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Zhu C, Sun J, Huang Y, Lian Z. Sleep and risk of hip fracture and falls among middle-aged and older Chinese. Sci Rep 2024; 14:23273. [PMID: 39375471 PMCID: PMC11458578 DOI: 10.1038/s41598-024-74581-4] [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: 04/28/2024] [Accepted: 09/27/2024] [Indexed: 10/09/2024] Open
Abstract
The study aimed to assess the prospective associations between sleep duration, sleep restfulness, midday napping and hip fracture (HF) and falls in a nationally representative Chinese population. Data were from the China Health and Retirement Longitudinal Study which was conducted from 2013 to 2018. In total, 10,508 individuals without a history of HF in 2013 were included. Nighttime sleep duration, sleep restfulness and midday napping were self-reported. Logistic regression analyses were performed to examine the relationships between sleep problems and HF as well as falls, adjusting for covariates. A total of 313 (3.0%) participants reported HF, and 3899 (37.1%) experienced at least one fall event over the following 5-year period. Participants who had a short sleep duration (≤ 6) were more likely to report HF (OR = 1.27, 95% CI = 1.00-1.62) and falls (OR = 1.18, 95% CI = 1.07-1.30) than those who had a normal sleep duration (6-9 h) in the fully adjusted model. Participants having unrestful sleep were also more likely to report falls (OR = 1.23, 95% CI = 1.11-1.36) than those who had restful sleep. However, there was no significant association between midday napping and HF and falls. In conclusion, short sleep duration and sleep restfulness were independently associated with an increased risk of HF and falls, which may have important clinical and public health implications. Interventions to improve sleep quality may reduce the risk of HF and fall accidents among middle-aged and older people.
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Affiliation(s)
- Chunsu Zhu
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
- Fujian Key Laboratory of Advanced Technology for Cancer Screening and Early Diagnosis, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Jing Sun
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
| | - Yongying Huang
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
| | - Zhiwei Lian
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China.
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Coundouris SP, Henry JD, Oestreich LKL. Multidimensional frailty and sleep quality in late adulthood: A UK biobank examination. J Sleep Res 2024:e14359. [PMID: 39313314 DOI: 10.1111/jsr.14359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/25/2024] [Accepted: 09/10/2024] [Indexed: 09/25/2024]
Abstract
Frailty and sleep disturbances are two major concerns in late adulthood, that not only profoundly threaten health and wellbeing at the individual level but place enormous demands on our healthcare systems. Given that both constructs represent dynamic states that are preventable and reversible, understanding the potential pathways to and effects of these variables on one another is critical in providing effective and tailored support. However, despite growing interest in the relationship between sleep and frailty, only one study to date has directly explored their potential bidirectionality. Accordingly, this study was designed to extend the current understanding by investigating the reciprocal relationship of frailty and sleep quality at the multidimensional level. Specifically, the bidirectionality of these relationships was considered separately for physical, psychological, cognitive, and social frailty. Four random-intercept cross-lagged panel models with three time points were conducted, using 3192 older adults (Mage = 60.21; 46.37% female at baseline) from the UK Biobank. The results revealed that while physical, psychological, and cognitive frailty were neither predictive of, nor predicted by, sleep quality, social frailty and sleep share a reciprocal relationship. These data therefore offer important preliminary evidence for the efficacy of early intervention and prevention strategies aimed at enhancing sleep quality to reduce social frailty, and vice versa.
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Affiliation(s)
- Sarah P Coundouris
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Lena K L Oestreich
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Advanced Imaging and Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Queensland, Australia
- National Imaging Facility, The University of Queensland, Brisbane, Queensland, Australia
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Ding X, Qi LX, Sun DY. Differences in insomnia-related self-reported outcomes among elderly hospitalized patients. World J Psychiatry 2024; 14:686-694. [PMID: 38808082 PMCID: PMC11129157 DOI: 10.5498/wjp.v14.i5.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/20/2024] [Accepted: 03/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Insomnia is among the most common sleep disorders worldwide. Insomnia in older adults is a social and public health problem. Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses. Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues. AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients. METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study. Self-reported symptoms were assessed using the Athens Insomnia Scale (AIS), Generalized Anxiety Disorder Scale-7 (GAD-7), Geriatric Depression Scale-15 (GDS-15), Memorial University of Newfoundland Scale of Happiness (MUNSH), Barthel Index Evaluation (BI), Morse Fall Scale (MFS), Mini-Mental State Examination, and the Short Form 36 Health Survey Questionnaire (SF-36). Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms. Effects of insomnia was analyzed using Logistic regression analysis. RESULTS Nineteen patients with AIS ≥ 6 were included in the insomnia group, and the incidence of insomnia was 19% (19/100). The remaining 81 patients were assigned to the non-insomnia group. There were significant differences between the two groups in the GDA-7, GDS-15, MUNSH, BI, MFS, and SF-36 items (P < 0.05). Patients in the insomnia group were more likely to experience anxiety, depression, and other mental illnesses, as well as difficulties with everyday tasks and a greater risk of falling (P < 0.05). Subjective well-being and quality of life were poorer in the insomnia group than in the control group. The AIS scores positively correlated with the GAD-7, GDS-15, and MFS scores in elderly hospitalized patients with insomnia (P < 0.05). Logistic regression analysis showed that GDS-15 ≥ 5 was an independent risk factor for insomnia in elderly hospitalized patients (P < 0.05). CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia. Therefore, we should focus on the main complaints of patients to meet their care needs.
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Affiliation(s)
- Xia Ding
- Department of Gangzha General Medical Center, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Ling-Xia Qi
- Department of Anesthesiology and Surgery, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Dong-Yun Sun
- Department of Ophthalmic Surgery Room, The Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
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Kato M, Ozaki E, Omichi C, Kurita Y, Nakano S, Takagi D, Kuriyama N, Koyama T. Association between poor sleep quality and locomotive syndrome in middle-aged and older women: A community-based, cross-sectional study. Mod Rheumatol 2024; 34:414-421. [PMID: 36919986 DOI: 10.1093/mr/road025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Poor sleep quality, such as nocturnal arousal and sleep inefficiency, is associated with frailty and sarcopenia. Herein, we evaluated the relationship between poor sleep quality and locomotive syndrome (LS), a motor organ dysfunction common among community-dwelling middle-aged and older women. METHODS Participants comprised 2246 Japanese middle-aged and older women. LS was classified into stages LS-1, LS-2, and LS-3 (from least to most severe) according to the results of the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. RESULTS The Pittsburgh Sleep Quality Index scores were significantly higher in the LS group than that in the non-LS group (P < .001). Multivariate logistic regression analyses adjusted for potential confounders identified poor sleep quality as an independent factor of LS (odds ratio 1.59 [95% confidence interval 1.30-1.93], P < .001). Similar results were observed in the sensitivity analysis in postmenopausal women. LS and trouble sleeping because of pain showed stepwise association in all LS stages. CONCLUSIONS Poor sleep quality was independently associated with LS among community-dwelling middle-aged and older women. As the stage of LS progressed, the proportion of women with poor sleep quality increased significantly.
