This study aimed to validate the Geriatric Sleep Questionnaire (GSQ) for assessing subjective sleep quality among elderly individuals in Iran. The GSQ underwent evaluation for face and content validity. Participants were selected via convenience sampling from five healthcare centers. Sociodemographic variables, including gender, number of children, recreational activities, budget deficits, and family conflicts were analyzed. Confirmatory factor analysis was conducted to verify the results. Internal consistency was assessed using Cronbach's α, and test-retest reliability was evaluated using the intraclass correlation coefficient (ICC). 200 older adults (mean age 66.8 years) completed the questionnaires. Face and content validity were confirmed by 30 experts (S-CVI/average = 0.96). The final model exhibited good fit indices (χ2/df = 2.89, CFI = 0.96). The scale demonstrated acceptable internal consistency (α = 0.81) and test-retest reliability (ICC = 0.98). The Persian GSQ demonstrates high reliability and validity for assessing sleep quality in older adults, aiding research in this field.

Introduction Sleep quality is an important health index in the elderly. As age increases, changes occur in sleep quality leading to sleep disorders and recurrent complaints. Sleep quality management of the elderly requires identification of its determinants. The present study aimed to determine the mediating roles of stress, anxiety, and depression in the relationship between constipation and sleep quality among the elderly using structural equation modeling (SEM). Materials and Methods A correlational design was used in the present study through structural equation modeling. In this work, 363 elderlies were examined by multi-stage random sampling. Data collection tools included four questionnaires, namely a demographic information questionnaire, the constipation questionnaire (ROME III), the Depression, Anxiety, and Stress Scale-short form, and the Pittsburgh Sleep Quality Index (PSQI), which were completed by interview and the self-report method. The SPSS Statistics for Windows, version 22.0, and SPSS AMOS (IBM Corp., Armonk, NY, USA) were used to analyze the data. Results The results indicated that the proposed model had an acceptable fit (p < 0.000, root mean square error of approximation [RMSEA] = 0.062, comparative fit index [CFI] = 0.83, goodness-of-fit index [GFI] = 0.87, and Χ²/df = 1.94). The fitted model could explain 60% of the sleep quality variance. According to the proposed model, constipation could significantly predict sleep quality due to the mediation of stress, anxiety, and depression (p < 0.05). Conclusion The constructs of this model (constipation, stress, anxiety, and depression) can be used as a reference framework to design effective interventions and improve sleep quality in old people. Received: 13 December 2021 Accepted: 05 April 2022 Article published online: 19 April 2023 © 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Cognitive dysfunction is a significant issue in old age and can cause many problems in older adults, especially those with diabetes. This study aimed to investigate the association between oral health status and DMFT index with cognitive dysfunction in community-dwelling older adults with T2D (type 2 diabetes). This was a cross-sectional study that included 245 older people aged 60 years and older with T2D, visiting healthcare centers in north of Iran, using the cluster sampling method. Data collection tools included clinical-demographic questionnaire, the Geriatric Oral Health Assessment Index (GOHAI) and the Mini-Mental State Examination (MMSE) questionnaire. A P-value <.05 was considered significant. The mean age of older adults in this study was 64.86 ± 3.99 years. The mean and standard deviation for the DMFT index, GOHAI index and MMSE scale were 9.39 ± 3.83, 34.29 ± 17.93 and 15.18 ± 10.04 respectively. The results showed statistically significant relationship between poor oral health status and the cognitive status of older adults with T2D (p < .001). Additionally, the relationship between oral health index domains (physical function, psychosocial function and pain) and cognitive status in older adults was significant (p < .001). Another finding indicated an inverse and significant relationship between the DMFT index and cognitive dysfunction in older adults (p < .001). Poor oral health was associated with cognitive dysfunction among the community-dwelling older adults with T2D. Given the high prevalence of T2D in older adults and the critical importance of oral and dental health for cognition, it is necessary to develop interventions to improve oral health in older adults with T2D.

Chronic kidney disease (CKD) presents a growing global challenge among aging populations. Effective self-care remains a cornerstone of disease management in elderly patients. This study investigated the association between loneliness and self-care behaviors, including basic and instrumental activities of daily living (ADLs), in elderly individuals with CKD attending selected educational and medical centers affiliated with Tabriz University of Medical Sciences. In this descriptive-analytical study conducted in 2022, 310 elderly individuals diagnosed with CKD were assessed using validated instruments: the Chronic Kidney Disease Self-Care (CKDSC) questionnaire, basic and instrumental ADL scales, and a standardized loneliness measure. Structural equation modeling using AMOS software was employed to evaluate model fit and estimate the predictive value of loneliness on variance in self-care. The proposed model demonstrated acceptable fit indices (p < 0.001; root mean square error of approximation, RMSEA = 0.072; comparative fit index, CFI = 0.995; goodness-of-fit index, GFI = 0.994). The final model accounted for 83% of the variance in self-care. Loneliness exerted the most substantial effect on self-care behaviors (β = 1.29, 95% CI [1.17, 1.41]; p < 0.001). Findings indicate that loneliness may unexpectedly enhance self-care engagement among elderly individuals with CKD. These results underscore the importance of context-specific interventions that address the complex psychological dynamics influencing self-management. Future longitudinal studies are warranted to explore the mediating pathways underlying this association.