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Kuo PC, Restinia M, Lin SH, Jou YH, Chiu CJ. Exploring the association between sleep and health performance of migrant home care workers and elderly care recipients in Taiwan. Home Health Care Serv Q 2024:1-17. [PMID: 38984632 DOI: 10.1080/01621424.2024.2375711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
This study, conducted in June and July 2022 through purposive sampling, aimed to explore the relationship between sleep and health performance in 33 pairs of elderly individuals and their migrant caregivers in southern Taiwan. Participants completed a structured questionnaire and wore an Actiwatch for seven days. Pearson correlation and independent t-test were used for analysis. Nearly 50% of foreign home care workers suffered from insomnia, and 80% of elderly care recipients with disabilities experienced sleep disorders. The number of chronic illnesses and/or dementia among the elderly and insomnia among care workers were associated with poor self-perceived health (r = -0.667, p < .001) and sleep disorders among the elderly (r = 0.368, p = .035). The problem of caregiving should be addressed. Future studies should increase the sample size and extend the duration of the study to enhance the generalizability of the findings.
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Affiliation(s)
- Po-Ching Kuo
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mita Restinia
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Tangerang Selatan, Indonesia
| | - Shu-Huei Lin
- Department of Labor Relations, College of Social Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Yuh-Huey Jou
- Institute of Ethnology, Academia Sinica, Taipei, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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2
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Komleva Y, Gollasch M, König M. Nocturia and frailty in older adults: a scoping review. BMC Geriatr 2024; 24:498. [PMID: 38844878 PMCID: PMC11155172 DOI: 10.1186/s12877-024-05049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/06/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND More than one in two older people wake up several times a night to urinate. Far from being a minor inconvenience, nocturia is associated with poor health outcomes. Given the importance of sleep as a foundation for resilience and healthy ageing, nocturia may promote the development of frailty, which is inextricably linked to physical decline, disability, and mortality. The aim of this scoping review was to collate published evidence on the relationship between nocturia and frailty, using the methodological framework of Arksey and O'Malley, together with the Joanna Briggs Institute methodology as guidance (OSF registration: osf.io/d5ct7). METHODS Relevant publications were retrieved via PubMed, Embase, the Cochrane Library and Google Scholar. The Rayyan tool was used to facilitate the screening process. Data were extracted by two independent reviewers. 250 publications were initially identified, of which 87 met the eligibility criteria. RESULTS Most of the evidence came from cross-sectional studies, most of which had been published within the last 5 years. The researchers were diverse, with 27% having a geriatric background. Only few publications established a clear association between nocturia and frailty. Other topics included: the association between nocturia and poor sleep quality and duration; the association between sleep and frailty; the association between frailty, multimorbidity, and age-related changes in the lower urinary tract. CONCLUSION The findings emphasize the increasing interest and interdisciplinary nature of research into the relationship between frailty, nocturia, lower urinary tract symptoms, and sleep disturbances. Further research is required to enhance understanding, establish causality, and identify potential therapeutic approaches.
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Affiliation(s)
- Yulia Komleva
- Klinik und Poliklinik für Innere Medizin D-Geriatrie, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49, 17475, Greifswald, Germany
| | - Maik Gollasch
- Klinik und Poliklinik für Innere Medizin D-Geriatrie, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49, 17475, Greifswald, Germany
- Altersmedizinisches Zentrum, Kreiskrankenhaus Wolgast, Wolgast, Germany
| | - Maximilian König
- Klinik und Poliklinik für Innere Medizin D-Geriatrie, Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49, 17475, Greifswald, Germany.
- Altersmedizinisches Zentrum, Kreiskrankenhaus Wolgast, Wolgast, Germany.
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3
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Shang Q, Zhou J, Yao J, Feng C, Lou H, Cong D. Sleep duration and the risk of new-onset arthritis in middle-aged and older adult population: results from prospective cohort study in China. Front Public Health 2024; 12:1321860. [PMID: 38873298 PMCID: PMC11169742 DOI: 10.3389/fpubh.2024.1321860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/21/2024] [Indexed: 06/15/2024] Open
Abstract
Background The pain and sleep disorders caused by arthritis are health issues that have been re-emphasized with the aging population. However, the majority of research on arthritis and sleep disorders has focused on cases that have already been diagnosed with arthritis. This research aims to explore the correlation between sleep duration and new-onset arthritis in middle-aged and older adult individuals. Methods Utilizing data from the China Health and Retirement Longitudinal Study from baseline (2011) to the Wave 3 follow-up (2018), we conducted a 7-year longitudinal investigation targeting populations with valid sleep questionnaire records and without arthritis. Sleep duration was assessed from nighttime sleep and daytime nap records. The new-onset of arthritis was determined based on self-reported diagnosis. We employed different logistic regression models to consider the potential impact of sleep duration on arthritis and conducted mediation analyses to assess the involvement of BMI in the association between sleep duration and the new-onset risk of arthritis. Results Out of the 6,597 individuals analyzed in the cohort, 586 (8.9%) were diagnosed with new-onset arthritis. Median sleep duration was notably shorter in the new-onset arthritis group (6.63 vs. 6.41 h, p < 0.05). There was a notable negative correlation found between new-onset risk of arthritis and sleep duration, with each Interquartile Range (IQR) increment in sleep leading to a 16% risk reduction (OR: 0.864; 95% CI: 0.784-0.954). Stratified analyses revealed BMI as a potential modifier in the sleep-arthritis relationship (P for interaction = 0.05). Mediation analyses further showed that about 3.5% of the association was mediated by BMI. Additionally, the inclusion of sleep duration improved the arthritis predictive power of our model, with an IDI of 0.105 (0.0203, 0.1898) and an NRI of 0.0013 (0.0004, 0.0022) after adding sleep duration to the basic model. Conclusion In the middle-aged and older adult demographic of China, increased sleep duration is associated with a decreased new-onset risk of arthritis, with BMI potentially playing a role in mediating this connection.
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Affiliation(s)
- Qiangqiang Shang
- Department of Tuina, The First Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jie Zhou
- Department of Anorectal, The First Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Junjie Yao
- College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Chaoqun Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huijuan Lou
- Department of Tuina, The First Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Deyu Cong
- Department of Tuina, The First Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
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4
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Hung ST, Cheng YC, Wu CC, Su CH. Examining Physical Wellness as the Fundamental Element for Achieving Holistic Well-Being in Older Persons: Review of Literature and Practical Application in Daily Life. J Multidiscip Healthc 2023; 16:1889-1904. [PMID: 37435298 PMCID: PMC10329914 DOI: 10.2147/jmdh.s419306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
This review examines the impact of physical activity, nutrition, and sleep evaluations on the physical wellness (PW) and overall well-being of older individuals. A comprehensive search was conducted in databases like PubMed, Google Scholar, and EBSCO Information Services. The search spanned from January 2000 to December 2022, resulting in 19,400 articles, out of which 98 review articles met the inclusion criteria. Through the analysis of these articles, key characteristics of the literature were summarized, and opportunities to enhance the practical application of physical activity (PA), nutrition, and sleep evaluations in the daily lives of older persons were identified. Regular physical activity is crucial for older persons to maintain their physical, mental, and emotional well-being and prevent age-related health issues. Older persons have specific nutritional needs, including increased protein, vitamin D, calcium, and vitamin B12 intake. Poor sleep quality in older persons is associated with negative health outcomes such as cognitive decline, physical disability, and mortality. This review emphasizes the significance of considering physical wellness as a fundamental element for achieving holistic well-being in older persons and highlights the importance of physical activity, nutrition, and sleep evaluations in improving their overall health and well-being. By understanding and implementing these findings, we can enhance the quality of life and promote healthy aging in older persons.
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Affiliation(s)
- Sheng-Te Hung
- Graduate Institute of Sports Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Yi-Chen Cheng
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sports Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
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5
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Chodosh J, Mitchell MN, Cadogan M, Brody AA, Alessi CA, Hernandez DE, Mangold M, Martin JL. Improving sleep using mentored behavioral and environmental restructuring (SLUMBER): A randomized stepped-wedge design trial to evaluate a comprehensive sleep intervention in skilled nursing facilities. Contemp Clin Trials 2023; 126:107107. [PMID: 36716989 PMCID: PMC10026593 DOI: 10.1016/j.cct.2023.107107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/04/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Poor sleep is ubiquitous in skilled nursing facilities (SNFs) and is associated with a myriad of negative symptoms. Non-pharmacological interventions can improve sleep, yet sustainability has not been demonstrated. The Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER) trial will test whether a staff mentoring approach to address resident sleep issues positively impacts sleep quality and whether improved sleep benefits mood, cognitive performance, and activity engagement for residents living in SNFs. INTERVENTION This is a four-year hybrid type I effectiveness/implementation randomized stepped-wedge trial using a comprehensive sleep improvement program conducted in three urban SNFs. METHODS We will provide SNF staff with sleep promotion strategies over a four-month intervention. Staff will have access to in-person workshops, webinars, weekly sleep pearls via text messaging, environmental data, and expert program mentors. We will consent residents for data collection (at baseline, end of intervention, and three- and six-months post-intervention) including resident observations, questionnaires, and wrist actigraphy (to objectively measure sleep). We will also use selected Minimum Data Set 3.0 (MDS) measures. CONCLUSION SLUMBER uses a unique strategy to iteratively improve sleep interventions through SNF staff buy-in, expert mentoring, and technological supports within a quality improvement framework. As a stepped-wedge trial, the initial SNF units provide opportunities for program improvement in subsequent units, accounting for variation across resident populations at different sites. Protocol limitations include strategies which may require substantial customization for greater spread. A comprehensive staff training program that addresses both sleep quality and related symptoms has the opportunity for considerable dissemination. TRIAL REGISTRATION USGOV Clinical Trials ID: NCT03327324.