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Affiliation(s)
- Michitaka Kato
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Omichi
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yasunari Kurita
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Satoko Nakano
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Daisuke Takagi
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Yang S, Wang S, Liu G, Li R, Li X, Chen S, Zhao Y, Liu M, Liu Y, He Y. The relationship between sleep status and activity of daily living: based on China Hainan centenarians cohort study. BMC Geriatr 2023; 23:796. [PMID: 38049752 PMCID: PMC10694970 DOI: 10.1186/s12877-023-04480-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/13/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVE This study, based on the China Hainan Centenarians Cohort Study (CHCCS), aims to comprehensively describe the characteristic of daytime, night and total sleep duration, sleep quality and different sleep mode of Hainan centenarians and their associations with activity of daily living (ADL) functions. METHOD The baseline data of CHCCS was used. ADL function was evaluated the Bathel index, sleep quality was evaluated by Pittsburgh sleep quality index (PSQI), sleep status including daytime, night and total sleep duration as well as sleep quality and sleep mode. Multivariate logistic regression model was used to explore the association between sleep status and ADL disability and ADL moderate & severe disability. RESULTS A total of 994 centenarians were included in this study with the age range 100-116 years old. Compared with the centenarians who sleep 6-9 h at night and < 2 h in the daytime, the adjusted OR between sleep > 9 h at night and sleep ≥ 2 h in the daytime and ADL disability was 2.93 (95% CI: 1.02-8.44), and adjusted OR of ADL moderate & severe disability was 2.75 (95% CI: 1.56-4.83). Compared with centenarians who sleep for 7-9 h and have good sleep quality, centenarians who sleep for > 9 h and have poor sleep quality have an increased risk of ADL moderate & severe disability (OR = 3.72, 95% CI: 1.54-9.00). CONCLUSION Relation between sleep duration and ADL disability was more significant compared with sleep quality in Hainan centenarians. Poor sleep quality can aggravate the relationship between sleep duration and ADL moderate & severe disability.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Guangdong Liu
- Sixth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Rongrong Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Xuehang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Shimin Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Yali Zhao
- Central Laboratory of Hainan Hospital, Chinese People's Liberation Army General Hospital, Sanya, 572013, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
| | - Yunxi Liu
- Department of Disease Prevention and Control, First Medical Center, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
- State Key Laboratory of Kidney Diseases, Beijing, 100853, China.
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Takagi D, Kato M, Ozaki E, Kurita Y, Nakano W, Matsui D, Koyama T. The combination of locomotive syndrome and poor sleep quality is a risk factor of falls among community-dwelling middle-aged and older women: A cross-sectional study. Geriatr Gerontol Int 2023; 23:912-918. [PMID: 37932124 DOI: 10.1111/ggi.14710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 11/08/2023]
Abstract
AIM The combination of locomotive syndrome (LS) and poor sleep quality (PQ) has not yet been shown to result in falls or to affect bone conditions in old age and middle age. [Correction added on 1 December 2023, after first online publication: The preceding sentence has been updated for clarity.] METHODS: This cross-sectional study enrolled 2233 community-dwelling middle-aged to older Japanese women. LS and PSQ were assessed by the stand-up test, two-step test, the 25-question Geriatric Locomotive Function Scale, and the Pittsburgh Sleep Quality Index (PSQI). Participants with both LS 1-3 (any) and a PSQI score ≥6 were classified as belonging to the LS(+)/PSQ(+) group. The incidence of falls in the previous month was collected using a self-administered questionnaire. Bone conditions were evaluated using an ultrasonic bone densitometer. RESULTS The LS(+)/PSQ(+) group independently had a higher risk of falls after adjusting for confounding factors than the LS(-)/PSQ(-) group using multiple logistic regression analysis (odds ratio 1.92, 95% confidence interval 1.01-3.65, P < 0.05). No relationships between LS(-)/PSQ(+) and LS(+)/PSQ(-) groups and the incidences of fall were observed (P > 0.05). [Correction added on 1 December 2023, after first online publication: The two preceding sentences have been corrected to provide greater clarity.] The LS(+)/PSQ(+) group had lower trabecular bone density and cortical bone thickness than the LS(-)/PSQ(-) group (P < 0.05). CONCLUSION The combination of LS and PSQ is an independent risk factor of falls, indicating that assessing both LS and PSQ could be useful in detecting middle-aged and older women with low bone density and thickness who fall easily at an early stage. Geriatr Gerontol Int 2023; 23: 912-918.
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Affiliation(s)
- Daisuke Takagi
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Michitaka Kato
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yasunari Kurita
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Wataru Nakano
- Department of Shizuoka Physical Therapy, Faculty of Health Science, Tokoha University, Shizuoka, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Rozing MP, Wium-Andersen MK, Wium-Andersen IK, Jørgensen TSH, Jørgensen MB, Osler M. Use of hypnotic-sedative medication and risk of falls and fractures in adults: A self-controlled case series study. Acta Psychiatr Scand 2023; 148:394-404. [PMID: 37665682 DOI: 10.1111/acps.13610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To evaluate the risk of falls and fractures in users of benzodiazepines, Z-drugs, or melatonin. METHODS We followed 699,335 adults with a purchase of benzodiazepines, Z-drugs, or melatonin in the Danish National Prescription Registry between 2003 and 2016 for falls and fractures in the Danish National Patient Registry between 2000 and 2018. A self-controlled case-series analysis and conditional Poisson regression were used to derive incidence rate ratios (IRR) of falls and fractures during six predefined periods. RESULTS In total 62,105 and 36,808 adults, respectively, experienced a fall or fracture. For older adults, the risk of falls was highest during the 3-month pre-treatment period (IRRmen+70 , 4.22 (95% confidence interval, 3.53-5.05), IRRwomen + 70 , 3.03 (2.59-3.55)) compared to the baseline (>1 year before initiation). The risk continued to be higher in the later treatment periods. Contrarily, in men and women aged 40-69 years, the risk was only higher in the 3-month pre-treatment period. The incidence of falls among young men and women was slightly lower after initiation of sedating medication (treatment period, IRRmen15-39 , 0.66 (0.50-0.86), IRRwomen15-39 , 0.65 (0.51-0.83)). Analyses with fractures as outcome yielded similar results. CONCLUSIONS Although falls and fractures occur more often in persons using sedative-hypnotic medication, the higher risk of falls and fractures in the pre-treatment period relative to the period directly after treatment, suggests that this association is better explained by other factors that elicited the prescription of this medication rather than the adverse effects of the sedative-hypnotic medication.
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Affiliation(s)
- Maarten Pieter Rozing
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Kim Wium-Andersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
| | - Ida Kim Wium-Andersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
| | - Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Merete Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Nakagawa H, Takeshima T, Ozaka A, Sasaki S, Kurita N, Hamaguchi S, Fukuhara S. Poor Sleep Quality as a Risk Factor for Constipation Among Community-Dwelling Older Adults in Japan. Cureus 2023; 15:e46175. [PMID: 37905294 PMCID: PMC10613326 DOI: 10.7759/cureus.46175] [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] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Background Older adults commonly experience both sleep disturbances and constipation. Pathophysiological mechanisms such as inhibition of colonic peristalsis due to sympathetic activation associated with sleep disturbances have been postulated. Here, we aimed to assess the temporal association between the degree of sleep quality and the incidence of constipation. Methods We conducted a prospective cohort study of independent community-dwelling older adults aged ≥75 years (the Sukagawa Study). Using a self-administered questionnaire inquiring about awareness of own constipation or the use of laxatives in 2019 and 2020, we determined the onset of constipation. The Japanese version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality in 2019. The global PSQI score was divided into quartiles. We analyzed the association between the degree of sleep quality and the incidence of constipation using logistic regression models. Results Overall, 1,696 participants without constipation at baseline were analyzed after 1 year, of whom 823 (48.5%) were male. The mean age of participants was 79.9 years. In total, 191 participants (11.3%) developed constipation. The median (interquartile range; IQR) global PSQI score was 4 (2, 6). According to the quartiles of the global PSQI scores (0-2, 3-4, 5-6, and ≥7), 35 (7.8%), 55 (11.3%), 48 (12.8%), and 53 (13.8%), respectively, developed constipation. Compared to those with global PSQI scores of 0-2, the odds ratios, adjusted by age, sex, smoking status, alcohol status, educational level, working status, exercise, and medical history were 1.57, 1.78, and 2.02 for participants with global PSQI scores of 3-4, 5-6, and ≥7, respectively (p = 0.003 for trend). Conclusions We identified poor sleep quality as a new risk factor for developing constipation in independent, community-dwelling, older adults aged ≥75 years.
