Relationship between Sleep Quality and Gait Speed in Geriatric Patients


  • Tezcan Kaya Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey
  • Ahmet Nalbant
  • İlhan Yıldırım
  • Kubilay İşsever
  • Cengiz Karacaer
  • Cahit Bilgin
  • Mehmet Bülent Vatan
  • Türkan Acar


Aged, Gait speed, Geriatrics, Physical Performance, Sleep quality


OBJECTIVE: To identify the relationship between sleep quality and gait speed in geriatric patients.

METHODOLOGY: This cross-sectional study involved 140 Geriatric patients (aged ?65 years) who consecutively applied for the internal medicine outpatient clinic of an Education Research Hospital between July and September 2021 using a non-probability consecutive sampling technique. Participants with cancer, rheumatic or muscle disease, insomnia, amputations or motor dysfunction in the extremities, Parkinson's or Alzheimer's disease, who could not walk alone, and those with cognitive impairment who could not answer questions were excluded. The Pittsburgh Sleep Quality Index (PSQI) assessed participants' sleep quality. Gait speed for a 4-meter distance was measured. Parameters were compared concerning sleep quality and gait speed.

RESULTS: The gait speed of poor sleepers was significantly slower than good sleepers (p=0.012). Slow walkers were more prevalent among the poor than good sleepers (p=0.030). The median PSQI score of slow walkers was higher than that of normal walkers (p=0.009). The ratio of patients with poor sleep quality was significantly higher among slow walkers than among normal walkers (p=0.030). A significant positive correlation was found between the total PSQI score and gait speed time (r=0.250, p=0.003). The receiver operating characteristics curve of gait speed time was statistically significant for predicting poor sleep quality (AUC=0.629; p=0.012).

CONCLUSION: Gait speed was slower in geriatric patients with poor sleep quality. Poor sleep quality and gait speed time were positively correlated, and gait speed was a predictor of sleep quality in geriatric patients.


United Nations. United Nations World Population Ageing 2019. Highlights. Accessed: April 01, 2022. Available from: publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.

Lee WJ, Peng LN, Lin MH, Loh CH, Chen LK. Determinants and indicators of successful ageing associated with mortality: A 4-year population-based study. Aging (Albany, NY). 2020; 12(3): 2670-9. doi: 10.18632/aging.102769.

Del Brutto OH, Mera RM, Del Brutto VJ, Recalde BY, Castillo PR. The association between physical activity and sleep quality in stroke-free adults living in rural settings. The Three Villages Study. Sleep Med. 2020; 70: 2-5. doi: 10.1016/j.sleep.2020.01.029.

Teas E, Friedman E. Sleep and functional capacity in adults: Cross-sectional associations among self-report and objective assessments. Sleep Heal. 2021; 7(2): 198-204.

doi: 10.1016/j.sleh.2020.12.001.

Del Brutto OH, Mera RM, Zambrano M, Simon LV, Matcha GV, Castillo PR. Sleep quality correlates with the carotid intima-media thickness in stroke-free community-dwelling adults living in rural Ecuador. The Atahualpa Project. Sleep Med. 2019; 55: 22-5 doi: 10.1016/j.sleep.2018.11.017.

Zhang H, Li Y, Zhao X, Mao Z, Abdulai T, Liu X et al. The association between PSQI score and hypertension in a Chinese rural population: the Henan Rural Cohort Study. Sleep Med. 2019; 58: 27-34. doi: 10.1016/j.sleep.2019.03.001.

Jiang J, Li Y, Mao Z, Wang F, Huo W, Liu R et al. Abnormal night sleep duration and poor sleep quality are independently and combinedly associated with elevated depressive symptoms in Chinese rural adults: Henan Rural Cohort. Sleep Med. 2020; 70: 71-8. doi: 10.1016/j.sleep.2019.10.022.

Ensrud KE, Blackwell TL, Ancoli-Israel S, Redline S, Cawthon PM, Paudel ML et al. Sleep disturbances and risk of frailty and mortality in older men. Sleep Med. 2012; 13(10): 1217-25. doi: 10.1016/j.sleep.2012.04.010.

Hublin C, Partinen M, Koskenvuo M, Kaprio J. Sleep and mortality: A population-based 22-year follow-up study. Sleep. 2007; 30(10): 1245-53. doi: 10.1093/sleep/30.10.1245.