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Affiliation(s)
- Joshua Chodosh
- Department of Medicine, New York University Grossman School of Medicine, New York City, NY, United States of America; Medicine Service, VA New York Harbor Healthcare System, New York City, NY, United States of America.
| | - Michael N Mitchell
- Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, CA, United States of America
| | - Mary Cadogan
- School of Nursing, University of California, Los Angeles, CA, United States of America
| | - Abraham A Brody
- Department of Medicine, New York University Grossman School of Medicine, New York City, NY, United States of America; Rory Meyers College of Nursing, New York University, New York City, NY, United States of America
| | - Cathy A Alessi
- Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, CA, United States of America; David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
| | - Diana E Hernandez
- Department of Medicine, New York University Grossman School of Medicine, New York City, NY, United States of America
| | - Michael Mangold
- Department of Medicine, New York University Grossman School of Medicine, New York City, NY, United States of America; Mount Sinai Beth Israel, New York, NY, United States of America
| | - Jennifer L Martin
- Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, CA, United States of America; David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
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6
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Alcohol and aging - An area of increasing concern. Alcohol 2023; 107:19-27. [PMID: 35940508 DOI: 10.1016/j.alcohol.2022.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/18/2022]
Abstract
Alcohol use is increasing among adults 65 and older and the size of this population is expanding rapidly. Aging is associated with systemic inflammation, sleep disturbances, cancers, cognitive decline, and increased risk of injury and death from falls and other accidents. Alcohol misuse exacerbates and accelerates these age-related changes. Older drinkers are more sensitive to acute alcohol-induced impairments in memory, coordination, reaction time, and driving performance. Oxidative stress and DNA damage resulting from chronic heavy alcohol consumption contribute to an increased risk of cancer, liver disease, and cardiovascular disease. Medication use increases with age and many medications prescribed to older adults can interact negatively with alcohol. The rapid expansion of the population aged 65 and older, combined with higher levels of alcohol use and AUD in the Baby Boomer cohort than the preceding generation, could significantly increase the burden of alcohol on the healthcare system resulting from AUD and alcohol-related injuries and diseases. Screening and brief intervention for hazardous alcohol use among older patients along with education regarding potential interactions between alcohol and medications could substantially reduce the risk of harms from alcohol but currently is underutilized.
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7
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Frohnhofen H, Kühn KU. [Sleep and sleep disorders in the elderly]. MMW Fortschr Med 2023; 165:52-58. [PMID: 36826669 DOI: 10.1007/s15006-022-2244-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- Helmut Frohnhofen
- Klinik für Orthopädie und Unfallchirurgie/Altersmedizin, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Kai-Uwe Kühn
- Abteilung Gerontopsychiatrie und Psychotherapie, LVR-Klinik Bonn, Bonn, Deutschland
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8
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Higher Hospital Frailty Risk Score Is an Independent Predictor of In-Hospital Mortality in Hospitalized Older Adults with Obstructive Sleep Apnea. Geriatrics (Basel) 2022; 7:geriatrics7060127. [PMID: 36412616 PMCID: PMC9680342 DOI: 10.3390/geriatrics7060127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/30/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Frailty predisposes individuals to stressors, increasing morbidity and mortality risk. Therefore, this study examined the impact of frailty defined by the Hospital Frailty Risk Score (HFRS) and other characteristics in older hospitalized patients with Obstructive Sleep Apnea (OSA). Methods: We conducted a retrospective study using the National Inpatient Sample 2016 in patients ≥65 years old with OSA. Logistic regression was used to evaluate the impact of frailty on inpatient mortality. A Kaplan-Meier curve with a log-rank test was used to estimate survival time between frailty groups. Results: 182,174 discharge records of elderly OSA were included in the study. 54% of the cohort were determined to be a medium/high frailty risk, according to HFRS. In multivariable analysis, frailty was associated with a fourfold (medium frailty, adjusted odd ratio (aOR): 4.12, 95% Confidence Interval (CI): 3.76−4.53, p-value < 0.001) and sixfold (high frailty, OR: 6.38, 95% CI: 5.60−7.27, p-value < 0.001) increased odds of mortality. Hospital survival time was significantly different between the three frailty groups (Log-rank test, p < 0.0001). Comorbidity burden defined by Charlson comorbidity Index (CCI) was associated with increased mortality (p < 0.001). Conclusion: More than half of the whole cohort was determined to be at medium and high frailty risk. Frailty was a significant predictor of in-hospital deaths in hospitalized OSA patients. Frailty assessment may be applicable for risk stratification of older hospitalized OSA patients.
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9
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Sun J, Ma C, Zhao M, Magnussen CG, Xi B. Daytime napping and cardiovascular risk factors, cardiovascular disease, and mortality: A systematic review. Sleep Med Rev 2022; 65:101682. [PMID: 36027794 DOI: 10.1016/j.smrv.2022.101682] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 10/15/2022]
Abstract
Associations between night sleep duration and cardiovascular risk factors in adults have been well documented. However, the associations for daytime napping remain unclear. In this review, six databases were searched for eligible publications to April 8, 2022. A total of 11 articles were identified for umbrella review on the association of daytime napping with diabetes, metabolic syndrome (MetS), cardiovascular disease (CVD), and mortality in adults, 97 for systematic review on the association with CVD and several CVD risk factors. Our umbrella review showed that the associations of daytime napping with diabetes, MetS, CVD, and mortality in most meta-analyses were mainly supported by weak or suggestive evidence. Our systematic review showed that long daytime napping (≥1 h/d) was associated with higher odds of several CVD risk factors, CVD, and mortality, but no significant association was found between short daytime napping and most of the abovementioned outcomes. Our dose-response meta-analyses showed that daytime napping <30 min/d was not significantly associated with higher odds of most CVD risk factors and CVD among young and middle-aged adults. However, among older adults aged >60 years, we observed significant dose-response associations of daytime napping with higher odds of diabetes, dyslipidemia, MetS, and mortality starting from 0 min/d.
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Affiliation(s)
- Jiahong Sun
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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10
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Sleep habits are associated with cognition decline in physically robust, but not in frail participants: a longitudinal observational study. Sci Rep 2022; 12:11595. [PMID: 35804185 PMCID: PMC9270465 DOI: 10.1038/s41598-022-15915-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
Frail older adults are vulnerable to stressors; thus, sleep related cognition impairment might more greatly affect frail than healthy older adults. In the present study, we investigated whether the association between sleep problems and cognition varies with physical frailty status (modified from Fried et al.). Participants 55 years and older who completed a baseline and follow-up questionnaire (median follow-up: 5.5 years), were included in the analysis. Sleep parameters were evaluated in an interview at the baseline. Cognitive decline was defined as a loss of 3 or more points on the Mini-Mental State Examination (MMSE) at follow-up. Associations between sleep problems and cognitive decline were examined using logistic regression and were stratified by baseline physical frailty status, adjusted for potential confounders. A short total sleep duration (< 5 vs. 7-9 h, odds ratio (OR) = 1.88, 95% confidence interval (CI) 1.18-3.00), excessive daytime sleepiness (OR = 1.49, 95% CI 1.04-2.13), low sleep efficiency (< 65% vs. ≥ 85%, OR = 1.62, 95% CI 1.07-2.46), and insomnia complaints (OR = 2.34, 95% CI 1.23-4.43) were associated with MMSE decline in physically robust. The association was stronger for the sleep summary score, which summarized abnormal sleep duration, excessive daytime sleepiness, and insomnia complaints ([Formula: see text] 2 vs. 0, OR = 3.79, 95% CI 2.10-6.85, p < 0.0001). Due to the low prevalence of frailty in this community-dwelling population, the statistical power to detect an association was low. More evidence is needed to clarify the role of sleep in the progression of cognitive decline in frail individuals.
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Yoshimura S, Miyano I, Yasuda N. Associations of sleep duration with the incidence of needed support/long-term care certification according to presence or absence of sleep complaints in community-dwelling Japanese older adults. Arch Gerontol Geriatr 2022; 101:104712. [DOI: 10.1016/j.archger.2022.104712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/17/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022]
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12
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Frohnhofen H, Popp R. [Sleep and sleep disorders in old age]. Dtsch Med Wochenschr 2022; 147:258-268. [PMID: 35226925 DOI: 10.1055/a-1495-3348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The increasing interruptions of night sleep with normal ageing must be distinguished from sleep disorders. Somatic and psychiatric morbidity as well as medication have a huge impact on sleep. Furthermore, the relationship between sleep and morbidity is mutual. Disturbed sleep modifies the clinical appearance of diseases and morbidity affects the ability to sleep. Especially in geriatric medicine, geriatric syndromes such as falls, depression or dementia are modified by sleep disorders. Therefore, treatment for sleep disorders offers the chance to improve geriatric syndromes.When treating, it is important to identify the individual sleep disorders. Coincidences of different sleep disorders are common in the elderly. The history of a patient in connection with a sleeping diary is the basic diagnostic procedure. Sleep medicine provides further technical methods for further examination. Older people should also be examined in a sleep laboratory if the results have consequences that will be accepted by the patient. However, this should be clarified in advance.
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Umehara T, Kaneguchi A, Yamasaki T, Matsuura A, Kito N, Tanaka H, Yamaoka K. Interactive effects of exercise and sleep on frailty severity in community-dwelling older adults: a cross-sectional study. J Rural Med 2022; 17:21-28. [PMID: 35047098 PMCID: PMC8753256 DOI: 10.2185/jrm.2021-041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/02/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives: This study examined the effects of the interaction between
exercise and sleep on frailty severity in community-dwelling older adults. Materials and Methods: This was a cross-sectional study. Data were collected
in July 2019. In total, 2021 adults participated who responded to a questionnaire. Among
them, 672 participants (317 men and 355 women) with valid responses were included in the
analysis. Ordinal logistic regression analysis was performed to examine the association
between frailty severity and the interaction between exercise and sleep. The dependent
variable represents three different levels of frailty. The independent variables included
basic information and interaction between exercise and sleep. Results: The results of ordinal logistic regression analysis (odds ratio
[OR]) showed that the period from the start of exercise (OR=0.96), age (OR=1.00 for
participants in their 60 s, OR=1.65 for those in their 70s, and OR=3.13 for those aged
>80 years), poor subjective health perception (OR=2.12), poor quality of sleep
(OR=1.88), stress (OR=1.62), and exercise–sleep interaction (OR=1.00 based on
good-exercise–good-sleep interaction, OR=3.09 poor-exercise–good-sleep interaction, and
OR=3.50 poor-exercise–poor-sleep interaction) significantly contributed to the model. The
Nagelkerke coefficient of determination adjusted for degrees-of-freedom (R2),
which represents the contribution rate of the regression equation, was 0.334. Conclusions: Our results suggest that a combination of good exercise and
good sleep is needed to prevent frailty progression in community-dwelling older
adults.