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Affiliation(s)
- Hiroaki Nakagawa
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, JPN
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
| | - Taro Takeshima
- Center for University-wide Education, School of Health and Social Services, Saitama Prefectural University, Saitama, JPN
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
| | - Akihiro Ozaka
- Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR) Fukushima Medical University, Shirakawa, JPN
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
| | - Sho Sasaki
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, JPN
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, JPN
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, JPN
| | - Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, JPN
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, JPN
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, JPN
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, USA
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Xiao X, Li L, Yang H, Peng L, Guo C, Cui W, Liu S, Yu R, Zhang X, Zhang M. Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment. Aging Med (Milton) 2023; 6:245-253. [PMID: 37711258 PMCID: PMC10498826 DOI: 10.1002/agm2.12265] [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: 03/29/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
Objective To investigate the incidence of falls in elderly aged 65 years and above among outpatients and inpatients, and to analyze its related factors and identify prevention strategies. Methods A retrospective analysis was conducted on 451 patients aged 65 years and above who received comprehensive geriatric assessment in outpatients and inpatients from the Department of Geriatrics in the Second Xiangya Hospital from March 2021 to March 2022. According to whether there had been at least one fall in the past year, the patients were divided into a fall group and a non-fall group. Data were collected from the We-Chat applet of comprehensive geriatric assessment. A t test and chi-square test were performed to compare the difference between the two groups. Logistic regression analysis was then conducted to identify factors associated with falls. Results (1) The incidence of falls among the outpatient and inpatient was 28.8%. (2) The rate of light, moderate, and heavy dependence on daily living ability and decreased mobile balance ability were higher in the fall group than those in the non-fall group. The average calf circumference in the fall group was significantly lower than that in the non-fall group. (3) The prevalence of diabetes and eye diseases in the fall group was significantly higher than that in the non-fall group. (4) The percentage of insomnia and suspicious insomnia cases in the fall group was higher than that in the non-fall group. The mean scores for dysphagia, frailty, and incontinence were higher and the mean malnutrition score was lower in the fall group than in the non-fall group. (5) Multiple logistic regression analysis showed that frailty, insomnia, and malnutrition were independent influencing factors of fall (OR = 1.955, 1.652, 10.719, P = 0.044, 0.041, 0.025, respectively). Conclusions The incidence of falls among outpatients and inpatients aged 65 years and above is high. Frailty, insomnia, and malnutrition are the main factors influencing falls in these patients.
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Affiliation(s)
- Xun Xiao
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Ling Li
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Huijuan Yang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Lei Peng
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Chunbo Guo
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Wei Cui
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Shunying Liu
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Renhe Yu
- College of Public HealthCentral South UniversityChangshaChina
| | - Xiangyu Zhang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
- Hunan Clinical Medical Research Center for Geriatric SyndromeChangshaChina
| | - Mengxi Zhang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
- Hunan Clinical Medical Research Center for Geriatric SyndromeChangshaChina
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Baugh AD, Acho M, Arhin A, Barjaktarevic I, Couper D, Criner G, Han M, Hansel N, Krishnan J, Malcolm K, Namen A, Peters S, Schotland H, Sowho M, Zeidler M, Woodruff P, Thakur N. African American race is associated with worse sleep quality in heavy smokers. J Clin Sleep Med 2023; 19:1523-1532. [PMID: 37128722 PMCID: PMC10394362 DOI: 10.5664/jcsm.10624] [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: 01/03/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
STUDY OBJECTIVES To examine the association of self-identified race with sleep quality in heavy smokers. METHODS We studied baseline data from 1965 non-Hispanic White and 462 African American participants from SPIROMICS with ≥ 20 pack-years smoking history. We first examined the Pittsburgh Sleep Quality Index's (PSQI) internal consistency and item-total correlation in a population with chronic obstructive pulmonary disease. We then used staged multivariable regression to investigate the association of race and sleep quality as measured by the PSQI) The first model included demographics, the second added measures of health status, and the third, indicators of socioeconomic status. We next explored the correlation between sleep quality with 6-minute walk distance and St. George's Respiratory Questionnaire score as chronic obstructive pulmonary disease-relevant outcomes. We tested for interactions between self-identified race and the most important determinants of sleep quality in our conceptual model. RESULTS We found that the PSQI had good internal consistency and item-total correlation in our study population of heavy smokers with and without chronic obstructive pulmonary disease. African American race was associated with increased PSQI in univariable analysis and after adjustment for demographics, health status, and socioenvironmental exposures (P = .02; 0.44 95%CI: .06 to .83). Increased PSQI was associated with higher postbronchodilator forced expiratory volume in 1 second and lower household income, higher depressive symptoms, and female sex. We identified an interaction wherein depressive symptoms had a greater impact on PSQI score for non-Hispanic White than African American participants (P for interaction = .01). CONCLUSIONS In heavy smokers, self-reported African American race is independently associated with worse sleep quality. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Study of COPD Subgroups and Biomarkers (SPIROMICS); URL: https://clinicaltrials.gov/ct2/show/NCT01969344; Identifier: NCT01969344. CITATION Baugh AD, Acho M, Arhin A, et al. African American race is associated with worse sleep quality in heavy smokers. J Clin Sleep Med. 2023;19(8):1523-1532.
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Affiliation(s)
- Aaron D. Baugh
- University of California San Francisco, San Francisco, California
| | - Megan Acho
- University of Michigan, Ann Arbor, Michigan
| | | | - Igor Barjaktarevic
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - David Couper
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Gerard Criner
- Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Meilan Han
- University of Michigan, Ann Arbor, Michigan
| | | | | | | | - Andrew Namen
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Stephen Peters
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Michelle Zeidler
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | | | - Neeta Thakur
- University of California San Francisco, San Francisco, California
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11
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Olatunde K, Patton S. Association Between Insomnia and Healthcare Utilization: A Scoping Review of the Literature. Am J Lifestyle Med 2023. [DOI: 10.1177/15598276231164953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Insomnia is a sleep disorder that affects significant portion of the population. It can result in adverse health outcomes and increased healthcare utilization. The purpose of this review was to identify existing research on the association between insomnia and healthcare utilization. A five-stage scoping review process was conducted guided by the Joanna Briggs Institute process. Data sources searched through 2022 were PubMed, HINARI, Google Scholar and Cochrane, with additional studies identified through hand searching. Descriptive and exploratory analyses were conducted from the findings of the selected studies. After reviewing 124 references, 23 studies were selected. A strong and positive association between insomnia and healthcare utilization and healthcare costs was identified. We also found that insomnia was associated with absenteeism from work, lower work performance ratings, disability, difficulties in daily activities, and life dissatisfaction. An unexpected theme that emerged from the included studies is that there is a large population with persistent insomnia who do not seek help that could benefit from improved management. Findings suggest that identifying and managing insomnia could result in a decrease in healthcare utilization and costs. Further research is needed to determine the most effective methods of identifying and managing insomnia.
