. We used paired t tests to compare pre- and postoperative APFT score means and raw values for push-ups, sit-ups, and the 2-mile run. There were 56 subjects (62.9%) who improved in total APFT scores. Total score means increased from 235.9 preoperatively to 243.4 postoperatively (P = 0.0065). Of 28 subjects with at least 2 APFT scores before and after surgery, 20 (71.4%) improved in total scores. The subgroup&amp;amp;amp;amp;#39;s mean total score increased from 237.8 to 251.3 (P = 0.0009). Comparing individual pre- and postprocedure APFTs, all subjects demonstrated a mean 3.9% (SD, 0.1) improvement in total scores, and the subpopulation of 28 improved by 6.3% (SD, 0.1). In all events, mean performance values trended toward better postoperative scores. Differences were statistically significant for the total population for the number of sit-ups (P = 0.035), and, for the subgroup of 28, differences were statistically significant for the total score (P = 0.0009), sit-ups (P = 0.0002), and push-ups (P = 0.0134). Reduction mammaplasty was associated with postoperative physical fitness improvements among US Army active duty women. Soldier data are useful for objectively assessing physical fitness effects of breast reduction surgery.
Research Interests:
Research Interests: Archives, Medicine, California, Humans, Female, and 14 moreMale, Squamous Cell Carcinoma, Risk factors, Clinical Sciences, Aged, Middle Aged, Oral Squamous Cell Carcinoma (OSCC), Adult, Odds ratio, Retrospective Studies, Risk Factors, Cohort Studies, Skin Neoplasms, and Nonsteroidal Anti-inflammatory Drug
Información del artículo Estructura social, el estrés y la salud de la mujer.
Heat illnesses are important and potentially fatal conditions among physically active individuals. We determined predictors of heat illness among enlistees in a large military population experiencing common physical activity patterns. We... more
Heat illnesses are important and potentially fatal conditions among physically active individuals. We determined predictors of heat illness among enlistees in a large military population experiencing common physical activity patterns. We estimated the adjusted odds of mild and severe heat illness associated with demographic, health-related, and geographic factors among active-duty, United States Army soldiers enlisting between January 2011 - December 2014 (N=238,168) using discrete-time multivariable logistic regression analyses. We observed 2,612 incident cases of mild heat illness (MHI) and 732 incident cases of severe heat illness (SHI) during 427,922 person-years of follow-up, with a mean and median of 21.6 and 21 months per subject. During the first six duty months, 71.3% of the MHIs and 60.2% of the SHIs occurred, peaking at month two. The odds of MHI quadrupled among those with prior SHI (OR=4.02, 95% confidence interval [CI]: 2.67 - 6.03). Body mass index (BMI) extremes incr...
Research Interests:
Women may experience a decline in physical function during menopause. Whether this decline is due to aging or to changes in hormonal status is unknown. The authors performed a longitudinal data analysis on data collected between 1996 and... more
Women may experience a decline in physical function during menopause. Whether this decline is due to aging or to changes in hormonal status is unknown. The authors performed a longitudinal data analysis on data collected between 1996 and 2001 to determine the effects of menopausal status, age, race, and use of hormone replacement therapy (HRT) on 3-year changes in grip and pinch strength. Participants were 563 women from the Chicago, Illinois, site of the Study of Women’s Health Across the Nation. According to adjusted analyses, women who became postmenopausal showed a 1.04-kg decline in grip strength (p = 0.10) and a 0.57-kg decline in pinch strength (p = 0.002) relative to women who remained premenopausal. Women who became early perimenopausal showed a 0.20-kg decline in pinch strength (p = 0.04), whereas women who transitioned to late perimenopause showed a 0.93-kg decline in grip strength (p = 0.07). Effects of menopausal status on grip and
Research Interests:
Of all the social determinants of health, gender is one of the most significant. Research spanning multiple disciplines indicates that women have higher rates of psychological distress, depression, and physical morbidity than men. 1, 2... more
Of all the social determinants of health, gender is one of the most significant. Research spanning multiple disciplines indicates that women have higher rates of psychological distress, depression, and physical morbidity than men. 1, 2 According to the social stress model, 3, 4 group differences in mental and physical health partly reflect socially structured variations in exposure and vulnerability to stress. Thus, understanding the socioenvironmental factors that influence the number and types of stressors to which ...
Research Interests:
... Controls over the accumulation and decline of a nitrogen-fixing lichen, Stereocaulon vulcani, on young Hawaiian lava flows. Lianne M. Kurina,; Peter M. Vitousek. ... Correspondence: Lianne Kurina, 29 Hayes Close, Oxford OX3 ODZ, UK... more
... Controls over the accumulation and decline of a nitrogen-fixing lichen, Stereocaulon vulcani, on young Hawaiian lava flows. Lianne M. Kurina,; Peter M. Vitousek. ... Correspondence: Lianne Kurina, 29 Hayes Close, Oxford OX3 ODZ, UK (e-mail lkurina@alumni.princeton.edu). ...
Research Interests:
Research Interests:
Long-term occupational disability rates associated with eventual discharges from military service have risen sharply among active-duty US Army soldiers during the last three decades, with important implications for soldier health and... more
Long-term occupational disability rates associated with eventual discharges from military service have risen sharply among active-duty US Army soldiers during the last three decades, with important implications for soldier health and national security alike. To address this problem, we built predictive models for long-term, all-cause occupational disability and identified disability risk factors using a very large, multisource database on the total active-duty US Army. We conducted a cross-temporal retrospective cohort study and used mixed-effects logistic regression models to derive and validate disability risk assignments. The derivation cohort included 510 616 US Army soldiers on duty in December 2012, and the validation cohort included 483 197 soldiers on duty in December 2013. The predictive model yielded an overall c-statistic of 85.97% (95% CI 85.61% to 86.32%). Risk thresholds at the population's 75th and 95th centiles identified 80.53% and 42.08%, respectively, of the d...