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Affiliation(s)
- Takuya Umehara
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Yamasaki
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Akihiro Matsuura
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Hideki Tanaka
- Well-being and Wellness Center, Hiroshima International University, Japan.,Department of Psychology, Faculty of Health Science, Hiroshima International University, Japan
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
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14
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Popp R, Geisler P, Crönlein T. Insomnie – diagnostische Ansätze und Verfahren. SOMNOLOGIE 2021. [DOI: 10.1007/s11818-021-00324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lee E, Kim Y, Lee H. Association between depression or sleep problems and working time mismatch among Korean workers. Perspect Psychiatr Care 2021; 57:1331-1339. [PMID: 33230877 DOI: 10.1111/ppc.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/19/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to investigate the relationship between South Korean workers' working time mismatches and their depression and sleep disorders. DESIGN AND METHODS This study used raw data from the fifth Korean Working Conditions Survey (KWCS), which sampled 50,205 workers. FINDINGS The risk of occurrence of sleep problems among workers was shown to be proportional to actual working time. The risk of occurrence of depression increased along with the degree of working time mismatch. PRACTICE IMPLICATIONS To improve the health and welfare of workers, making a policy and labor culture that relieve working time mismatch is important.
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Affiliation(s)
- Eunmi Lee
- Department of Nursing, Hoseo University, Asan-si, Chungcheongnam-do, Republic of Korea
| | - Yujeong Kim
- College of Nursing, Kyungpook National University, Daegu, Republic of Korea
| | - Haeyoung Lee
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
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16
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Innes KE, Selfe TK, Montgomery C, Hollingshead N, Huysmans Z, Srinivasan R, Wen S, Hausmann MJ, Sherman K, Klatt M. Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial. J Clin Sleep Med 2021; 16:107-119. [PMID: 31957638 DOI: 10.5664/jcsm.8134] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVES To assess the effects of a yoga versus educational film (EF) program on restless legs syndrome (RLS) symptoms and related outcomes in adults with RLS. METHODS Forty-one community-dwelling, ambulatory nonpregnant adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or EF program (n = 22). In addition to attending classes, all participants completed practice/treatment logs. Yoga group participants were asked to practice at home 30 minutes per day on nonclass days; EF participants were instructed to record any RLS treatments used on their daily logs. Core outcomes assessed pretreatment and posttreatment were RLS symptoms and symptom severity (International RLS Study Group Scale (IRLS) and RLS ordinal scale), sleep quality, mood, perceived stress, and quality of life (QOL). RESULTS Thirty adults (13 yoga, 17 EF), aged 24 to 73 (mean = 50.4 ± 2.4 years), completed the 12-week study (78% female, 80.5% white). Post-intervention, both groups showed significant improvement in RLS symptoms and severity, perceived stress, mood, and QOL-mental health (P ≤ .04). Relative to the EF group, yoga participants demonstrated significantly greater reductions in RLS symptoms and symptom severity (P ≤ .01), and greater improvements in perceived stress and mood (P ≤ .04), as well as sleep quality (P = .09); RLS symptoms decreased to minimal/mild in 77% of yoga group participants, with none scoring in the severe range by week 12, versus 24% and 12%, respectively, in EF participants. In the yoga group, IRLS and RLS severity scores declined with increasing minutes of homework practice (r = .7, P = .009 and r = .6, P = .03, respectively), suggesting a possible dose-response relationship. CONCLUSIONS Findings of this exploratory RCT suggest that yoga may be effective in reducing RLS symptoms and symptom severity, decreasing perceived stress, and improving mood and sleep in adults with RLS. CLINICAL TRIAL REGISTRATION Registry: Clinicaltrials.gov; Title: Yoga vs. Education for Restless Legs: a Feasibility Study; Identifier: NCT03570515; URL: https://clinicaltrials.gov/ct2/show/NCT03570515.
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Affiliation(s)
- Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Terry Kit Selfe
- Health Science Center Libraries, University of Florida, Gainesville, Florida
| | - Caitlin Montgomery
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Nicole Hollingshead
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Zenzi Huysmans
- West Virginia University College of Physical Activity and Sport Sciences, Morgantown, West Virginia
| | - Roshini Srinivasan
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, Morgantown, West Virginia
| | - Madeleine J Hausmann
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
| | - Karen Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Maryanna Klatt
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, Ohio
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17
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Ord AS, Slogar SM, Sautter SW. Lifestyle Factors, Cognitive Functioning, and Functional Capacity in Older Adults. Int J Aging Hum Dev 2021; 94:387-414. [PMID: 33913787 DOI: 10.1177/00914150211009467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research suggests that clinical management of cognitive impairment can occur through interventions targeting lifestyle factors, such as physical exercise and sleep quality. The present study examined the associations among lifestyle factors (exercise and sleep quality), cognition, and functional capacity in older adults (ages 56-94) who completed an outpatient neuropsychological evaluation (N = 356). Exercise habits and sleep quality were accessed using a self-report questionnaire and a clinical interview. Cognitive functioning was assessed using the Dementia Rating Scale-2 (DRS-2). Functional capacity was measured by the Texas Functional Living Scale (TFLS). Results indicated that physical exercise and sleep quality were positively associated with better cognitive functioning and functional capacity. Further research is needed to elucidate the relationship between lifestyle factors, cognition, and functional capacity in older adults.
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Affiliation(s)
- Anna S Ord
- 8212 Regent University, Virginia Beach, VA, USA.,W. G. Hefner VA Medical Center, Salisbury, NC, USA.,Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC, USA.,Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Scott W Sautter
- 8212 Regent University, Virginia Beach, VA, USA.,Independent Practice, Virginia Beach, Virginia, USA
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18
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Du M, Liu M, Liu J. The association between sleep duration and the risk of mortality in the Chinese older adults: a national cohort study. J Clin Sleep Med 2021; 17:1821-1829. [PMID: 33913434 DOI: 10.5664/jcsm.9278] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Cohort studies about the sleep duration on the risk of deaths among Chinese older adults are still lacking. The aim of this study was to examine whether extremely sleep duration was associated with mortality in Chinese adults aged 65 years or older. METHODS We included participants aged 65 years or older in 2011 at baseline in 23 provinces from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) who were followed up at 2014/2018 in China. The sleep duration was categorized as short sleep duration (<7h) and long sleep duration (>8h). We used the cox proportional hazards model and restricted cubic spline analysis to explore the association between sleep duration and mortality. RESULTS Among 9578 participants, short sleep duration was associated with 11% higher risk of deaths (aHR: 1.11, 95% CI: 1.02-1.20) and long sleep duration was associated with 24% higher risk of deaths (aHR: 1.24, 95% CI: 1.15-1.34), after adjustment of all the covariates. There was a U-shaped association between sleep duration and all-cause mortality (non-linear: P<0.0001). Stratified analyses showed that the risk was higher among older people who smoked and had higher level of education both for short and long sleepers than those who never smoked and were illiterate (P value for interaction < 0.05). CONCLUSIONS There was a U-shaped association between sleep duration and all-cause mortality in the Chinese older adults, especially for educated population and smokers.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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19
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Arias-Fernández L, Smith-Plaza AM, Barrera-Castillo M, Prado-Suárez J, Lopez-Garcia E, Rodríguez-Artalejo F, Lana A. Sleep patterns and physical function in older adults attending primary health care. Fam Pract 2021; 38:147-153. [PMID: 32820329 DOI: 10.1093/fampra/cmaa085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep disturbances may contribute to physical function impairment among older adults. OBJECTIVE To examine the associations between sleep quality and duration and impaired physical function among older adults. METHODS Cross-sectional study involving 392 non-institutionalized adults aged ≥65 years, who were recruited from primary health care centres in Spain. Sleep quality and duration were assessed with the Pittsburgh Sleep Quality Index (PSQI). The FRAIL scale was used to identify physical frailty, the short physical performance battery to assess lower extremity functional impairment (LEFI) and grip strength was measured using a hand-held dynamometer to assess muscle weakness. Statistical analyses were performed with logistic regression models adjusted for potential confounders. RESULTS Participants with poor sleep quality (PSQI global score ≥10) were more likely to have functional limitations; the odds ratio (95% confidence interval) was 2.90 (1.10-7.64) for physical frailty, 2.73 (1.34-5.58) for LEFI and 2.32 (1.14-4.75) for muscle weakness. Sleep quality components associated with frailty were sleep disturbances, use of sleeping medication and daytime dysfunction. The only quality component associated with LEFI was poor sleep efficiency, while subjective poor sleep quality and daytime dysfunction were linked to muscle weakness. No associations were observed between night-time sleep duration and physical function indicators. CONCLUSIONS Poor self-reported sleep quality, but not sleep duration, was associated with an increased frequency of physical frailty, LEFI and muscle weakness. Interventions to improve sleep quality could contribute to healthy ageing.