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Affiliation(s)
- Kolade Olatunde
- Department of Public Policy/Health Policy, University of Arkansas, Fayetteville, AR, USA
| | - Susan Patton
- Department of Nursing, University of Arkansas, Fayetteville, AR, USA
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12
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Ganidagli S, Ozturk E, Ozturk ZA. Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment. Curr Med Res Opin 2023; 39:701-706. [PMID: 36927301 DOI: 10.1080/03007995.2023.2192124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults. METHODS The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). The Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA), and Mini Nutritional Assessment (MNA) were performed on the participants. RESULTS Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA, and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -.207, p = .01), EQ-5D index (r = -.372, p = .00), MNA (r = -.277, p = .00), and TBGA (r = -.263, p = .41) scores and a positive correlation with GDS (r = .426, p = .00) and BAI (r = .450, p = .00) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = .48, OR = 1.92; p = .20, OR = 1.11; and p <.01, OR = 1.11, respectively)]. CONCLUSIONS We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality-of-life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.
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Affiliation(s)
- Sencer Ganidagli
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Ercument Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Zeynel Abidin Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
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Tao Z, Feng Y, Liu J, Tao L. Trends and disparities in sleep quality and duration in older adults in China from 2008 to 2018: A national observational study. Front Public Health 2023; 11:998699. [PMID: 36875376 PMCID: PMC9982158 DOI: 10.3389/fpubh.2023.998699] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Background Poor sleep status as a common concern is a risk factor for many health problems among older people. China with an aging society lacks relevant nationwide data on the sleep status among older people. Therefore, the purpose of this study was to investigate trends and disparities in sleep quality and duration among older adults, and exploring influencing factors of poor sleep in China between 2008 and 2018. Method We used the four-waves data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Sleep quality and average sleep hours per day was investigated by using questionnaires in the CLHLS. We categorized sleep duration as three groups including ≤5 h (short duration), 5-9 h (normal duration), or ≥9 h (long duration) per day. Multivariate logistic regression models were used to examine trends and risk factors of poor sleep quality, short sleep duration, and long sleep duration. Results The prevalence of poor sleep quality significantly increased from 34.87% in 2008 to 47.67% in 2018 (p < 0.05). Short sleep duration significantly increased from 5.29 to 8.37%, whereas long sleep duration decreased from 28.77 to 19.27%. Multivariate analysis showed that female sex, poor economic status, a greater number of chronic diseases, underweight, poor self-reported quality of life, and poor self-reported health were associated with poor sleep quality and short sleep duration (p < 0.05). Conclusion Our findings revealed that older adults had increased prevalence of poor sleep quality and short sleep duration from 2008 to 2018. More attention should be paid to the increased sleep problems among older adults and early interventions should be made to improve sleep quality and guarantee enough sleep time.
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Affiliation(s)
- Zihao Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,School of Basic Medical Sciences, Peking University, Beijing, China
| | - Yuting Feng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Medical Examination Centre, Peking University Third Hospital, Beijing, China
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14
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Gordon NP, Yao JH, Brickner LA, Lo JC. Prevalence of sleep-related problems and risks in a community-dwelling older adult population: a cross-sectional survey-based study. BMC Public Health 2022; 22:2045. [PMID: 36348296 PMCID: PMC9644466 DOI: 10.1186/s12889-022-14443-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
Background Despite evidence of adverse health consequences of inadequate restorative sleep for older adults, assessment of sleep quantity, quality, and use of sleep aids is not routinely done. We aimed to characterize sleep problems, sleep risks, and advice received about sleep in a community-dwelling older adult population, overall and in subgroups with health conditions and functional difficulties. Methods This cross-sectional study used weighted self-report data for 5074 Kaiser Permanente Northern California members aged 65-79y who responded to a 2017 or 2020 Member Health Survey. We estimated usual amount of sleep (< 6, 6 to < 7, ≥7 hours) and prevalence of sleep problems (frequent insomnia, frequent daytime fatigue, poor quality sleep, and potential sleep apnea (OSA) symptoms (frequent very loud snoring, apnea episodes)) for older adults overall, by self-rated health, and in subgroups reporting hypertension, diabetes, heart disease, frequent problems with balance/walking, and frequent memory problems. We also estimated percentages who regularly used sleep aids and had discussed sleep adequacy with a healthcare professional in the past year. Results Approximately 30% of older adults usually got less than the recommended ≥7 hours sleep per day, and 9% experienced frequent daytime fatigue, 13% frequent insomnia, 18% frequent insomnia/poor quality sleep, and 8% potential OSA symptoms. Prevalence of frequent insomnia was higher among women than men (16% vs. 11%). Higher percentages of those in fair/poor health and those with frequent balance/walking and memory problems reported sleeping < 6 hours per day and having all four types of sleep problems. Nearly 20% of all older adults (22% of women vs. 17% of men) and 45% of those with frequent insomnia (no sex difference) reported regular sleep aid use. Only 10% of older adults reported discussing sleep with a healthcare professional whereas > 20% reported discussing diet and exercise. Conclusions Large percentages of older adults experience sleep problems or get less sleep than recommended for optimal sleep health. Older patients should routinely be assessed on multiple components of sleep health (sleep hygiene, quantity, quality, problems, and sleep aid use) and educated about sleep hygiene and the importance of getting adequate restorative sleep for their overall health and wellbeing.
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15
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Mizuno T, Isaka M, Kuramoto T, Inoue T, Kamide K. [The relationship between physical activity and sleep status among older adults requiring nursing care in the community]. Nihon Ronen Igakkai Zasshi 2022; 59:528-535. [PMID: 36476701 DOI: 10.3143/geriatrics.59.528] [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: 12/12/2022]
Abstract
AIM We investigated the relationship between physical activity and sleep status among older adults requiring nursing care in the community. METHOD We included 45 participants ≥65 years old (33 females; mean age, 83.2±4.4 years old) requiring nursing care. Physical activity was evaluated using the Life Space Assessment (LSA), and sleep status was measured by the Pittsburg Sleep Quality Index (PSQI) to determine the total sleep time, sleep efficiency, and PSQI total score. The physical function was measured by the timed up and go test (TUG) and grip strength. We performed a multiple regression analysis with the LSA as the dependent variable and sleep indicators (total sleep time, sleep efficiency, PSQI total score) and TUG as independent variables (demonstrating significant correlations with the LSA), and gender and age as adjusted variables. The analysis was divided into sleep time (Model 1), sleep efficiency (Model 2), and PSQI total score (Model 3). We used R commander, and < 0.05 was considered statistically significant. RESULTS TUG (β=-0.375) and sleep time (β=0.383) in Model 1, TUG (β=-0.368) and sleep efficiency (β=0.570) in Model 2, and TUG (β=-0.392) and PSQI total score (β=-0.590) in Model 3 were independently selected as significant variables. CONCLUSION In addition to TUG, sleep status, such as the sleep duration and sleep quality, was shown to be related to physical activity in older adults who require nursing care. To improve physical activity, it is necessary to consider not only the physical function but also quantitative and qualitative assessments of sleep.
