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Society"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To determine the association between sleep\u2010disordered breathing (\n                      <jats:styled-content style=\"fixed-case\">SDB<\/jats:styled-content>\n                      ) and decline in instrumental activities of daily living (\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      s) and mobility in older women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Minneapolis and Pittsburgh sites of the Study of Osteoporotic Fractures, participants' homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women with a mean age\u00a0\u00b1\u00a0standard deviation of 82.3\u00a0\u00b1\u00a03.2 (N\u00a0=\u00a0302).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Participants completed a single night of unattended polysomnography and provided data regarding difficulty with\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      s and mobility. They repeated\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      and mobility measures 5.0\u00a0\u00b1\u00a00.7\u00a0years later.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjustment for age, obesity, Mini\u2010Mental State Examination score, depressive symptoms, history of hypertension and chronic obstructive pulmonary disease, and number of IADL impairments at baseline, women with an apnea\u2010hypopnea index (AHI) of 15 or greater at baseline had more than twice the odds of an increase in number of IADL difficulties (adjusted odds ratio (\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      )\u00a0=\u00a02.22, 95% confidence interval (CI)\u00a0=\u00a01.09\u20134.53) and of incident IADL difficulty (\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      \u00a0=\u00a02.43, 95% CI\u00a0=\u00a01.00\u20135.92), of women with an AHI less than 5. There was no association between AHI and mobility difficulty. Women in the middle and highest tertiles of oxygen desaturation index had more than double the odds as those in the lowest tertile of an increase in number of IADL difficulties (middle tertile\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      \u00a0=\u00a02.64, 95% CI\u00a0=\u00a01.38\u20135.04, highest tertile\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      \u00a0=\u00a02.17, 95% CI\u00a0=\u00a01.13\u20134.17) and approximately three times the odds of incident IADL difficulty (middle tertile\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      \u00a0=\u00a02.84, 95% CI\u00a0=\u00a01.27\u20136.36, highest tertile\n                      <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\n                      \u00a0=\u00a03.07, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u00a0=\u00a01.31\u20137.18). Neither sleep fragmentation nor sleep duration was associated with\n                      <jats:styled-content style=\"fixed-case\">IADL<\/jats:styled-content>\n                      outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      SDB and associated hypoxemia are risk factors for functional decline in older women. Research is needed to determine whether treatment of\n                      <jats:styled-content style=\"fixed-case\">SDB<\/jats:styled-content>\n                      prevents functional decline.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.13108","type":"journal-article","created":{"date-parts":[[2014,11,6]],"date-time":"2014-11-06T05:43:52Z","timestamp":1415252632000},"page":"2040-2046","source":"Crossref","is-referenced-by-count":15,"title":["Sleep\u2010Disordered Breathing and Functional Decline in Older Women"],"prefix":"10.1111","volume":"62","author":[{"given":"Adam P.","family":"Spira","sequence":"first","affiliation":[{"name":"Department of Mental Health Bloomberg School of Public Health Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie L.","family":"Stone","sequence":"additional","affiliation":[{"name":"California Pacific Medical Center Research Institute San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George W.","family":"Rebok","sequence":"additional","affiliation":[{"name":"Department of Mental Health Bloomberg School of Public Health Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh M.","family":"Punjabi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Bloomberg School of Public Health Baltimore Maryland"},{"name":"Division of Pulmonary and Critical Care Medicine Department of Medicine School of Medicine Johns Hopkins University Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Brigham and Women's Hospital and Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Ancoli\u2010Israel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of California At San Diego California"},{"name":"Department of Medicine University of California at San Diego California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of California At San Francisco and San Francisco Veterans Affairs Medical Center San Francisco California"},{"name":"Department of Neurology University of California At San Francisco and San Francisco Veterans Affairs Medical Center San Francisco California"},{"name":"Department of Epidemiology and Biostatistics University of California at San Francisco and San Francisco Veterans Affairs Medical Center San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200709-155MG"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109080"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2004.02.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1115"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2001.49081.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/01.PHM.0000069194.61078.6E","article-title":"Sleep\u2010related breathing disorders and rehabilitation outcome of stroke patients: A prospective study","volume":"82","author":"Cherkassky T","year":"2003","journal-title":"Am J Phys Med Rehabil"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.2.252"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2007.00576.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0579.2003.00208.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1997.tb00970.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.7.531"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02490.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2012.04.010"},{"key":"e_1_2_6_15_1","volume-title":"A Manual of Standardized Terminology, Techniques and Scoring System of Sleep Stages of Human Subjects","author":"Rechtschaffen A","year":"1968"},{"key":"e_1_2_6_16_1","volume-title":"The Supplement on Aging to the 1984 National Health Interview Survey. 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