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Deng Z, Hu Y, Duan L, Buyang Z, Huang Q, Fu X, Luo H, Hou T. Causality between sleep traits and the risk of frailty: a Mendelian randomization study. Front Public Health 2024; 12:1381482. [PMID: 38784581 PMCID: PMC11112029 DOI: 10.3389/fpubh.2024.1381482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Background Research based on observation has demonstrated a relationship between sleep traits and frailty; however, it remains uncertain if this correlation indicates causation. The purpose of this study was to look at the causal relationship that exists between frailty and sleep traits. Method Using summaries from a genome-wide association study of self-reported sleep features and frailty index, we performed a bidirectional Mendelian randomization (MR) analysis. Examining the causal relationships between seven sleep-related traits and frailty was the goal. The major method used to calculate effect estimates was the inverse-variance weighted method, supplemented by the weighted median and MR-Egger approaches. The study investigated pleiotropy and heterogeneity using several methodologies, such as the MR-Egger intercept, the MR-PRESSO approach, and the Cochran's Q test. We took multivariate Mendelian randomization and genetic correlations between related traits to enhance the confidence of the results. Furthermore, we used MRlap to correct for any estimation bias due to sample overlap. Results Insomnia, napping during the day, and sleep apnea syndrome exhibited a positive connection with the frailty index in forward MR analysis. Conversely, there is a negative link between getting up in the morning, snoring and sleep duration with the frailty index. During the reverse MR analysis, the frailty index exhibited a positive correlation with insomnia, napping during the day, and sleep apnea syndrome, while demonstrating a negative correlation with sleep duration. There was no direct correlation between snoring, chronotype, and frailty. In MVMR analyses, the causal effect of sleep characteristics on frailty indices remained consistent after adjusting for potential confounders including BMI, smoking, and triglycerides. Conclusion The findings of our investigation yield novel evidence that substantiates the notion of a bidirectional causal connection between sleep traits and frailty. Through the optimization of sleep, it is potentially feasible to hinder, postpone, or even reverse the state of frailty, and we proposed relevant interventions.
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Affiliation(s)
- Zhen Deng
- Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yifan Hu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lincheng Duan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ziding Buyang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Huang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuedan Fu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hong Luo
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianshu Hou
- Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, China
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Zhang Y, Li X, Zheng J, Miao Y, Tan J, Zhang Q. Association of daytime napping and nighttime sleep with all-cause mortality: A prospective cohort study of China Health and Retirement Longitudinal Study. Sleep Med 2024; 115:14-20. [PMID: 38301491 DOI: 10.1016/j.sleep.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 02/03/2024]
Abstract
STUDY OBJECTIVES The correlation of daytime napping and nighttime sleep duration on mortality was inconsistent. We aimed to explore their separate links to all-cause/premature mortality, and evaluate their combined impact on all-cause mortality risk. METHODS All of 20617 (mean age: 56.90 ± 10.19, 52.18 % females) participants from China Health and Retirement Longitudinal Study were followed for a median of 7 years (interquartile range: 4-7) to detect death status. Baseline self-reported napping and sleep duration was categorized: napping as none, <60 min, 60-90 min, and ≥90 min, sleep as <6 h/night, 6-8 h/night, and ≥8 h/night. Death event was tracked, and premature death was defined using 2015 China's average life expectancy (73.64 years for men, and 79.43 years for women). Cox regression models analyzed the data. RESULTS During follow-up, 1621 participants (7.86 %) died, including 985 (4.78 %) premature deaths. Compared to none nappers, napping ≥90 min associated with a higher risk of all-cause mortality (Hazard ratio, [HR] 1.23, 95 % confidence interval [CI] 1.06-1.42) and premature mortality (HR 1.23, 95 % CI 1.02-1.49), while napping <60 min correlated with a lower risk of premature mortality (HR 0.71, 95 % CI 0.54-0.95), after adjustment. Compared to sleep 6-8 h/night, nighttime sleep ≥8 h was associated with an increased risk of all-cause mortality (HR 1.20, 95 % CI 1.04-1.37) and premature mortality (HR 1.28, 95 % CI 1.08-1.52). Participants napping ≥90 min and sleeping ≥8 h had a multi-adjusted HR (95%CI) of 1.50 (95 % CI 1.17-1.92) for all-cause mortality, versus no napping and 6-8 h/night sleep. CONCLUSIONS Prolonged napping and extended nighttime sleep linked to increased mortality risk, particularly in combination. Optimizing sleep patterns may have potential implication in mortality prevention.