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Affiliation(s)
- Toshiki Mizuno
- Department of Physical Therapy, Osaka Yukioka College of Health Science.,Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Masaaki Isaka
- Department of Physical Therapy, Osaka Yukioka College of Health Science.,Division of Health Sciences, Osaka University Graduate School of Medicine
| | | | | | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine
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16
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Bu H, Lu S, Wang L, Jiang D, Tian Z, Ding Y, Zhuang Q. Depressive symptoms increase the risk of falls and injurious falls in Chinese adults aged ≥ 45 years: A 3-year cohort study. Front Public Health 2022; 10:964408. [PMID: 36311574 PMCID: PMC9606331 DOI: 10.3389/fpubh.2022.964408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/14/2022] [Indexed: 01/24/2023] Open
Abstract
Background Falls and depressive symptoms are both public health concerns in China, but the effects of depressive symptoms on falls and injurious falls have not been thoroughly investigated. Methods This population-based prospective cohort study used data derived from adults aged ≥45 years acquired from the 2015 and 2018 China Health and Retirement Longitudinal Study. Data were analyzed from August 2021 to December 2021. Self-reported depressive symptoms were determined using a 10-item Center for Epidemiologic Studies Depression scale (CESD-10) with a total score range of 0-30. Item responses of 3-4 or 5-7 days were deemed indicative of specific depressive symptoms. The outcome variables were self-reported accidental falls and injurious falls. Results Of the 12,392 participants included in the study, 3,671 (29.6%) had high baseline depressive symptoms (CESD-10 scores ≥ 10), 1,892 (15.3%) experienced falls, and 805 (6.5%) experienced injurious falls during 2015-2018 follow-up. High depressive symptoms increased the risk of falls [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19-1.50] and injurious falls (OR 1.28, 95% CI 1.09-1.51) in a multivariable logistic regression model adjusted for major demographic, health-related, and anthropometric covariates. All of the 10 specific depressive symptoms except "felt hopeless" were associated with falls, and four specific symptoms significantly increased the risk of injurious falls; "had trouble concentrating" (OR 1.32, 95% CI 1.13-1.55); "felt depressed" (OR 1.32, 95% CI 1.12-1.55); "everything was an effort" (OR 1.23, 95% CI 1.04-1.45); and "restless sleep" (OR 1.18, 95% CI 1.02-1.40). Conclusion High depressive symptoms are significantly related to risk of falls and injurious falls. Four specific symptoms (had trouble concentrating, felt depressed, everything was an effort, and restless sleep) increase the risk of injurious falls in Chinese adults aged ≥ 45 years.
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Affiliation(s)
- Hanli Bu
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Suqing Lu
- Department of Ophthalmology, Affiliated Hospital of Guilin Medical University, Guilin, China,*Correspondence: Suqing Lu
| | - Linxian Wang
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Dan Jiang
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhenzhen Tian
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yi Ding
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qin Zhuang
- Department of General Practice, Affiliated Hospital of Jiangsu University, Zhenjiang, China,Qin Zhuang
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17
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Wang J, Qin W, Pang M, Zhao B, Xu J, Li S, Kong F. The Effect of Chronic Disease and Mental Health on Sleep Quality among Migrant Elderly Following Children in Weifang City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12734. [PMID: 36232032 PMCID: PMC9564950 DOI: 10.3390/ijerph191912734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Few studies have focused on the sleep quality among migrant elderly following children (MEFC). This study aimed to investigate the effects of chronic disease and mental health on the sleep quality of MEFC in Weifang, China. A cross-sectional study was conducted by multi-stage cluster random sampling, and in total 613 participants were enrolled. Sleep quality and mental health were assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale (DASS-21), respectively. Chronic disease was assessed by the question "how many chronic diseases do you have?" A descriptive analysis and chi-square test were used to describe participants' sociodemographic variables, chronic disease, mental health, and sleep quality. The relationship between chronic disease, mental health, and sleep quality was explored by establishing binary logistic regression models. The results showed that 18.3% of MEFC's sleep quality was poor. MEFCs who were male were more likely to report good sleep quality. MEFCs who have similar monthly family income compared with others around, with multimorbidity, depression, and anxiety were more likely to report poor sleep quality. Nearly 1/5 of MEFCs were having poor sleep quality in this study. Results indicated that chronic diseases, depression, and anxiety were risk factors for the sleep quality of MEFC. Implications for the government, communities, and families of MEFC were given for improving their sleep quality.
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Affiliation(s)
- Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Wen Qin
- Shandong University Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju 26493, Korea
| | - Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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Nguyen HT, Nguyen CC, Le Hoang T. Falls Among Older Adults During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study in Vietnam. Clin Interv Aging 2022; 17:1393-1404. [PMID: 36172531 PMCID: PMC9511889 DOI: 10.2147/cia.s382649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/14/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose We aimed to investigate the prevalence and factors associated with falls in older adult outpatients during the coronavirus disease (COVID-19) pandemic in Vietnam. Patients and Methods From February 2022 to June 2022, this cross-sectional study included 814 patients (aged ≥60 years; mean age 71.8 ± 7.3 years; women, 65.2%) attending three geriatric clinics for a comprehensive geriatric assessment. Self-reported fall events in the past 12 months and post-COVID-19 falls were assessed. Factors associated with falls were determined using logistic regression analysis. Results In total, 188 patients (23.1%) had falls (single fall, 75.5%; recurrent falls, 24.5%). The most frequent location, time, and circumstance of falls were the bedroom (43.1%), morning (54.3%), and dizziness (34.6%), respectively. Most patients experienced health issues after falls (bruise/grazes, 53.7%; fracture, 12.8%; immobility, 9.6%; hospital admission, 14.9%). In the adjusted model, factors associated with falls were being underweight (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.37–4.56, P = 0.003), limitations in instrumental activities of daily living (OR 2.03, 95% CI 1.05–3.95, P = 0.036), poor sleep quality (OR 1.83, 95% CI 1.10–3.05, P = 0.020), and fear of falling (OR 3.45, 95% CI 2.23–5.33, P <0.001). Among 357 COVID-19 infected patients, post-COVID-19 falls occurred in 35 patients (9.8%) and were associated with fear of falling (OR 3.14, 95% CI 1.18–8.40, P = 0.023) and post-COVID-19 lower limb weakness (OR 2.55, 95% CI 1.07–6.10, P = 0.035). Conclusion Our study found a substantial prevalence of falls among older outpatients during the COVID-19 pandemic in Vietnam. Management of factors associated with falls may be needed to reduce the burden of falls in the older population.
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Affiliation(s)
- Huan Thanh Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam
| | - Chanh Cong Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam
| | - Thien Le Hoang
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh city, Vietnam
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Dudziak A, Kocira A. Preference-Based Determinants of Consumer Choice on the Polish Organic Food Market. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10895. [PMID: 36078610 PMCID: PMC9518508 DOI: 10.3390/ijerph191710895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 05/27/2023]
Abstract
Background: The development of the organic food market in Poland is currently at a fairly high level. There is a growing demand for organic food, but the share of total sales remains low. There are still many barriers related to the availability of organic food and information about it. In addition, consumers are skeptical of the inspection system in organic farming and admit that these foods do not meet their expectations regarding sensory qualities. Methods: The article conducted its own research, using an author's survey questionnaire, which was distributed in Lublin Province. The research sample consisted of 342 respondents and was diverse in terms of gender, age and place of residence. The purpose of the analysis was to ascertain the determinants affecting the choice of organic food. For the study, the method of correspondence analysis was used, the purpose of which was to isolate characteristic groups of consumers who exhibit certain behaviors towards organic products. Results: Respondents admitted that they buy organic food several times a month, most often spending an amount of EUR 10-20 (per month). They also paid attention to product labeling, with labels read mostly by residents of small towns (up to 30,000 residents). Respondents were also asked about the reasons why they do not buy organic food. The results of the analysis show that respondents believe it is too expensive, but they also cannot point out differences with other products. Conclusions: The main purpose of this article was to study the preferences of organic food buyers and to identify factors that determine their choice but that may also be barriers to purchasing this category of food. These issues need to be further explored so as to create recommendations in this regard for various participants in the organic food market.