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Affiliation(s)
- Lucía Arias-Fernández
- Primary Health Care Network, Asturias Health Service, Asturias.,Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Asturias
| | | | | | | | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Asturias.,Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ; CIBER of Epidemiology and Public Health (CIBERESP), Madrid
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20
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Alves AM, Andrade NDO, Facina MEL, Melo BRDS, Gratão ACM, Martins TCR, Luchesi BM. Which older people in the community have the highest clinical-functional vulnerability? GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: To identify the factors related to clinical-functional vulnerability in older people. METHODS: This cross-sectional quantitative study was conducted in 2018/2019 with 492 older adults registered in Family Health Strategy units in the city of Três Lagoas, MS, Brazil. Sociodemographic data were collected and the Clinical-Functional Vulnerability Index (CFVI-20) was applied (possible score 0-40; higher scores indicate greater vulnerability). A multinomial logistic regression was performed to identify the risk factors for clinical-functional vulnerability. RESULTS: The sample’s mean age was 70.80 years (SD, 7.82) and the mean CFVI-20 score was 9.25 (SD, 7.09), with 17.07% at high risk of clinical-functional vulnerability, 38.82% at moderate risk, and 44.11% at low risk. Low education, social isolation, difficulty sleeping, and being female were risk factors for moderate vulnerability. On the other hand, low education, social isolation, difficulty sleeping, physical inactivity, being female, not using alcohol, and not participating in social groups were risk factors for high vulnerability. CONCLUSIONS: The CFVI-20 is convenient for primary health care contexts, since it is fast and easy to apply. By recognizing factors related to vulnerability, specific preventive actions can be planned. Keywords: frail elderly; primary health care; family health strategy; health vulnerabilit
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21
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Park D, Kim S, Shin C, Suh S. Prevalence of and factors associated with nightmares in the elderly in a population based cohort study. Sleep Med 2020; 78:15-23. [PMID: 33373930 DOI: 10.1016/j.sleep.2020.11.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Nightmares are extremely unpleasant and vivid recurring dreams that are accompanied with awakening during sleep. However, earlier studies were mostly conducted with children and adults, with very few studies on nightmares in older adults. This population-based study aims to investigate the prevalence of nightmares and its associated factors nightmares in the elderly. METHODS This study utilized a subsample from the Korean Genome and Epidemiology Study (KoGES). Participants (n = 2940; mean age 63.71 ± 6.73) completed the questionnaires on nightmares (Disturbing Dream and Nightmare Severity Index; DDNSI), depression, suicidal ideation, sleep quality and stress. RESULTS Among the sample, 2.7% (n = 79) were classified into the nightmare group (NG), which was classified with DDNSI scores. In the age group over 70, prevalence of nightmares was 6.3% (n = 37), which was significantly higher than other age groups. Marital status, employment status and family income were associated with nightmares. Additionally, NG reported significantly more sleep problems, higher suicidal ideation, depression and stress compared to the non-nightmare group (N-NG). Logistic regression analyses results indicated that the NG was 4.35 times at higher risk for depression, and 3.16 higher risks for stress, and 3.45 higher risks for suicidal ideation compared to the N-NG after controlling for covariates. CONCLUSIONS Our results indicate that psychological and demographic factors are associated with nightmares in the elderly. Furthermore, this population-based cohort study showed the prevalence of nightmares increased after age 70, which suggests the need for further studies of nightmares in older populations.
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Affiliation(s)
- Dasom Park
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea
| | - Soriul Kim
- Institute for Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chol Shin
- Institute for Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea; Division of Pulmonary Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea.
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22
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Lee E, Kim Y, Lee H. Association between Sleep Problems and Sedentary Behaviors during Work among Korean Workers. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1701-1708. [PMID: 33643945 PMCID: PMC7898088 DOI: 10.18502/ijph.v49i9.4087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background We aimed to identify the association between sleep problems and sedentary behaviors during work among Korean workers. Methods We employed a cross-sectional survey, and analyzed data from the 5th Korean Working Conditions Survey, conducted in 2017. The participants were 50,205 workers aged 15 years and above. The data were analyzed using Pearson's correlation, chi-square distribution, and logistic regression. Results Sleep problems occurred more frequently among female participants with higher ages; those with low educational levels; skilled agricultural, forestry, and fishery workers; elementary workers; and service and sales workers. With general characteristics as control variables, it was found that the odds of sleep problems were 5.547 times higher if the duration of sedentary behavior was longer. Conclusion It is important to improving work environment and provide education on various physical activities for workers with a long duration of sedentary behaviors to reduce sleep problems among them.
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Affiliation(s)
- Eunmi Lee
- Department of Nursing, Hoseo University, 20, Hoseo-ro 79, Asan 31499, Republic of Korea
| | - Yujeong Kim
- College of Nursing, Kyungpook National University, 680 Gukchabosangro, Jung-gu, Daegu 41944, Republic of Korea
| | - Haeyoung Lee
- College of Nursing, Chung-Ang University Red Cross, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea
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23
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Frailty and Sleep Disorder in Chronic Liver Diseases. Life (Basel) 2020; 10:life10080137. [PMID: 32764402 PMCID: PMC7459910 DOI: 10.3390/life10080137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 02/08/2023] Open
Abstract
We aimed to investigate the association in frailty and sleep disorder as assessed by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in patients with chronic liver diseases (CLDs, n = 317, 141 males). Frailty was determined using the following five phenotypes: unintentional body weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity. Sleep disorder was defined as patients with PSQI-J score 6 or greater. Robust (phenotype, 0), prefrail (1 or 2 phenotypes) and frailty (3 phenotypes or greater) were observed in 101 (31.9%), 174 (54.9%) and 42 (13.2%), respectively. The median (interquartile range (IQR)) PSQI-J score was 4 (3, 7). Sleep disorder was found in 115 patients (36.3%). The median (IQR) PSQI-J scores in patients of the robust, prefrail, and frail groups were 3 (2, 5), 5 (3, 7), and 8 (4.75, 10.25), respectively (p < 0.0001 between any two groups and overall p < 0.0001). The ratios of sleep disorder in patients with robust, prefrail and frailty were 15.8% (16/101), 39.1% (68/174), and 73.8% (31/42), respectively (overall p < 0.0001). In conclusion, CLD patients with frailty can involve poorer sleep quality. As sleep disorder in CLDs is potentially remediable, future frailty-preventive strategies must take sleep complaints into account.
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24
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Association between Neighborhood Environment and Quality of Sleep in Older Adult Residents Living in Japan: The JAGES 2010 Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041398. [PMID: 32098114 PMCID: PMC7068387 DOI: 10.3390/ijerph17041398] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/11/2022]
Abstract
Poor sleep is associated with lifestyle, however, few studies have addressed the association between sleep quality and the neighborhood environment. This study aimed to investigate the associations between living environment factors and sleep quality in older people. Participants were community-dwelling people aged ≥65 years who participated in the 2010 Japanese Gerontological Evaluation Study. The data of 16,650 people (8102 men, 8548 women) were analyzed. Sleep quality (good or poor) was evaluated using a self-administered questionnaire. Multilevel Poisson regression analysis stratified by depressive status (measured by the Geriatric Depression Scale-15 [GDS]) was conducted with sleep quality as the dependent variable and social and physical environmental factors as explanatory variables. The 12,469 non-depressive respondents and 4181 depressive respondents were evaluated. The regression analysis indicated that non-depressive participants slept better if they lived in environments with few hills or steps (prevalence ratio [PR] = 0.75, 95% CI: 0.56–0.9) and with places where they felt free to drop in (PR = 0.51, 95% CI: 0.26–0.98). For depressive participants, these associations were not evident. Living alone, poor self-rated health, low income, and unemployment were associated with poor sleep quality. In addition to support with these individual factors, improving environmental factors at the neighborhood level may improve the sleep quality of community-dwelling older adults.
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25
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Richter K, Kellner S, Miloseva L, Frohnhofen H. [Treatment of insomnia in old age]. Z Gerontol Geriatr 2020; 53:105-111. [PMID: 31965284 DOI: 10.1007/s00391-019-01684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Insomnia is one of the most frequent health disorders in old age. It causes suffering and numerous health problems. Therefore, treatment is often indicated. Behavioral therapy is the treatment of choice even in older individuals. In addition, light therapy also has an important role. Pharmacological treatment measures are less well studied, the benefits in long-term use are unclear and should only be applied in the short term to reduce suffering as well as being integrated into a comprehensive treatment concept.
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Affiliation(s)
- Kneginja Richter
- Universitätsklinik für Psychiatrie und Psychotherapie, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
| | - Stefanie Kellner
- Institut für E-Beratung, Fakultät für Sozialwissenschaften, Technische Hochschule Nürnberg, Nürnberg, Deutschland
| | - Lence Miloseva
- Fakultät für Medizinwissenschaften, Universität Goce Delcev, Stip, Stip, Nordmazedonien
| | - Helmut Frohnhofen
- Fakultät für Gesundheit, Universität Witten Herdecke, Witten, Deutschland
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26
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Sun XH, Ma T, Yao S, Chen ZK, Xu WD, Jiang XY, Wang XF. Associations of sleep quality and sleep duration with frailty and pre-frailty in an elderly population Rugao longevity and ageing study. BMC Geriatr 2020; 20:9. [PMID: 31906855 PMCID: PMC6945401 DOI: 10.1186/s12877-019-1407-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 12/22/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous studies suggest that poor sleep quality or abnormal sleep duration may be associated with frailty. Here we test the associations of sleep disturbances with both frailty and pre-frailty in an elderly population. METHODS Participants included 1726 community-dwelling elders aged 70-87 years. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbances. Frailty was defined using phenotype criteria. Logistic regression models were used to estimate odds ratio of the associations. RESULTS The average PSQI score was 5.4 (SD, 3.1). Overall 43.6% of the participants had poor sleep quality (PSQI> 5), 8.2% had night sleep time ≤ 5 h, and 27.8% had night sleep time ≥ 9 h. The prevalence of frailty and pre-frailty was 9.2 and 52.8%, respectively. The proportions of PSQI> 5 increased with the severity of frailty status (robust: pre-frail: frail, 34.5%: 48%: 56.1%, P < 0.001). After adjustment for multiple potential confounders, poor sleep quality (PSQI> 5) was associated with higher odds of frailty (OR = 1.78, 95% CI 1.19-2.66) and pre-frailty (OR = 1.51, 95% CI 1.20-1.90). Sleep latency, sleep disturbance, and daytime dysfunction components of PSQI measurements were also associated with frailty and pre-frailty. In addition, sleep time 9 h/night was associated with higher odds of frailty and pre-frailty. CONCLUSIONS We provided preliminary evidences that poor sleep quality and prolonged sleep duration were associated with being frailty and pre-frailty in an elderly population aged 70-87 years. The associations need to be validated in other elderly populations.