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Affiliation(s)
- Yiting Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Xuerui Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Jun Zheng
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Yuyang Miao
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Jin Tan
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China.
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Sharma SD, Cook MJ, Antonio L, Gielen E, Bartfai G, Casanueva FF, Huhtaniemi IT, Maggi M, Punab M, Rastrelli G, Slowikowska-Hilczer J, Tournoy J, Vanderschueren D, Wu FC, O'Neill TW. Does testosterone influence the association between sleep and frailty in men: results from the European Male Aging Study. BMC Geriatr 2023; 23:813. [PMID: 38057724 PMCID: PMC10702097 DOI: 10.1186/s12877-023-04450-8] [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: 12/29/2022] [Accepted: 11/01/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Previous studies have suggested an association between sleep disturbance and frailty. The mechanism is unknown, although it has been suggested that hormonal factors may play a role. METHODS The aim was to determine the association between sleep duration, sleep quality and frailty, and to determine whether testosterone influenced this association. Males aged 40-79 years were recruited from eight European centres to the European Male Aging Study (EMAS). Subjects completed an interviewer-assisted questionnaire including questions regarding sleep quality and duration. Sleep quality was scored 0-20 and categorised as 0-4, 5-9, 10-14, and 15-20, with higher scores indicating poorer quality. A 39-component frailty index (FI) was constructed. Total testosterone levels were measured. The association between sleep duration, sleep quality and the FI was assessed using negative binomial regression, with adjustment for putative confounders including testosterone level. RESULTS Two thousand three hundred ninety-three participants contributed data to the analysis. The mean age was 63.3 years and mean sleep duration was 7.01 h. The mean frailty index was 0.15. Mean testosterone levels declined with decreasing sleep quality. After adjustment, compared to those with a sleep score of 0-4, the FI was 57% (95% CI 38%, 78%) higher among those with a sleep score of 15-20. After adjustment compared to those with normal sleep duration (6-9 h), those with a short (< 6 h) and long (≥ 9 h) sleep duration had a 16% (95% CI 6%, 28%) and 11% (95% CI 0%, 23%) higher FI, respectively. Adjustment for testosterone did not influence the strength of either association. CONCLUSION Frailty is associated with impaired sleep quality and sleep duration. The association cannot, however, be explained by variation in testosterone levels.
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Affiliation(s)
- Seema D Sharma
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK.
| | - Michael J Cook
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK
| | - Leen Antonio
- Department of Clinical and Experimental Medicine, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Louvain, Belgium
- Department of Endocrinology, University Hospitals Leuven, Louvain, Belgium
| | - Evelien Gielen
- Centre for Metabolic Bone Diseases, Department of Geriatrics, University Hospitals Leuven, Louvain, Belgium
| | - Gyorgy Bartfai
- Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary
| | - Felipe F Casanueva
- Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), Instituto Salud Carlos III, CB06/03, Santiago de Compostela, Spain
| | - Ilpo T Huhtaniemi
- Institute of Reproductive and Developmental, Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, London, UK
| | - Mario Maggi
- Andrology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Margus Punab
- Andrology Clinic, Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Giulia Rastrelli
- Andrology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - Jos Tournoy
- Department of Geriatrics, University Hospitals Leuven, Louvain, Belgium
- Department of Public Health and Primary Care, KU Leuven, Louvain, Belgium
| | - Dirk Vanderschueren
- Department of Clinical and Experimental Medicine, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Louvain, Belgium
- Department of Endocrinology, University Hospitals Leuven, Louvain, Belgium
| | - Frederick C Wu
- Department of Endocrinology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
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Zhang Y, Zhou L, Ge M, Lin X, Dong B. Association between daytime nap duration and risks of frailty: Findings from the China Health and Retirement Longitudinal Study. Front Public Health 2023; 10:1098609. [PMID: 36777767 PMCID: PMC9911424 DOI: 10.3389/fpubh.2022.1098609] [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: 11/15/2022] [Accepted: 12/28/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction Night sleep duration and total sleep duration are associated with frailty. However, the association between daytime nap duration and the risks of frailty has not been explored thoroughly. Methods This study used data from the China Health and Retirement Longitudinal Study (CHARLS). Participants aged 60 years and older at baseline were included in this study. Individuals with daytime nap duration were categorized into four groups: no napping, short napping (< 30 min), moderate napping (30-89 min), and extended