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Affiliation(s)
- Agnieszka Dudziak
- Department of Power Engineering and Transportation, Faculty of Production Engineering, University of Life Sciences in Lublin, 20-612 Lublin, Poland
| | - Anna Kocira
- Institute of Human Nutrition and Agriculture, The University College of Applied Sciences in Chełm, 22-100 Chełm, Poland
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Prospective Association between Multimorbidity and Falls and Its Mediators: Findings from the Irish Longitudinal Study on Ageing. J Clin Med 2022; 11:jcm11154470. [PMID: 35956086 PMCID: PMC9370027 DOI: 10.3390/jcm11154470] [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: 06/26/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 11/21/2022] Open
Abstract
This study including older adults from Ireland aimed to analyze the prospective association between multimorbidity and falls and to identify the mediators in this relationship. The present study used data from two consecutive waves of the Irish Longitudinal Study on Ageing (TILDA) survey. Multimorbidity was assessed at Wave 1 (2009–2011) and was defined as the presence of at least two chronic conditions. Falls occurring at Wave 2 (2012–2013) were self-reported. Mediating variables considered were polypharmacy, cognitive impairment, sleep problems, pain, low handgrip strength, difficulty in activities of daily living (ADL), obesity, and underweight. Multivariable binary logistic regression and mediation analysis using the Karlson Holm Breen method were conducted. This study included 6900 adults aged ≥50 years (51.6% women; mean [SD] age 63.1 [8.9] years). Compared to no chronic conditions at baseline, there was a positive and significant association between multimorbidity and falls at follow-up, with ORs ranging from 1.32 (95% CI = 1.06–1.64) for 2 conditions to 1.92 (95% CI = 1.54–2.38) for ≥4 conditions. Pain (23.5%), polypharmacy (13.3%), and difficulty in ADL (10.7%) explained the largest proportion of the multimorbidity-fall relationship. Multimorbidity increased risk for incident falls in older adults from Ireland. Interventions should be implemented to reduce fall risk in people with multimorbidity, especially targeting the identified mediators.
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Wang L, Zou B. The Association Between Gait Speed and Sleep Problems Among Chinese Adults Aged 50 and Greater. Front Neurosci 2022; 16:855955. [PMID: 35557611 PMCID: PMC9087727 DOI: 10.3389/fnins.2022.855955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe relationship between sleep problems and walking speed has been less explored. The present cross-sectional study was to investigate the association between sleep quality and sleep duration and gait speed in Chinese adults.MethodsA total of 13,367 participants were recruited in this cross-sectional study, retrieving the data from the Global Aging and Adult Health Survey (SAGE). Gait speed was measured using the 4-m walking test. Age, sex, education years, smoking status, alcohol consumption, physical activity, chronic disease, sleep problems were self-reported by participants. To explore the association between sleep problems and gait speed, multivariate linear regression models were employed.ResultsIn the adjusted model, poor sleep quality and longer sleep duration were significantly associated with slower normal walking speed in Chinese adults (p < 0.001). Moreover, there were negatively significant associations between normal gait speed and sleep quality in male adults (p < 0.01).ConclusionThe findings suggest that slower normal walking speed was associated with poor sleep quality and longer sleep duration (>8 h) in Chinese male adults.
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Affiliation(s)
- Lili Wang
- School of Martial Arts and Dance, Shenyang Sport University, Shenyang, China
| | - Benxu Zou
- School of Social Sports, Shenyang Sport University, Shenyang, China
- *Correspondence: Benxu Zou,
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Kirshner D, Spiegelhalder K, Shahar RT, Shochat T, Agmon M. The association between objective measurements of sleep quality and postural control in adults: A systematic review. Sleep Med Rev 2022; 63:101633. [DOI: 10.1016/j.smrv.2022.101633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/18/2022] [Accepted: 04/03/2022] [Indexed: 01/31/2023]
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Kakazu VA, Pinto RZ, Dokkedal-Silva V, Fernandes GL, Gobbi C, Andersen ML, Tufik S, Pires GN, Morelhão PK. Does poor sleep quality and excessive daytime sleepiness influence fear of falling among older adults? A cross-sectional study. Sleep Biol Rhythms 2022; 20:287-295. [PMID: 38469257 PMCID: PMC10899936 DOI: 10.1007/s41105-021-00368-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/25/2021] [Indexed: 11/30/2022]
Abstract
Poor sleep is a risk factor for falling among older adults. This study aimed to investigate whether poor sleep quality and excessive daytime sleepiness in older people was associated with fear of falling. Participants aged 60 years or older were interviewed, with those who did not have preserved cognitive skills being excluded. Data on age, gender, body mass index, alcohol consumption, mental status, depression, excessive daytime sleepiness, sleep quality, comorbidities and fear of falling were collected. Univariate and multivariate linear regression were conducted. The logistic regression assessed the association between daytime sleepiness and fear of falling. The odds of an older adult being afraid of falling was 3 times higher among those with excessive daytime sleepiness, in comparison to those with no excessive daytime sleepiness. The higher the daytime sleepiness, the greater the fear of falling. Health professionals should be aware of older patients' sleepiness because it can increase fear of falling and influence their treatment.
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Affiliation(s)
- Viviane Akemi Kakazu
- Departamento de Fisioterapia, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente, Brazil
| | - Rafael Zambelli Pinto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vinicius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
| | - Guilherme Luiz Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
| | - Cynthia Gobbi
- Departamento de Fisioterapia, Universidade Cesumar (UniCesumar), Maringá, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
| | - Priscila Kalil Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925 Vila Clementino, São Paulo, 04024-002 Brazil
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Knechel NA, Chang PS. The relationships between sleep disturbance and falls: A systematic review. J Sleep Res 2022; 31:e13580. [PMID: 35288982 DOI: 10.1111/jsr.13580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
The purpose of this systematic review was to examine critically the literature that addresses the association between sleep disturbance and falls. Electronic databases OVID MEDLINE, PubMed, and CINAHL were searched using MeSH terms "sleep" and "accidental falls." Search limits included adults, humans, and English. The articles selected for the final sample were assessed for methodological quality. Eleven key attributes of sleep disturbance were extracted. The search yielded 177 articles from OVID MEDLINE, 124 from PubMed, and 46 from CINAHL. The final sample included 42 papers. The mean methodological quality score was 7.5 (range 2-10). Those who self-report >11 h or ≤5 h of nocturnal sleep duration may have a greater fall risk, but variations in cutoff points, study designs, and data collection methods contribute to difficulty in comparing study results. Subjective sleep fragmentation is associated with falls. The few studies on obstructive sleep apnea and insomnia demonstrate evidence of an increased risk for falls. It remains unclear whether daytime sleepiness, self-reported sleep quality, snoring, or napping are associated with falls, since some but not all studies demonstrate an association and the study quality did not differ.