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Affiliation(s)
- Xue-Hui Sun
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China
| | - Teng Ma
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shun Yao
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China
| | - Ze-Kun Chen
- Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China
| | - Wen-Dong Xu
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao-Yan Jiang
- Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, 200092, People's Republic of China.
| | - Xiao-Feng Wang
- Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, Fudan University, Shanghai, China. .,Human Phenome Institute, Fudan University, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. .,Shanghai Key Laboratory of Clinical Geriatric Medicine and Huadong Hospital Clinical Research Center for Geriatric Medicine, Shanghai, China. .,Unit of epidemiology, Human Phenome Institute, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, 200433, China.
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27
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Prevalence and Associated Factors of Frailty in Community-Dwelling Older Adults in Indonesia, 2014-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010010. [PMID: 31861327 PMCID: PMC6981585 DOI: 10.3390/ijerph17010010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/05/2019] [Accepted: 11/15/2019] [Indexed: 12/30/2022]
Abstract
Objective: The investigation aims to study the prevalence and correlates of frailty in a national community-dwelling sample of older Indonesians. Methods: Participants were 2630 older adults, 60 years and older (median age 66.0 years, interquartile range = 9.0) who took part in the cross-sectional Indonesia Family Life Survey (IFLS-5) in 2014–2015. They were requested to provide information about sociodemographic and various health variables, including frailty. Multivariable Poisson regression analysis was utilized to estimate the correlates of socio-demographic factors, health variables, and frailty. Results: The overall prevalence of frailty was 8.1%; 61.6% were prefrail. In adjusted Poisson regression analysis, older age, being unmarried, separated, divorced or widowed, residing in Java and major island groups, poor cognitive functioning, loneliness, and functional disability were associated with frailty. Conclusion: Several sociodemographic and health risk factors for frailty were identified that can help in guiding intervention strategies in Indonesia.
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28
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Campanini MZ, Mesas AE, Carnicero-Carreño JA, Rodríguez-Artalejo F, Lopez-Garcia E. Duration and Quality of Sleep and Risk of Physical Function Impairment and Disability in Older Adults: Results from the ENRICA and ELSA Cohorts. Aging Dis 2019; 10:557-569. [PMID: 31165000 PMCID: PMC6538215 DOI: 10.14336/ad.2018.0611] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 06/11/2018] [Indexed: 12/24/2022] Open
Abstract
Sleep duration and quality have been associated with poor physical function, but both the temporality of the association and the independence of sleep duration and quality are unclear. We examined the prospective association of sleep duration and quality with physical function impairment and disability in older adults. Data were taken from participants in the Seniors-ENRICA (2012-2015, n= 1,773) and in the ELSA cohort (waves 4 and 6, n=4,885) aged ≥60 years. Sleep duration and quality were self-reported. Physical function impairment and disability was obtained either from self-reports (ENRICA and ELSA) or from performance assessment (ENRICA). Logistic regression models were adjusted for potential confounders. After a follow-up of 2.0-2.8 years, no association was found between changes in sleep duration and physical function impairment or disability. However, in both studies, poor general sleep quality was linked to higher risk of impaired agility [OR: 1.93 (95% CI: 1.30-2.86) in Seniors-ENRICA and 1.65 (1.24-2.18) in ELSA study] and mobility [1.46 (0.98-2.17) in Seniors-ENRICA and 1.59 (1.18-2.15) in ELSA study]. Poor general sleep quality was also associated with decreased physical component summary (PCS) [1.39 (1.05-1.83)], disability in instrumental activities of daily living [1.59 (0.97-2.59)] and in basic activities of daily living [1.73 (1.14-2.64)] in Seniors-ENRICA. In addition, compared to those with no sleep complaints, participants with 2 or more sleep complaints had greater risk of impaired agility, impaired mobility, decreased PCS and impaired lower extremity function in both cohorts. Poor sleep quality was associated with higher risk of physical impairment and disability in older adults from Spain and from England.
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Affiliation(s)
- Marcela Z. Campanini
- Department of Public Health, Universidade Estadual de Londrina, Londrina, Brazil.
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Spain.
| | - Arthur E. Mesas
- Department of Public Health, Universidade Estadual de Londrina, Londrina, Brazil.
| | | | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Spain.
- CIBER of Epidemiology and Public Health, Madrid, Spain.
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain.
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Spain.
- Foundation for Biomedical Research, Getafe University Hospital, Getafe, Spain.
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain.
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Selfe TK, Wen S, Sherman K, Klatt M, Innes KE. Acceptability and feasibility of a 12-week yoga vs. educational film program for the management of restless legs syndrome (RLS): study protocol for a randomized controlled trial. Trials 2019; 20:134. [PMID: 30770767 PMCID: PMC6377785 DOI: 10.1186/s13063-019-3217-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/21/2019] [Indexed: 01/28/2023] Open
Abstract
Background Restless legs syndrome (RLS) is a common and burdensome sleep disorder associated with profound impairment of health, well-being, and quality of life. Unfortunately, the medications used for RLS management carry risk of serious side effects, including augmentation of symptoms. Yoga, an ancient mind-body discipline designed to promote physical, emotional, and mental well-being, may offer a viable, low-risk new treatment. The primary objectives of this pilot, parallel-arm, randomized controlled trial (RCT) are to assess the acceptability and feasibility of a 12-week yoga vs. educational film program for the management of RLS. Methods Forty-four adults with confirmed moderate to severe RLS will be recruited and randomized to a 12-week yoga (n = 22) or standardized educational film program (N = 22). Yoga group participants will attend two 75-min Iyengar yoga classes per week for the first 4 weeks, then one 75-min class per week for the remaining 8 weeks, and will complete a 30-min homework routine on non-class days. Educational film group participants will attend one 75-min class per week for 12 weeks and complete a daily RLS treatment log; classes will include information on: RLS management, including sleep hygiene practices; other sleep disorders; and complementary therapies likely to be of interest to those participating in a yoga and sleep education study. Yoga and treatment logs will be collected weekly. Feasibility outcomes will include recruitment, enrollment, and randomization rates, retention, adherence, and program satisfaction. Program evaluation and yoga-dosing questionnaires will be collected at week 12; data on exploratory outcomes (e.g., RLS symptom severity (IRLS), sleep quality (PSQI), mood (POMS, PSS), and health-related quality of life (SF-36)) will be gathered at baseline and week 12. Discussion This study will lay the essential groundwork for a planned larger RCT to determine the efficacy of a yoga program for reducing symptoms and associated burden of RLS. If the findings of the current trial and the subsequent larger RCTs are positive, this study will also help support a new approach to clinical treatment of this challenging disorder, help foster improved understanding of RLS etiology, and ultimately contribute to reducing the individual, societal, and economic burden associated with this condition. Trial registration ClinicalTrials.gov, ID: NCT03570515. Retrospectively registered on 1 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3217-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Terry Kit Selfe
- Health Science Center Libraries, University of Florida, PO Box 100206, Gainesville, FL, 32610, USA.
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
| | - Karen Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maryanna Klatt
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
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Hernández-García J, Navas-Carrillo D, Orenes-Piñero E. Alterations of circadian rhythms and their impact on obesity, metabolic syndrome and cardiovascular diseases. Crit Rev Food Sci Nutr 2019; 60:1038-1047. [PMID: 30633544 DOI: 10.1080/10408398.2018.1556579] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Circadian system is comprised by central circadian pacemaker and several peripheral clocks that receive information from the external environment, synchronizing the circadian clocks. It is widely known that physiology is rhythmic and that the rupture of this rhythmicity can generate serious consequences. Circadian clocks, led by suprachiasmatic nucleus (SCN) in the central nervous system, are the responsible for generating this biological rhythmicity. These clocks are affected by external signals such as light (changes between day and night) and feeding rhythms. In this review, the basic principles of the circadian system and current knowledge of biological clocks are addressed, analyzing the relationship between circadian system, food intake, nutrition, and associated metabolic processes. In addition, the consequences occurring when these systems are not well coordinated with each other, such as the development of cardiovascular and metabolic pathologies, will be thoroughly discussed.