napping (≥90 min). Frailty was assessed using a modified Physical Frailty Phenotype (PFP) scale. Non-frail participants at baseline were followed up for 4 years. The association between nap duration and risks of frailty at baseline and incident frailty was evaluated by logistic regression and discrete-time Cox regression analyses, respectively. Results In total, 5,126 participants were included in this study. For individuals with night sleep duration of ≥9 h, short nappers showed higher odds [odds ratio (OR) = 4.08, 95% confidence interval (CI): 1.30-12.78] for frailty compared with non-habitual nappers at baseline, while moderate nappers were less likely to be frail (OR = 0.18, 95% CI: 0.04-0.73). In the follow-up study, short nappers showed higher risks for frailty compared with participants of the no napping group with night sleep duration of < 6 h [hazard ratio (HR) = 1.91, 95% CI: 1.07-3.43] or 6-9 h (HR = 1.97, 95% CI: 1.18-3.30). Compared with short nappers, older adults with extended napping (HR = 0.41, 95% CI: 0.22-0.77) showed lower risks for frailty in those with night sleep duration of 6-9 h. For individuals with night sleep duration of ≥9 h, moderate napping (HR = 0.20, 95% CI: 0.05-0.77) decreased the risks for frailty compared with short napping. Conclusion Among older adults with night sleep duration of < 9 h, short nappers posed higher risks for frailty compared with non-habitual nappers. Extended naps for those with a night sleep duration of 6-9 h or moderate naps for those with night sleep duration of ≥9 h could lower the risk of frailty compared with short naps. Future studies on the timing, purpose, frequency, and quality of daytime napping and objectively measured nap duration are needed to explore the association between daytime napping and risks of frailty.
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Affiliation(s)
- Yan Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lixing Zhou
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meiling Ge
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiufang Lin
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Birong Dong
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Birong Dong ✉
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Mizuno T, Godai K, Kabayama M, Akasaka H, Kido M, Isaka M, Kubo M, Gondo Y, Ogawa M, Ikebe K, Masui Y, Arai Y, Ishizaki T, Rakugi H, Kamide K. Age Group Differences in the Association Between Sleep Status and Frailty Among Community-Dwelling Older Adults: The SONIC Study. Gerontol Geriatr Med 2023; 9:23337214231205432. [PMID: 37842342 PMCID: PMC10576426 DOI: 10.1177/23337214231205432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Objective: We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. Method: This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6-8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. Results: In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. Conclusions: The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.
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Affiliation(s)
- Toshiki Mizuno
- Osaka University Graduate School of Medicine, Japan
- Osaka Yukioka College of Health Science, Japan
| | - Kayo Godai
- Osaka University Graduate School of Medicine, Japan
| | - Mai Kabayama
- Osaka University Graduate School of Medicine, Japan
| | | | - Michiko Kido
- Osaka University Graduate School of Medicine, Japan
| | - Masaaki Isaka
- Osaka University Graduate School of Medicine, Japan
- Osaka Yukioka College of Health Science, Japan
| | - Mio Kubo
- Osaka University Graduate School of Medicine, Japan
| | - Yasuyuki Gondo
- Osaka University Graduate School of Human Sciences, Japan
| | - Madoka Ogawa
- Osaka University Graduate School of Human Sciences, Japan
| | | | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, Japan
| | | | | | | | - Kei Kamide
- Osaka University Graduate School of Medicine, Japan
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Relationships between Inflammation and Age-Related Neurocognitive Changes. Int J Mol Sci 2022; 23:ijms232012573. [PMID: 36293430 PMCID: PMC9604276 DOI: 10.3390/ijms232012573] [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: 06/21/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
The relationship between inflammation and age-related neurocognitive changes is significant, which may relate to the age-related immune dysfunctions characterized by the senescence of immune cells and elevated inflammatory markers in the peripheral circulation and the central nervous system. In this review, we discuss the potential mechanisms, including the development of vascular inflammation, neuroinflammation, organelle dysfunctions, abnormal cholesterol metabolism, and glymphatic dysfunctions as well as the role that the key molecules play in the immune-cognition interplay. We propose potential therapeutic pharmacological and behavioral strategies for ameliorating age-related neurocognitive changes associated with inflammation. Further research to decipher the multidimensional roles of chronic inflammation in normal and pathological aging processes will help unfold the pathophysiological mechanisms underpinning neurocognitive disorders. The insight gained will lay the path for developing cost-effective preventative measures and the buffering or delaying of age-related neurocognitive decline.
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