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Honda H, Ashizawa R, Kiriyama K, Take K, Hirase T, Arizono S, Yoshimoto Y. Chronic pain in the frail elderly mediates sleep disorders and influences falls. Arch Gerontol Geriatr 2022; 99:104582. [DOI: 10.1016/j.archger.2021.104582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 11/29/2022]
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Ouyang S, Zheng C, Lin Z, Zhang X, Li H, Fang Y, Hu Y, Yu H, Wu G. Risk factors of falls in elderly patients with visual impairment. Front Public Health 2022; 10:984199. [PMID: 36072374 PMCID: PMC9441862 DOI: 10.3389/fpubh.2022.984199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To examine the risk factors for falls in elderly patients with visual impairment (VI) and assess the predictive performance of these factors. METHODS Between January 2019 and March 2021, a total of 251 elderly patients aged 65-92 years with VI were enrolled and then prospectively followed up for 12 months to evaluate outcomes of accidental falls via telephone interviews. Information of demographics and lifestyle, gait and balance deficits, and ophthalmic and systemic conditions were collected during baseline visits. Forward stepwise multivariable logistic regression analysis was performed to identify independent risk factors of falls in elderly patients with VI, and a derived nomogram was constructed. RESULTS A total of 143 falls were reported in 251 elderly patients during follow-up, with an incidence of 56.97%. The risk factors for falls in elderly patients with VI identified by multivariable logistic regression were women [odds ratio (OR), 95% confidence interval (CI): 2.71, 1.40-5.27], smoking (3.57, 1.34-9.48), outdoor activities/3 months (1.31, 1.08-1.59), waking up frequently during the night (2.08, 1.15-3.79), disorders of balance and gait (2.60, 1.29-5.24), glaucoma (3.12, 1.15-8.44), other retinal degenerations (3.31, 1.16-9.43) and best-corrected visual acuity (BCVA) of the better eye (1.79, 1.10-2.91). A nomogram was developed based on the abovementioned multivariate analysis results. The area under receiver operating characteristic curve of the predictive model was 0.779. CONCLUSIONS Gender, smoking, outdoor activities, waking up at night, disorders of balance and gait, glaucoma, other retinal degeneration and BCVA of the better eye were independent risk factors for falls in elderly patients with VI. The predictive model and derived nomogram achieved a satisfying prediction of fall risk in these individuals.
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Affiliation(s)
- Shuyi Ouyang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunwen Zheng
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Graduate School, Shantou University Medical College, Shantou, China
| | - Zhanjie Lin
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Graduate School, Shantou University Medical College, Shantou, China
| | - Xiaoni Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haojun Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Yijun Hu
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Honghua Yu
| | - Guanrong Wu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
- Guanrong Wu
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Kim JH, Song JH, Wee JH, Lee JW, Choi HG. Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults. Gerontology 2021; 68:518-528. [DOI: 10.1159/000518007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/19/2021] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. <b><i>Objectives:</i></b> This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. <b><i>Methods:</i></b> This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. <b><i>Results:</i></b> The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for <5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. <b><i>Conclusions:</i></b> Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls.
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Sleep efficiency affecting the occurrence of falls among the frail older adults. Geriatr Nurs 2021; 42:1461-1466. [PMID: 34656862 DOI: 10.1016/j.gerinurse.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to clarify whether reduced sleep efficiency affects the occurrence of falls among the frail older adults. This was a prospective cohort study. The subjects were frail older adult individuals living within a community, attending an older adult care center. Variables assessed include sleep efficiency, walking ability, history of cerebrovascular disease, depressive symptoms, cognitive impairment, chronic pain, frequency of sleeping medication use, and frequency of nocturnal urination. A fall calendar was used to record daily falls over a 6-month period beginning after administering a baseline survey. The Mann-Whitney U test was used to analyze the association between sleep efficiency and the occurrence of falls. Logistic regression analysis showed a significant association between falls and sleep efficiency. In conclusion, after adjusting for multiple confounders, reduced sleep efficiency did affect the occurrence of falls. Accordingly, approaches for improving sleep efficiency could offer new strategies toward fall prevention.
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Zhang L, Liu S, Li Y, Li S, Wu Y. Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference. Gerontology 2021; 68:1-7. [PMID: 33895741 DOI: 10.1159/000514894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Although previous studies have reported the significant associations of sleep quality with gait speed and falls, the mechanisms underlying these associations are unclear. We aimed to examine the gender-specific associations of sleep quality with gait speed and falls among older adults and to explore the possible mediating effect of muscle strength on these relationships. METHODS Data were taken from wave 6 (2012-2013) of the English Longitudinal Study of Aging (ELSA), including 7,664 participants aged 60 years and older. Sleep quality and falls were assessed by self-report. Gait speed was measured by the "timed walking test" and then adjusted by height. As an indicator of overall muscle strength, grip strength was measured by using the Smedley dynamometer. Baron and Kenny's causal steps and the Karlson/Holm/Breen method were used to examine the mediating effect. RESULTS Higher sleep quality was associated with the higher level of gait speed (β = 0.008, p = 0.031 in men; β = 0.008, p = 0.017 in women) and with lower prevalence of falls (OR = 0.878, 95% CI: 0.773, 0.998 in men; OR = 0.874, 95% CI: 0.792, 0.965 in women). Grip strength mediated these associations in men but not in women, and the mediating effects of grip strength can explain 23.74 and 11.01% of the total effect of sleep quality on gait speed and falls, respectively. CONCLUSION Our findings help explain the mechanism underlying the associations of sleep quality with gait speed and falls. Effort to maintain the mobility of the older men should focus on improving both sleep quality and muscle strength.
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Affiliation(s)
- Li Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Shuqin Liu
- Department of Emergency, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yujie Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Suyun Li
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
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Liu JH, Ma QH, Sun HP, Xu Y, Pan CW. Depressive symptom as a mediator of the influence of self-reported sleep quality on falls: a mediation analysis. Aging Ment Health 2021; 25:728-733. [PMID: 31920106 DOI: 10.1080/13607863.2020.1711860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives: It is well known that sleep quality was associated with falls. This study aimed to examine whether the presence of depressive symptoms mediate the association of self-reported sleep quality with falls.Methods: Data of community-based study including 4,579 adults aged 60 years or older were analyzed. Information regarding sleep quality and falls was self-reported by participants using pre-designed questionnaires. The nine-item Patient Health Questionnaire (PHQ-9) without the sleep item was used to assess the presence of depressive symptoms. A bootstrapping approach was performed to explore whether the relationship between self-reported sleep quality and falls was partially mediated by depressive symptoms. The mediator was considered significant if the 95% confidence interval (CI) did not include 0.Results: Older adults with poor sleep quality had higher odds of falls than their counterparts with normal sleep. In the equation regressed falls on self-reported sleep quality and PHQ-9 score, the association between self-reported sleep quality and falls disappeared. Depressive symptoms partially mediated the association between self-reported sleep quality and falls based on the significance of indirect effect (β = 0.15, 95% bootstrap CI = 0.08, 0.22).Conclusions: The presence of depressive symptoms might partially mediate the association of self-reported sleep quality with falls among older adults.
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Affiliation(s)
- Jing-Hong Liu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qing-Hua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Hong-Peng Sun
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
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Ardaneh M, Fararouei M, Hassanzadeh J. Factors Contributing to Falls Leading to Fracture among Older Adults. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09326-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kirshner D, Kizony R, Gil E, Asraf K, Krasovsky T, Haimov I, Shochat T, Agmon M. Why Do They Fall? The Impact of Insomnia on Gait of Older Adults: A Case-Control Study. Nat Sci Sleep 2021; 13:329-338. [PMID: 33727875 PMCID: PMC7955755 DOI: 10.2147/nss.s299833] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/16/2021] [Indexed: 12/22/2022] Open
Abstract
STUDY OBJECTIVES To compare gait and cognitive performance conducted separately as a single- (ST) and simultaneously as a dual-task (DT), ie, when a cognitive task was added, among community-dwelling older adults with and without insomnia. METHODS Participants included: 39 (28 females) community-dwelling older adults with insomnia, 34 (21 females) controls without insomnia. Subject groups were matched for age, gender, and education. Sleep quality was evaluated based on two-week actigraphy. Gait speed and cognition were assessed as ST and DT performance. DT costs (DTCs) were calculated for both tasks. Outcomes were compared via independent samples t-tests or Mann-Whitney U-tests. RESULTS Older adults with insomnia demonstrated significantly slower gait speed during ST (1 ± 0.29 vs 1.27 ± 0.17 m/s, p<0.001) and DT (0.77 ± 0.26 vs 1.14 ± 0.20 m/s, p<0.001) and fewer correct responses in the cognitive task during ST (21 ± 7 vs 27 ± 11, p=0.009) and DT (19 ± 7 vs 23 ± 9, p=0.015) compared to control group. DTC for the gait task was higher among older adults with insomnia (18.32%, IQR: 9.48-30.93 vs 7.81% IQR: 4.43-14.82, p<0.001). However, no significant difference was observed in DTC for the cognitive task (14.71%, IQR: -0.89-38.84 vs 15%, IQR: -0.89-38.84%, p=0.599). CONCLUSION Older adults with insomnia have lower gait speed and poorer cognitive performance during ST and DT and an inefficient pattern of task prioritization during walking, compared to counterparts without insomnia. These findings may explain the higher risk of falls among older adults with insomnia. Geriatric professionals should be aware of potential interrelationships between sleep and gait.