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Affiliation(s)
| | - Diana Navas-Carrillo
- Department of Surgery, Hospital de la Vega Lorenzo Guirao, University of Murcia, Murcia, Spain
| | - Esteban Orenes-Piñero
- Department of Biochemistry and Molecular Biology-A, University of Murcia, Murcia, Spain
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31
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Crow RS, Lohman MC, Titus AJ, Cook SB, Bruce ML, Mackenzie TA, Bartels SJ, Batsis JA. Association of Obesity and Frailty in Older Adults: NHANES 1999-2004. J Nutr Health Aging 2019; 23:138-144. [PMID: 30697622 PMCID: PMC6371801 DOI: 10.1007/s12603-018-1138-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Body composition changes with aging can increase rates of obesity, frailty and impact function. Measuring adiposity using body fat (%BF) or central adiposity using waist circumference (WC) have greater diagnostic accuracy than traditional measures such as body mass index (BMI). DESIGN This is an observational study. SETTING This study focused on older community-dwelling participants. PARTICIPANTS We identified individuals age ≥ 60 years old using the 1999-2004 cross-sectional National Health and Nutrition Survey (NHANES). INTERVENTION The primary analysis evaluated the association between frailty and %BF or WC. Frailty was the primary predictor (robust=referent) and %BF and WC were considered continuous outcomes. Multiple imputation analyses accounted for missing characteristics. MEASUREMENT Dual energy x-ray absorptiometry was used to assess %BF and WC was objectively measured. Frailty was defined using an adapted version of Fried's criteria that was self-reported: (low BMI<18.5kg/m2; slow walking speed [<0.8m/s]; weakness [unable to lift 10lbs]; exhaustion [difficulty walking between rooms on same floor] and low physical activity [compared to others]). Robust, pre-frail and frail persons met zero, 1 or 2, and ≥3 criteria, respectively. RESULTS Of the 4,984 participants, the mean age was 71.1±0.2 (SE) years and 56.5% were females. We classified 2,246 (50.4%), 2,195 (40.3%), and 541 (9.2%) individuals as robust, pre-frail and frail, respectively. Percent BF was 35.9±0.13, 38.3±0.20 and 40.0±0.46 in the robust, pre-frail and frail individuals, respectively. WC was 99.5±0.32 in the robust, 100.1±0.43 in pre-frail, 104.7±1.17 in frail individuals. Compared to robust individuals, only frail individuals had greater %BF on average (β=0.97±0.43,p=0.03); however, pre-frail and frail individuals had 2.18 and 4.80 greater WC, respectively (β=2.18±0.64,p=0.002, and β=4.80±1.1,p<0.001). CONCLUSION Our results demonstrate that in older adults, frailty and pre-frailty are associated with a greater likelihood of high WC (as dichotomized) and a greater average WC (continuous).
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Affiliation(s)
- R S Crow
- Rebecca Crow, DO, Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, Telephone: (603) 653-9500, Facsimile: (603) 650-0915, E-mail:
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Kang I, Kim S, Kim BS, Yoo J, Kim M, Won CW. Sleep Latency in Men and Sleep Duration in Women Can Be Frailty Markers in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). J Nutr Health Aging 2019; 23:63-67. [PMID: 30569070 DOI: 10.1007/s12603-018-1109-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To test whether sleep disturbances are associated with frailty in older men and women. DESIGN Cross-sectional analysis of cohort study data. The participants were 1168 community-dwelling older adults aged 70 to 84 years who took part in the Korean Frailty and Aging Cohort Study and completed both self-reported sleep parameters and assessment of frailty. Univariate and multivariate survey logistic regression models were used to calculate odds ratios (OR) with 95% confidence intervals (CI) for frailty. Frailty was defined using the Fried's criteria. RESULTS Frailty was associated with sleep latency in men. The odds ratio for this association was 3.39 (95% CI 1.31-8.76) after adjusting for age, body mass index (BMI), physical activity, and select comorbidities, and 2.16 (95% CI 0.75-6.23) after further adjusting for depression. Frailty was associated with long sleep duration of more than 8 hours a night in women. The odds ratio for this association was 3.95 (95% CI, 1.27-12.33) after adjusting for age, BMI, physical activity, select comorbidities, and the number of medications. CONCLUSION Prolonged sleep latency (≥60 minutes) in men and long sleep duration (>8hr per night) in women were each independently associated with higher odds of frailty. Long sleep latency in elderly men and long sleep duration in elderly women may suggest they have a high chance of frailty.
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Affiliation(s)
- I Kang
- Chang Won Won, MD. Ph.D, Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Kyungheedaero 23, Dongdaemun-gu, Seoul, 02447 Republic of Korea.Tel: +82 2 958 8700; E-mail:
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Koyama S, Aida J, Cable N, Tsuboya T, Matsuyama Y, Sato Y, Yamamoto T, Kondo K, Osaka K. Sleep duration and remaining teeth among older people. Sleep Med 2018; 52:18-22. [DOI: 10.1016/j.sleep.2018.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/30/2018] [Accepted: 07/12/2018] [Indexed: 12/30/2022]
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Frase L, Nissen C, Riemann D, Spiegelhalder K. Making sleep easier: pharmacological interventions for insomnia. Expert Opin Pharmacother 2018; 19:1465-1473. [DOI: 10.1080/14656566.2018.1511705] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- University Hospital of Psychiatry and Psychotherapy, University Psychiatric Services, Bern, Switzerland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Peterson MJ. The Risk Factors of Performance-Based Early Frailty in Midlife and Older Age. Gerontol Geriatr Med 2018; 4:2333721418770035. [PMID: 29761132 PMCID: PMC5946353 DOI: 10.1177/2333721418770035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/28/2018] [Accepted: 03/14/2018] [Indexed: 11/15/2022] Open
Abstract
Background: Identifying impairments prior to onset of physical frailty may inform targeted interventions. An objective, clinically feasible early frailty measure, termed performance-based early frailty (PBEF) was developed, and antecedent and current risk factors were examined. Method: Data were from N = 104 participants of the Fels Longitudinal Study. PBEF was derived from age-specific cut points for time to complete five chair stands and walk four meters. "Pre-PBEF" and "PBEF" were defined as impairment in one or both measures, respectively. Candidate PBEF risk factors included body composition, health and quality of life, grip strength, and biomarker measures. Results: Pre-PBEF was identified in 26% and 30% of midlife and older adults, and PBEF was identified in 11% and 14% of midlife and older adults, respectively. When predicting midlife PBEF, only current physical activity was significant (odds ratio [OR] = 0.18). In older adults, PBEF status was predicted by previous heavier drinking (OR = 3.09), previous better grip strength (OR = 0.92), current poorer sleep habits (OR = 1.19), and current higher C-reactive protein concentrations (OR = 1.20). Conclusion: Differing age group patterns of predictors emerged, suggesting that PBEF in midlife is likely a state influenced by current health status, whereas older age PBEF is influenced by both current and antecedent factors.
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Serrano Merino J, Pérula de Torres LÁ, Bardwell WA, Muñoz Gómez R, Roldán Villalobos A, Feu Collado N, Ruiz-Moral R, Jurado-Gámez B. Impact of Positive Pressure Treatment of the Airway on Health-Related Quality of Life in Elderly Patients With Obstructive Sleep Apnea. Biol Res Nurs 2018; 20:452-461. [DOI: 10.1177/1099800418774633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Obstructive sleep apnea (OSA) is a chronic illness that increases in prevalence with age. Treatment includes continuous positive airway pressure (CPAP) devices. Studies about the use of CPAP in the elderly are scarce. The main objective of this study is to determine whether CPAP contributes to improvement in health-related quality of life (HRQL) in elderly patients with OSA. Method: This was a prospective, pre-/postintervention assessment of a cohort of patients ≥65 years of age with OSA diagnosis by polysomnography who were being treated with CPAP and were physically independent and had good cognitive status. We determined HRQL before and after 3 months of CPAP treatment using the Short Form-36 Health Survey (SF-36, a 36-item, patient-reported survey) and Sleep Apnea Quality of Life Index (SAQLI). The effect of CPAP on daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Results: Of the 103 participants with a mean age of 71.5 ± 4.19 years, 66% were male. After 3 months of therapy, the mean CPAP usage was 6.3 ± 1.41 hr/day. The effectiveness of CPAP in controlling the OSA was demonstrated (mean difference pre- and posttherapy: 34.30 ± 18.52 events/hr, p < .001). Postintervention, the categories of the SF-36 improved meaningfully ( p < .001). Moreover, all categories of SAQLI improved ( p < .001) with the exception of “symptoms” ( p = .073). ESS scores also improved significantly (difference = 5.2 ± 4.47, p < .001) postintervention. Conclusion: Therapy with CPAP in elderly patients with OSA helps improve their HRQL and reduces daytime sleepiness.
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Affiliation(s)
- Jesús Serrano Merino
- Sleep Unit, Respiratory Department, University Hospital Reina Sofia, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
| | - Luis Ángel Pérula de Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
- Unidad Docente de Medicina Familiar y Comunitaria, Health District of Córdoba and Guadalquivir, Córdoba, Spain
| | - Wayne A. Bardwell
- Department of Psychiatry, University of California, San Diego, CA, USA
| | | | - Ana Roldán Villalobos
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
- Unidad Docente de Medicina Familiar y Comunitaria, Health District of Córdoba and Guadalquivir, Córdoba, Spain
| | - Nuria Feu Collado
- Sleep Unit, Respiratory Department, University Hospital Reina Sofia, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
| | - Roger Ruiz-Moral
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
- Faculty of Medicine, University of Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - Bernabé Jurado-Gámez
- Sleep Unit, Respiratory Department, University Hospital Reina Sofia, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University Hospital Reina Sofia, University of Córdoba, Córdoba, Spain
- Faculty of Medicine, University of Córdoba, Córdoba, Spain
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Tampi RR, Manikkara G, Balachandran S, Taparia P, Hrisko S, Srinivasan S, Tampi DJ. Suvorexant for insomnia in older adults: a perspective review. Drugs Context 2018; 7:212517. [PMID: 29445409 PMCID: PMC5804870 DOI: 10.7573/dic.212517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 01/01/2023] Open
Abstract
The aim of this review was to identify published randomized control trials (RCTs) that evaluated the efficacy and tolerability of suvorexant for the treatment of insomnia among older adults (≥65 years). A literature search was conducted of PubMed, MEDLINE, EMBASE, PsycINFO and Cochrane collaboration databases for RCTs in any language evaluating suvorexant for the treatment of insomnia in older adults. Additionally, references of full-text articles that were included in this review were searched for further studies. Data from three RCTs of suvorexant were included in this review. All the three studies fulfilled the criteria for being of good quality based on the items listed by the Center for Evidence Based Medicine (CEBM) for the assessment of RCTs. None of the three studies were conducted exclusively among older adults. However, they also included older individuals diagnosed with primary insomnia. These studies included a total of 1298 participants aged ≥65 years in age. Trial durations ranged from 3 months to 1 year. Available data from these studies indicate that suvorexant improves multiple subjective and polysomnographic sleep parameters for sleep onset and maintenance among older individuals with a diagnosis of primary insomnia and is generally well tolerated. Current evidence, although limited, indicates that suvorexant benefits older adults with primary insomnia and is generally well tolerated.