Pulignano G, Del Sindaco D, Di Lenarda A, Alunni G, Senni M, Tarantini L et al. Incremental Value of Gait Speed in Predicting Prognosis of Older Adults With Heart Failure: Insights From the IMAGE-HF Study. JACC Hear Fail. 2016; 4(4): 289-98. doi: 10.1016/j.jchf.2015.12.017.

Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M et al. Gait speed and survival in older adults. J Am Med Assoc. 2011; 305(1). doi: 10.1001/jama.2010.1923.

Perera S, Patel KV, Rosano C, Rubin SM, Satterfield S, Harris T et al. Gait Speed Predicts Incident Disability: A Pooled Analysis. Journals Gerontol - Ser A Biol Sci Med Sci. 2015; 71(1): 63-71 doi: 10.1093/gerona/glv126.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2): 175-91. doi: 10.3758/bf03193146.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2). doi: 10.1016/0165-1781(89)90047-4.

Zhang L, Liu S, Li Y, Li S, Wu Y. Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference. Gerontology. 2022; 68(1). doi: 10.1159/000514894.

Kirshner D, Kizony R, Gil E, Asraf K, Krasovsky T, Haimov I et al. Why Do They Fall? The Impact of Insomnia on Gait of Older Adults: A Case-Control Study. Published online 2021. doi: 10.2147/NSS.S299833.

Paudel ML, Taylor BC, Vo TN, Kats AM, Schousboe JT, Lui L-Y et al. Sleep Disturbances and Risk of Hospitalization and Inpatient Days Among Older Women. Sleep. 2017; 40(4): zsx037. doi: 10.1093/sleep/zsx037.

Tighe CA, Brindle RC, Stahl ST, Wallace ML, Bramoweth AD, Forman DE et al. Multidimensional Sleep Health and Physical Functioning in Older Adults. Gerontol Geriatr Med. 2021; 7. doi: 10.1177/23337214211016222.

Goldman SE, Stone KL, Ancoli-Israel S, Blackwell T, Ewing SK, Boudreau R et al. Poor Sleep is associated with poorer physical performance and greater functional limitations in older women. Sleep. 2007; 30(10): 1317-24. doi: 10.1093/sleep/30.10.1317.

Serrano-Checa R, Hita-Contreras F, Daniel Jiménez-García J, Achalandabaso-Ochoa A, Aibar-Almazán A, Martínez-Amat A. Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women. Int J Environ Res Public Heal Artic. 2020; 17(11): 4043. doi: 10.3390/ijerph17114043.

Chang J, Nathalie J, Nguyenhuy M, Xu R, Virk SA, Saxena A. Slow gait speed is associated with worse postoperative outcomes in cardiac surgery: A systematic review and meta-analysis. J Card Surg. 2022; 37(1): 197-204. doi: 10.1111/JOCS.16089.

Ostir G V., Berges I, Kuo YF, Goodwin JS, Ottenbacher KJ, Guralnik JM. Assessing gait speed in acutely ill older patients admitted to an acute care for elders hospital unit. Arch Intern Med. 2012; 172(4). doi: 10.1001/archinternmed.2011.1615.

Dociak-Salazar E, Barrueto-Deza JL, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. Gait speed as a predictor of mortality in older men with cancer: A longitudinal study in Peru. Heliyon. 2022; 8(2): 1-8. doi: 10.1016/j.heliyon.2022.e08862.

Allali G, Van Der Meulen M, Beauchet O, Rieger SW, Vuilleumier P, Assal F. The Neural Basis of Age-Related Changes in Motor Imagery of Gait: An fMRI Study. Med Sci Cite J as J Gerontol A Biol Sci Med Sci. 2014; 69(11): 1389-98.

doi: 10.1093/gerona/glt207.

Additional Files



How to Cite

Kaya T, Nalbant A, Yıldırım İlhan, İşsever K, Karacaer C, Bilgin C, Vatan MB, Acar T. Relationship between Sleep Quality and Gait Speed in Geriatric Patients. J Liaq Uni Med Health Sci [Internet]. 2023 Mar. 29 [cited 2023 May 30];22(01):09-13. Available from: