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Okoye SM, Szanton SL, Perrin NA, Nkimbeng M, Schrack JA, Han HR, Nyhuis C, Wanigatunga S, Spira AP. Objectively measured sleep and physical function: Associations in low-income older adults with disabilities. Sleep Health 2021; 7:735-741. [PMID: 34602384 DOI: 10.1016/j.sleh.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Late-life sleep health has been tied to physical function, but little is known about these associations among socially disadvantaged populations. DESIGN We determined cross-sectional associations of sleep with physical function in low-income, predominantly Black older adults with disabilities. PARTICIPANTS One hundred thirty-six older adults (mean age 76.0 years, 83.8% women, 82.4% Black). MEASUREMENTS Primary predictors were actigraphic total sleep time (TST), wake after sleep onset (WASO), and subjective sleep complaints. Outcomes were objective physical performance (Short Physical Performance Battery (SPPB)) and participant-reported difficulties in basic and instrumental activities of daily living (ADLs and IADLs). RESULTS In regression models adjusted for potential confounders, both longer TST and greater WASO were associated with lower SPPB scores and increased IADL difficulty. Participants with a mean TST in the longest (>7.5 hours) vs. intermediate (6.3-7.5 hours) tertile had 27% higher odds of additional IADL difficulty (incident rate ratio = 1.27, 95% confidence interval [CI] 1.03, 1.58). Each additional 10 minutes of WASO was associated with 0.13 point lower SPPB scores (B = -0.13, 95% CI -0.25, -0.01) and increased IADL difficulty (B = 0.02, 95% CI 0.0003, 0.04). Sex moderated the associations of WASO with IADL and ADL difficulties: associations were stronger for males. Subjective sleep complaints were not statistically significantly associated with function. CONCLUSIONS Among disabled, low-income, mostly Black older adults, objective measures of long sleep and greater WASO are associated with poorer physical function. Effect sizes for the associations were modest; however, findings may have important implications given the significant consequences of decreased function on quality of life and caregiving demands.
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Affiliation(s)
- Safiyyah M Okoye
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA.
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
| | - Nancy A Perrin
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Manka Nkimbeng
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jennifer A Schrack
- Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Casandra Nyhuis
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sarah Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adam P Spira
- Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Fonseca-Rodrigues D, Rodrigues A, Martins T, Pinto J, Amorim D, Almeida A, Pinto-Ribeiro F. Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2021; 61:53-75. [PMID: 34152386 DOI: 10.1093/rheumatology/keab512] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Osteoarthritis (OA) is a chronic degenerative musculoskeletal disease that causes articular damage and chronic pain, with a prevalence of up to 50% in individuals >60 years of age. Patients suffering from chronic painful conditions, including OA, also frequently report anxiety or depression. A systematic review and meta-analysis were performed to assess the correlation between pain severity and depressive and anxious symptomatology in OA patients. METHODS A systematic search was conducted using four databases (PubMed, Medline, Scopus, and Web of Science) from inception up to 14th January of 2020. We included original articles evaluating pain severity and anxiety and/or depression severity in OA-diagnosed patients. Detailed data were extracted from each study, including patients' characteristics and pain, anxiety, and depression severity. When available, the Pearson correlation coefficient between pain and depression severity and pain and anxiety severity was collected and a meta-analysis of random effects was applied. RESULTS This systematic review included 121 studies, with a total of 38085 participants. The mean age was 64.3 years old and subjects were predominantly female (63%). The most used scale to evaluate pain severity was the Western Ontario and the McMaster Universities Osteoarthritis Index, while for anxiety and depression, the Hospital Anxiety and Depression Scale was the most used. The meta-analysis showed a moderate positive correlation between pain severity and both anxious (r = 0.31, p < 0.001) and depressive symptomatology (r = 0.36, p < 0.001). CONCLUSIONS Our results demonstrate a significant correlation between pain and depression/anxiety severity in OA patients, highlighting the need for its routine evaluation by clinicians.
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Affiliation(s)
- Diana Fonseca-Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - André Rodrigues
- School of Medicine, University of Minho, Braga, Portugal.,Anesthesiology Department, Coimbra Hospital and Universitary Centre (CHUC), Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - Teresa Martins
- School of Medicine, University of Minho, Braga, Portugal
| | - Joana Pinto
- School of Medicine, University of Minho, Braga, Portugal
| | - Diana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
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Dai Z, Neogi T, Brown C, Nevitt M, Lewis CE, Torner J, Felson DT. Sleep Quality Is Related to Worsening Knee Pain in Those with Widespread Pain: The Multicenter Osteoarthritis Study. J Rheumatol 2020; 47:1019-1025. [PMID: 31732550 DOI: 10.3899/jrheum.181365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We examined the association between sleep and odds of developing knee pain, and whether this relationship varied by status of widespread pain (WSP). METHODS At the 60-month visit of the Multicenter Osteoarthritis Study, sleep quality and restless sleep were each assessed by using a single item from 2 validated questionnaires. Each sleep measure was categorized into 3 levels, with poor/most restless sleep as the reference. WSP was defined as pain above and below the waist on both sides of the body and axially using a standard homunculus, based on the American College of Rheumatology criteria. Outcomes from 60-84 months included (1) knee pain worsening (KPW; defined as minimal clinically important difference in WOMAC pain), (2) prevalent, and (3) incident consistent frequent knee pain. We applied generalized estimating equations in multivariable logistic regression models. RESULTS We studied 2329 participants (4658 knees; 67.9 yrs, body mass index 30.9]. We found that WSP modified the relationship between sleep quality and KPW (p = 0.002 for interaction). Among persons with WSP, OR (95% CI) for KPW was 0.53 (0.35-0.78) for those with very good sleep quality (p trend < 0.001); additionally, we found the strongest association of sleep quality in persons with > 8 painful joint sites (p trend < 0.01), but not in those with ≤ 2 painful joint sites. Similar results were observed using restless sleep, in the presence of WSP. The cross-sectional relationship between sleep and prevalence of consistent frequent knee pain was significant. CONCLUSION Better sleep was related to less KPW with coexisting widespread pain.
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Affiliation(s)
- Zhaoli Dai
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK. .,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust.
| | - Tuhina Neogi
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
| | - Carrie Brown
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
| | - Michael Nevitt
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
| | - Cora E Lewis
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
| | - James Torner
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
| | - David T Felson
- From the Boston University School of Medicine, Department of Medicine, Section of Rheumatology, Boston, Massachusetts, USA; Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama; Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa, Iowa, USA; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia; Centre for Epidemiology, University of Manchester and the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC), Manchester University National Health Service (NHS) Trust, Manchester, UK.,Z. Dai, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and The University of Sydney, Faculty of Medicine and Health, School of Pharmacy; T. Neogi, MD, PhD, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; C. Brown, MS, Boston University School of Medicine, Department of Medicine, Section of Rheumatology; M. Nevitt, PhD, Epidemiology and Biostatistics, University of California, San Francisco; C.E. Lewis, MD, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham; J. Torner, MD, The Department of Epidemiology and the Institute for Clinical and Translational Science, The University of Iowa; D.T. Felson, MD, MPH, Boston University School of Medicine, Department of Medicine, Section of Rheumatology, and Centre for Epidemiology, University of Manchester and the NIHR Manchester BRC, Manchester University NHS Trust
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