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Affiliation(s)
- Rajesh R Tampi
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.,Department of Psychiatry, MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Geetha Manikkara
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.,Department of Psychiatry, MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Silpa Balachandran
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.,Department of Psychiatry, MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Piyush Taparia
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.,Department of Psychiatry, MetroHealth, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Stephanie Hrisko
- Department of Neuropsychiatry and Behavioral Sciences, Palmetto Health USC, 15 Medical Park, Suite 141, Columbia, SC 29203, USA
| | - Shilpa Srinivasan
- Department of Neuropsychiatry and Behavioral Sciences, Palmetto Health USC, 15 Medical Park, Suite 141, Columbia, SC 29203, USA
| | - Deena J Tampi
- Diamond Healthcare, 701 E. Byrd Street, 15th Floor, Richmond, VA 23219, USA
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van Oostrom SH, van der A DL, Rietman ML, Picavet HSJ, Lette M, Verschuren WMM, de Bruin SR, Spijkerman AMW. A four-domain approach of frailty explored in the Doetinchem Cohort Study. BMC Geriatr 2017; 17:196. [PMID: 28854882 PMCID: PMC5577839 DOI: 10.1186/s12877-017-0595-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 08/22/2017] [Indexed: 11/24/2022] Open
Abstract
Background Accumulation of problems in physical, psychological, cognitive, or social functioning is characteristic for frail individuals. Using a four-domain approach of frailty, this study explored how sociodemographic and lifestyle factors, life events and health are associated with frailty. Methods The study sample included 4019 men and women (aged 40–81 years) examined during the fifth round (2008–2012) of the Doetinchem Cohort Study. Four domains of frailty were considered: physical (≥4 of 8 criteria: unintentional weight loss, exhaustion, strength, perceived health, walking, balance, hearing and vision impairments), psychological (2 criteria: depressive symptoms, mental health), cognitive (<10th percentile on global cognitive functioning), and social frailty (≥2 of 3 criteria: loneliness, social support, social participation). Logistic regression was used to study the cross-sectional association of sociodemographic factors, lifestyle, life events and chronic diseases with frailty domains. Results About 17% of the population was frail on one or more domains. Overlap between the frailty domains was limited since 82% of the frail population was frail on one domain only. Low educated respondents were at higher risk of being psychologically and socially frail. Having multiple diseases was associated with a higher risk of being physically and psychologically frail. Being physically active was consistently associated with a lower risk of frailty on each of the four domains. Short or long sleep duration was associated with a higher risk of being physically, psychologically, and socially frail. Conclusions Sociodemographic factors, lifestyle and multimorbidity contributed differently to the four frailty domains. It is important to consider multiple frailty domains since this helps to identify different groups of frail people, and as such to provide tailored care and support. Lifestyle factors including physical activity, smoking and sleep duration were associated with multiple domains of frailty. Electronic supplementary material The online version of this article doi: 10.1186/s12877-017-0595-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands.
| | - Daphne L van der A
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands
| | - M Liset Rietman
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands
| | - Manon Lette
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Simone R de Bruin
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands
| | - Annemieke M W Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, P.O. Box 1, 3720, Bilthoven, BA, The Netherlands
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Young C, Conard PL, Armstrong ML, Lacy D. Older Military Veteran Care: Many Still Believe They Are Forgotten. J Holist Nurs 2017. [PMID: 28627285 DOI: 10.1177/0898010117713582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Almost 44% of our nation's 23 million men and women veterans are 65 years of age or older. Most are proud of their service, yet many believe their services for our country were forgotten, especially those in combat between 1950 and 1975. PURPOSE Further information to ultimately assist their holistic well-being will be important for nursing practice as countless older veterans are beginning to obtain more care within civilian facilities. Using the Korean War (1950-1953) as a backdrop to illustrate the interconnectiveness of older veteran physical, emotional, and spiritual concerns that can occur from a military deployment, the major purposes of this article are to provide a brief historical snapshot of that war and discuss prior-era military environmental situations that now are producing the lingering effects from their combat exposure. DESIGN Relevant literature about the Korean War and Veterans was compiled. FINDINGS Some of these health risks for both the Korean men and women veterans are cold exposure, neurologic, and posttraumatic stress disorder concerns, as well as the need for hepatitis C and suicide assessments. CONCLUSIONS To ultimately improve their bio-psycho-socio-spiritual well-being, prompt identification of the older military veteran, their lingering combat effects, and reminiscing will be important.
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Affiliation(s)
- Cathy Young
- Texas Christian University.,Texas Tech University Health Sciences Center
| | - Patricia L Conard
- Nursing Consultant, Van Buren, Arkansas.,Texas Tech University Health Sciences Center
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Gouveia CJ, Cramer JD, Liu SYC, Capasso R. Sleep Surgery in the Elderly: Lessons from the National Surgical Quality Improvement Program. Otolaryngol Head Neck Surg 2017; 156:757-764. [PMID: 28195824 DOI: 10.1177/0194599817691475] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Assess the frequency and nature of postoperative complications following sleep surgery. Examine these issues specifically in elderly patients to provide guidance for their perioperative care. Study Design Retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Methods We identified patients with obstructive sleep apnea undergoing sleep surgery procedures from 2006 to 2013 in the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional outcomes program designed to improve surgical quality. We analyzed patients by comparing age groups: <65 and ≥65 years. Summary data were analyzed, and multivariate regression was used to adjust for patient characteristics, comorbidities, and surgical procedure. Results We identified 2230 patients who had sleep surgery, which included 2123 patients <65 years old and 107 patients ≥65 years old. Elderly patients were significantly more likely to have hypertension requiring medication ( P < .001) and higher American Society of Anesthesiologists scores ( P < .001). There were no significant differences in the rates of nasal ( P = .87), palate ( P = .59), tongue base ( P = .73), and multilevel ( P = .95) surgery being performed on both groups of patients. Elderly patients had higher rates of wound complications and urinary tract infections as compared with younger patients. On multivariate analysis, age ≥65 was significantly associated with complications from sleep surgery (odds ratio, 2.35; 95% CI, 1.04-5.35). Conclusion Elderly patients undergoing sleep surgery have increased postoperative complication risk as compared with younger patients treated similarly. This information can help direct quality improvement efforts in the care of older patients.
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Affiliation(s)
- Christopher J Gouveia
- 1 Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - John D Cramer
- 1 Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Stanley Yung-Chuan Liu
- 2 Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California, USA
| | - Robson Capasso
- 2 Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California, USA
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Netzer NC, Ancoli-Israel S, Bliwise DL, Fulda S, Roffe C, Almeida F, Onen H, Onen F, Raschke F, Martinez Garcia MA, Frohnhofen H. Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force. Eur Respir J 2016; 48:992-1018. [DOI: 10.1183/13993003.01975-2015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/03/2016] [Indexed: 12/11/2022]
Abstract
Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulatedviadiscussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group.
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Abstract
KEY POINTS Sleep disordered breathing (SDB) is common and its prevalence increases with age. Despite this high prevalence, SDB is frequently unrecognised and undiagnosed in older people.There is accumulating evidence that SDB in older people is associated with worsening cardio- cerebrovascular, cognitive and functional outcomes.There is now good evidence to support the use of continuous positive airway pressure therapy in older patients with symptomatic SDB. EDUCATIONAL AIMS To highlight the prevalence and presentation of sleep disordered breathing (SDB) in older people.To inform readers about the risk factors for SDB in older people.To explore the impact of SDB in older people.To introduce current evidence based treatment options for SDB in older people. Sleep disordered breathing (SBD) increases in prevalence as we age, most likely due to physiological and physical changes that occur with ageing. Additionally, SDB is associated with comorbidity and its subsequent polypharmacy, which may increase with increasing age. Finally, the increased prevalence of SDB is intrinsically linked to the obesity epidemic. SDB is associated with serious outcomes in younger people and, likewise, older people. Thus, identification, diagnosis and treatment of SDB is important irrelevant of age. This article reviews the age-related changes contributing to SDB, the epidemiology and the risk factors for SDB in older people, the association of SDB with adverse outcomes, and diagnostic and treatment options for this population.
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Affiliation(s)
- Alison McMillan
- Sleep and Respiratory Dept, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Mary J. Morrell
- Academic Unit of Sleep and Ventilation, National Heart and Lung Institute, Imperial College, London, UK
- Respiratory Disease Biomedical Research Unit at the Royal Brompton Hospital and Harefield NHS Foundation Trust, London, UK
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Kim HJ, Lee Y, Sohng KY. The effects of footbath on sleep among the older adults in nursing home: A quasi-experimental study. Complement Ther Med 2016; 26:40-6. [PMID: 27261980 DOI: 10.1016/j.ctim.2016.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/23/2016] [Accepted: 02/12/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To examine the long-term effects of foot-bathing therapy, using different water temperatures, on the sleep quality of older adults living in nursing homes. DESIGN A quasi-experimental study design with non-equivalent control group. SETTINGS Thirty participants were recruited from a nursing home in Gyeong-gi Province, South Korea. INTERVENTIONS The participants were randomly assigned to experimental, placebo, and control groups. The foot-bathing therapy was performed for 30min daily for four weeks. Water at 40°C was used for the experimental group, while water at 36.5°C was used for the placebo group. The control group did not receive any intervention. MAIN OUTCOME MEASURES The participants' sleep patterns (total sleep amount, sleep efficiency, and sleep latency) and sleep-disturbed behaviors were compared based on group, using actigraphy and a sleep disorder inventory. RESULTS The total amount of sleep and sleep efficiency were significantly different for the experimental group, especially those with poor sleep quality. There were no differences in sleep latency or sleep-disturbed behaviors among the groups. The long-term effect of the therapy decreased in the third week of the therapy. CONCLUSIONS Daily, 30-min foot-bathing therapy sessions with water at 40°C were effective in improving sleep quality for older adults. The therapy was more effective for participants with poor sleep quality at baseline assessment than those with relatively good sleep quality. The long-term effects of foot-bathing therapy decreased three weeks after initiation; therefore, it might be desirable to deliver the therapy for two weeks, pause it for a week, and then resume it.
