Comorbid Psychopathology of Insomnia: A Validity Study of the Insomnia Severity Index Among Older Adults

The Insomnia Severity Index (ISI) is a brief screening tool that assesses the presence and severity of insomnia symptoms. Although widely validated, its psychometric properties remain understudied in older adults, a population at increased risk for insomnia due to age-related changes in sleep architecture and quality. This study assessed the concurrent and factorial validity of the ISI among community-dwelling older adults ( N = 250) who completed the ISI and measures of comorbid symptoms: Brief Geriatric Suicide Ideation Scale, Michigan Alcohol Screening Test-Geriatric Version, Geriatric Depression Scale-15, and Geriatric Anxiety Scale. Bivariate correlations supported concurrent validity, with insomnia positively associated with anxiety, depression, suicidal ideation, and alcohol misuse. Anxiety was the strongest correlate and the only unique predictor of ISI scores in multivariate analyses. Exploratory factor analysis revealed a one-factor solution. Findings support the concurrent validity and factor structure of the ISI and highlight comorbidity with other mental health symptoms among older adults.

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Publication Details

Journal
The International Journal of Aging and Human Development
Published
2026-10-19
DOI
https://doi.org/10.1177/00914150261495494
Primary Topic
Sleep and related disorders
Type
article
Field-Weighted Citation Impact
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article

Comorbid Psychopathology of Insomnia: A Validity Study of the Insomnia Severity Index Among Older Adults

Daniel L. Segal, Colleen Elaine Mock, Colin J. Schmitt
The International Journal of Aging and Human Development
Sleep and related disorders
article

Comorbid Psychopathology of Insomnia: A Validity Study of the Insomnia Severity Index Among Older Adults

Daniel L. Segal, Colleen Elaine Mock, Colin J. Schmitt
article en

Abstract

The Insomnia Severity Index (ISI) is a brief screening tool that assesses the presence and severity of insomnia symptoms. Although widely validated, its psychometric properties remain understudied in older adults, a population at increased risk for insomnia due to age-related changes in sleep architecture and quality. This study assessed the concurrent and factorial validity of the ISI among community-dwelling older adults ( N = 250) who completed the ISI and measures of comorbid symptoms: Brief Geriatric Suicide Ideation Scale, Michigan Alcohol Screening Test-Geriatric Version, Geriatric Depression Scale-15, and Geriatric Anxiety Scale. Bivariate correlations supported concurrent validity, with insomnia positively associated with anxiety, depression, suicidal ideation, and alcohol misuse. Anxiety was the strongest correlate and the only unique predictor of ISI scores in multivariate analyses. Exploratory factor analysis revealed a one-factor solution. Findings support the concurrent validity and factor structure of the ISI and highlight comorbidity with other mental health symptoms among older adults.

The International Journal of Aging and Human Development
University of Colorado Colorado Springs (US)
Openalex Percentile: Top 8%
Sleep and related disorders
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