Research Interests:
Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional... more
Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional rhabdomyolysis, in a large population of active persons who had undergone laboratory tests for hemoglobin AS (HbAS) and who were subject to exertional-injury precautions. We used Cox proportional-hazards models to test whether the risks of exertional rhabdomyolysis and death varied according to sickle cell trait status among 47,944 black soldiers who had undergone testing for HbAS and who were on active duty in the U.S. Army between January 2011 and December 2014. We used the Stanford Military Data Repository, which contains comprehensive medical and administrative data on all active-duty soldiers. There was no significant difference in the risk of death among soldiers with sickle cell trait, as compared with those without the trait (hazard ratio, 0.99; 95% c...
Research Interests:
No evidence-based mechanism currently exists to inform U.S. Army clinicians of soldiers at risk of being found &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Medically Not... more
No evidence-based mechanism currently exists to inform U.S. Army clinicians of soldiers at risk of being found &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Medically Not Ready&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; for combat duty. Historically, musculoskeletal conditions represent high-frequency medical problems among Army soldiers. We explored the feasibility of using centrally archived medical and administrative data on Army soldiers in the automated prediction of musculoskeletal-related Medically Not Ready soldiers who did not deploy. We examined 56,443 active duty U.S. Army soldiers who underwent precombat medical screening during March through December 2009 and in March 2010. Musculoskeletal problems were associated with 23.0% of nonreadiness cases in the study population. We used multivariable logistic regression in derivation cohorts to compute risk coefficients and cut points. We then applied these coefficients to covariates in validation cohorts, simulating predictions 2 to 3 months before their medical screenings. The analysis yielded c statistics ranging from 83 to 90%. The predictions identified 45 to 73% and 50 to 82% of the individual male and female outcome-positive soldiers, respectively, while obtaining 83 to 95% specificity. Our findings demonstrate the potential of Army data to create evidence-based estimates of nonreadiness risk. These methods could enable earlier patient referrals and improved management, and potentially reduce medically related nondeployment.
Research Interests:
Cohort studies have found that short and long sleep are both associated with worse outcomes, compared with intermediate sleep times. While demonstrated biological mechanisms could explain health effects for short sleep, long-sleep risk is... more
Cohort studies have found that short and long sleep are both associated with worse outcomes, compared with intermediate sleep times. While demonstrated biological mechanisms could explain health effects for short sleep, long-sleep risk is puzzling. Most studies reporting the U shape use a single question about sleep duration, a measurement method that does not correlate highly with objectively measured sleep. We hypothesised that the U shape, especially the poor outcomes for long sleepers, may be an artefact of how sleep is measured. We examined the cross-sectional prevalence of fair/poor health by sleep hour categories (≤6, ≤7, ≤8, ≤9, >9 h) in a national US sample of adults aged 62-90 that included several types of sleep measures (n=727). Survey measures were: a single question; usual bedtimes and waking times; and a 3-day sleep log. Actigraphy measures were the sleep interval and total sleep time. Fair/poor health was regressed on sleep hour categories adjusted for demographic...
Research Interests: Human Geography, Humans, United States, Female, Male, and 15 moreSleep, Risk factors, Health Status, Actigraphy, Aged, Prevalence, Middle Aged, Longitudinal Studies, Adult, Public health systems and services research, Time Factors, Health surveys, Risk Factors, Cross Sectional Studies, and Logistic Models
Research Interests:
The relationship of sleep to health has been an active area of research in recent years, and the National Social Life, Health, and Aging Project (NSHAP) expanded sleep data collection in Wave 2 with enhanced core questions and a novel... more
The relationship of sleep to health has been an active area of research in recent years, and the National Social Life, Health, and Aging Project (NSHAP) expanded sleep data collection in Wave 2 with enhanced core questions and a novel sleep module that included an objective measure of sleep duration and quality. A randomly selected one-third of Wave 2 participants and their spouses or coresident partners were invited to participate in the sleep module. Objective sleep data were collected using wrist actigraphy, an accelerometer that records an integrated measure of motion over short epochs (15 s each). This information is stored and subsequently analyzed to determine sleep and wake periods by epoch. Individuals were instructed to wear the actiwatches for 72 hr. Several sleep parameters were derived from the accelerometer. Individuals concurrently kept a sleep diary. Sleep actigraphy data were successfully collected from 780 individuals. Many of the survey-based and the actigraph-est...
Research Interests:
Reports of insomnia symptoms are common among the elderly. However, little is known about the relationship between insomnia symptoms and objective assessments of sleep in the general population of older adults. We assessed concordance... more
Reports of insomnia symptoms are common among the elderly. However, little is known about the relationship between insomnia symptoms and objective assessments of sleep in the general population of older adults. We assessed concordance between insomnia symptoms and actigraphic sleep characteristics in a nationally representative sample of older Americans. In a national probability sample of 727 adults aged 62-91 years in 2010-2011 from the National Social Life, Health, and Aging Project, respondents were asked how often they (a) feel rested when they wake up, (b) have trouble falling asleep, (c) have trouble with waking up during the night, and (d) have trouble waking up too early and not being able to fall asleep again. Responses to these questions were compared to sleep characteristics estimated from three nights of actigraphy for the same individuals. Statistical analyses were adjusted for age, gender, race and ethnicity, income, assets, and education. Feeling rested (Question (a)...