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Affiliation(s)
- Hyun-Joo Kim
- Shineville Seniors Longterm Care Facilities, Gyeong-gi Province, Republic of Korea
| | - Yaelim Lee
- Yeouido St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Kyeong-Yae Sohng
- College of Nursing, The Catholic University of Korea, 222 Banpodaero, Socho-gu, Seoul 137-701, Republic of Korea.
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Yeom HA, Baldwin CM, Lee MA, Kim SJ. Factors affecting mobility in community-dwelling older Koreans with chronic illnesses. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:7-13. [PMID: 25829204 DOI: 10.1016/j.anr.2014.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/21/2014] [Accepted: 09/23/2014] [Indexed: 10/23/2022] Open
Abstract
PURPOSE This descriptive study aims to describe the levels of mobility in community-dwelling older Koreans with chronic illnesses, and to examine the associations of their mobility with sleep patterns, physical activity and physical symptoms including fatigue and pain. METHODS The participants were a total of 384 community-dwelling older adults recruited from three senior centers in Seoul, Korea. Measures included mobility assessed using 6-minute walk test (6MWT), physical activity behavior, sleep profiles, fatigue and pain. Data were collected from July to December 2012. RESULTS The mean 6MWT distance was 212.68 meters. Over 90% of the study participants (n = 373) were classified as having impaired mobility using 400 meters as the cutoff point diagnostic criteria of normal mobility in 6MWT. The 6MWT distance was 246.68 meters for participants in their 60s, 212.32 meters for those in their 70s, and 175.54 meters for those in their 80s. Significant predictors of mobility included younger age, taking mediation, regular physical activity, female gender, higher income, higher fatigue and better perception on sleep duration, which explained 18% of the total variance of mobility. CONCLUSIONS A high-risk group for mobility limitation includes low income, sedentary older men who are at risk for increased fatigue and sleep deficit. Further research should incorporate other psychological and lifestyle factors such as depression, smoking, drinking behavior, and/or obesity into the prediction model of mobility to generate specific intervention strategies for mobility enhancement recommendations for older adults.
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Affiliation(s)
- Hye-A Yeom
- The Catholic University of Korea College of Nursing, South Korea; Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA.
| | - Carol M Baldwin
- Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, USA
| | - Myung-Ah Lee
- The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Su-Jeong Kim
- University of Illinois, College of Nursing, Chicago, IL, USA
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Pa J, Goodson W, Bloch A, King AC, Yaffe K, Barnes DE. Effect of exercise and cognitive activity on self-reported sleep quality in community-dwelling older adults with cognitive complaints: a randomized controlled trial. J Am Geriatr Soc 2015; 62:2319-26. [PMID: 25516028 DOI: 10.1111/jgs.13158] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints. DESIGN Randomized controlled trial. SETTING General community. PARTICIPANTS Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3 ± 6.1; 60% women). INTERVENTION Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks). MEASUREMENTS Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005 to 2006 National Health and Nutrition Examination Survey (range 0-28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods. RESULTS Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (P < .005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arms (all P < .05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (P = .02) and taking sleep medications (P = .004). CONCLUSION Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results.
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Affiliation(s)
- Judy Pa
- Department of Neurology, University of California at San Francisco, San Francisco, California; Department of Neurology, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
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Abstract
Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants.
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Affiliation(s)
- Jaime M. Hughes
- School of Social Work University of North Carolina at Chapel Hill
| | - Jennifer L. Martin
- Geriatric Research, Education, and Clinical Center VA Greater Los Angeles Healthcare System; David Geffen School of Medicine University of California at Los Angeles
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A change in sleep pattern may predict Alzheimer disease. Am J Geriatr Psychiatry 2014; 22:1262-71. [PMID: 23954041 DOI: 10.1016/j.jagp.2013.04.015] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 04/21/2013] [Accepted: 04/22/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Sleep problems may adversely affect neuronal health. We examined a subjective report of change (reduced duration and/or depth) in sleep pattern in relation to subsequent risk of incident all-cause dementia and Alzheimer disease (AD) over 9 years. METHODS This longitudinal study used data from a population-based sample of 214 Swedish adults aged 75 and over who were dementia-free both at baseline and at first follow-up (3 years later). The sample was 80% female and, on average, 83.4 years of age at baseline. All participants underwent a thorough clinical examination to ascertain all-cause dementia and AD. RESULTS Forty percent of participants reported a change in sleep duration at baseline. Between the 6th and 9th year after baseline, 28.5% were diagnosed with all-cause dementia, 22.0% of whom had AD. Reduced sleep was associated with a 75% increased all-cause dementia risk (hazard ratio: 1.75; 95% confidence interval: 1.04-2.93; Wald = 4.55, df = 1, p = 0.035) and double the risk of AD (hazard ratio: 2.01; 95% confidence interval: 1.12-3.61; Wald = 5.47, df = 1, p = 0.019) after adjusting for age, gender, and education. The results remained after adjusting for lifestyle and vascular factors but not after adjusting for depressive symptoms. No evidence supported a moderating effect of the use of sleeping pills, and the sleep-dementia relationship remained after controlling for the presence of the apolipoprotein E ε4 allele. CONCLUSION Self-reported sleep problems may increase the risk for dementia, and depressive symptoms may explain this relationship. Future research should determine whether treatment, in particular, behavioral or nonpharmacologic treatment, may represent one avenue toward reduction of dementia risk in late life.
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Abstract
Maintaining a stable and adequate sleeping pattern is associated with good health and disease prevention. As a restorative process, sleep is important for supporting immune function and aiding the body in healing and recovery. Aging is associated with characteristic changes to sleep quantity and quality, which make it more difficult to adjust sleep–wake rhythms to changing environmental conditions. Sleep disturbance and abnormal sleep–wake cycles are commonly reported in seriously ill older patients in the intensive care unit (ICU). A combination of intrinsic and extrinsic factors appears to contribute to these disruptions. Little is known regarding the effect that sleep disturbance has on health status in the oldest of old (80+), a group, who with diminishing physiological reserve and increasing prevalence of frailty, is at a greater risk of adverse health outcomes, such as cognitive decline and mortality. Here we review how sleep is altered in the ICU, with particular attention to older patients, especially those aged ≥80 years. Further work is required to understand what impact sleep disturbance has on frailty levels and poor outcomes in older critically ill patients.
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Affiliation(s)
- Roxanne Sterniczuk
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada ; Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Benjamin Rusak
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada ; Department of Psychiatry, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
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Hägg M, Houston B, Elmståhl S, Ekström H, Wann-Hansson C. Sleep quality, use of hypnotics and sleeping habits in different age-groups among older people. Scand J Caring Sci 2014; 28:842-51. [DOI: 10.1111/scs.12119] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Miriam Hägg
- Department of Care Science; Faculty of Health and Society; Malmö University; Malmö Sweden
| | - Britta Houston
- Department of Care Science; Faculty of Health and Society; Malmö University; Malmö Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine; Department of Health Sciences; Lund University; Malmö Sweden
| | - Henrik Ekström
- Division of Geriatric Medicine; Department of Health Sciences; Lund University; Malmö Sweden
| | - Christine Wann-Hansson
- Department of Care Science; Faculty of Health and Society; Malmö University; Malmö Sweden
- The Swedish Institute of Health Sciences (Vårdalinstitutet); Lund University; Lund Sweden
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50
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Cribbet MR, Carlisle M, Cawthon RM, Uchino BN, Williams PG, Smith TW, Gunn HE, Light KC. Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults. Sleep 2014; 37:65-70. [PMID: 24470696 DOI: 10.5665/sleep.3308] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
STUDY OBJECTIVES To examine whether subjective sleep quality and sleep duration moderate the association between age and telomere length (TL). DESIGN Participants completed a demographic and sleep quality questionnaire, followed by a blood draw. SETTING Social Neuroscience Laboratory. PARTICIPANTS One hundred fifty-four middle-aged to older adults (age 45-77 y) participated. Participants were excluded if they were on immunosuppressive treatment and/or had a disease with a clear immunologic (e.g., cancer) component. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and TL was determined using peripheral blood mononuclear cells (PBMCs). There was a significant first-order negative association between age and TL. Age was also negatively associated with the self-reported sleep quality item and sleep duration component of the PSQI. A significant age × self-reported sleep quality interaction revealed that age was more strongly related to TL among poor sleepers, and that good sleep quality attenuated the association between age and TL. Moreover, adequate subjective sleep duration among older adults (i.e. greater than 7 h per night) was associated with TL comparable to that in middle-aged adults, whereas sleep duration was unrelated to TL for the middle-aged adults in our study. CONCLUSIONS The current study provides evidence for an association between sleep quality, sleep duration, and cellular aging. Among older adults, better subjective sleep quality was associated with the extent of cellular aging, suggesting that sleep duration and sleep quality may be added to a growing list of modifiable behaviors associated with the adverse effects of aging.
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Affiliation(s)
- Matthew R Cribbet
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - McKenzie Carlisle
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - Richard M Cawthon
- Department of Human Genetics, University of Utah, Salt Lake City, UT
| | - Bert N Uchino
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - Paula G Williams
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - Timothy W Smith
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - Heather E Gunn
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT
| | - Kathleen C Light
- Department of Anesthesiology, University of Utah, Salt Lake City, UT
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