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Affiliation(s)
- Dani Kirshner
- Clalit Health Services; Faculty of Medicine, Technion, Haifa, Israel
| | - Rachel Kizony
- Occupational Therapy Department, University of Haifa, Haifa, Israel.,Occupational Therapy Department, Sheba Medical Center, Tel- Hashomer, Tel-Aviv, Israel
| | - Efrat Gil
- Clalit Health Services; Faculty of Medicine, Technion, Haifa, Israel
| | - Kfir Asraf
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Tal Krasovsky
- Physical Therapy Department, University of Haifa, Haifa, Israel.,Pediatric Rehabilitation Department, Sheba Medical Center, Tel- Hashomer, Tel-Aviv, Israel
| | - Iris Haimov
- The Center for Psychobiological Research, Department of Psychology, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Tamar Shochat
- School of Nursing, Faculty of Health and Social Welfare, University of Haifa, Haifa, Israel
| | - Maayan Agmon
- School of Nursing, Faculty of Health and Social Welfare, University of Haifa, Haifa, Israel
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Mota SGD, Jesus ITMD, Inouye K, Macedo MNGF, Brito TRPD, Santos-Orlandi AAD. IS POOR QUALITY SLEEP PRESENT IN OLDER ADULTS WITH WORSE SOCIAL AND HEALTH STATUS? TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the relationship among sleep and sociodemographic aspects, health, frailty, performance in activities of daily living, cognitive performance and depressive symptoms of older residents in the community. Method: a cross-sectional, quantitative study was conducted with 81 older adults residents in the area covered by a Family Health Unit in the city of São Carlos (SP), Brazil. Data collection occurred in 2019, through the application of the following instruments: questionnaire for socioeconomic and health characterization of the older adult, Pittsburgh Sleep Quality Index, Frailty Phenotype proposed by Linda Fried, Mini Mental State Examination, Geriatric Depression Scale, Katz Index and Lawton Scale. Participants were divided into comparative groups according to sleep quality scores. Fisher's exact and Pearson's χ2 were used. A significance level of 5% was adopted. Results: 50.6% of the older adults had poor quality sleep (n=41), followed by 33.3% of older adults with good quality sleep (n=27) and 16.1% had sleep disorders (n=13). There was a relationship between sleep quality and sex (p=0.008), work status (p=0.001), self-assessment of health (p=0.013), falls (p=0.034), pain (p=0.012), frailty level (p=0.026) and the slow gait criterion (p<0.001). Conclusion: there was a higher prevalence of poor quality sleep and sleep disorders in older patients, who do not work outside the home, who evaluated their health as regular or poor, who suffered falls in the last year and who complained of pain, frailty and slow gait.
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Affiliation(s)
| | | | - Keika Inouye
- Universidade Federal de São Carlos, Brasil; Universidade Federal de São Carlos, Brasil
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Sleep Quality and Associated Factors among Diabetes, Hypertension, and Heart Failure Patients at Debre Markos Referral Hospital, Northwest Ethiopia. SLEEP DISORDERS 2020; 2020:6125845. [PMID: 32523782 PMCID: PMC7261322 DOI: 10.1155/2020/6125845] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022]
Abstract
Background Chronic illnesses have a negative impact on the quality of sleep; however, patients with chronic illness do not bring sleep issues while they are coming to a health institution for a follow-up. As a result, poor sleep quality among patients with chronic illness is often unrecognized and untreated, and it results to a negative impact on the prognosis of chronic illness. Methods An institutional-based cross-sectional study design was employed from February 22, 2018, to April 6, 2018. The total sample size was 396. The study employed a stratified random sampling technique, and study participants were selected by systematic sampling. The data were collected by a Pittsburgh Sleep Quality Index (PSQI) questionnaire which is a validated and standardized tool. The data were analyzed by SPSS version 25; text, tables, and figures were utilized for data presentation. By considering a 95% confidence level and P value of 0.05, binary logistic regression and Kruskal-Wallis test were enrolled. Results The prevalence of poor sleep quality among diabetes, hypertension, and heart failure patients was 36.5%. The odds of being a poor sleeper are increased when age increased. Patients who have poor perception towards the prognosis of their illness were four times more likely to be a poor sleeper compared to patients with good perception (AOR = 4.21, 95%CI = 1.94-9.13, P = 0.001). Patients who have anxiety were four times more likely to be a poor sleeper compared with patients without anxiety (AOR = 3.69, 95%CI = 2.19-6.20, P = 0.001). The educational level and residence were other factors associated with sleep quality. There was a statistically significant difference of sleep quality between patients with diabetes and hypertension, and diabetes and heart failure (F (2, 384) = 10.92, P = 0.004). Conclusion and Recommendations. In this study, over one-third of patients had poor sleep quality. Age, educational level, residence, perception towards prognosis of illness, and anxiety were factors associated with sleep quality. All health care providers should assess and provide advice about sleep hygiene and influencing factors. Assessment of sleep quality for every diabetes, hypertension, and heart failure patients in every visit should be incorporated in the care package.
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Konishi S, Hatakeyama S, Imai A, Kumagai M, Okita K, Togashi K, Hamaya T, Hamano I, Okamoto T, Iwamura H, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. Overactive bladder and sleep disturbance have a significant effect on indoor falls: Results from the community health survey in Japan. Low Urin Tract Symptoms 2020; 13:56-63. [PMID: 32496639 DOI: 10.1111/luts.12326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/22/2020] [Accepted: 05/12/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To evaluate the effect of overactive bladder (OAB) and frailty on indoor fall events in community-dwelling adults aged 50 or older. METHODS We conducted a cross-sectional study involving 723 adults between 2016 and 2017 in Hirosaki, Japan. OAB symptoms and sleep disturbance were assessed using the Overactive Bladder Symptom Score (OABSS) and the Pittsburgh Sleep Quality Index (PSQI). Indoor fall events (falls or near-falls) within 1 year were evaluated. Frailty was evaluated by the frailty discriminant score. We investigated the association of OAB symptoms with sleep disturbance, frailty, and indoor fall events. Multivariate logistic regression analysis was performed to investigate the effect of OAB symptoms on fall events controlling for confounding factors such as age, gender, comorbidity, frailty, and sleep disturbance. RESULTS The median age was 64. We observed OABSS ≥6 in 98 participants (14%), nocturia ≥2 in 445 (62%), urgency score ≥3 in 80 (11%), urge incontinence score ≥3 in 36 (5.0%), PSQI ≥6 in 153 (21%), frailty in 169 (23%), and indoor fall events in 251 (35%). Older age, diabetes, OABSS, nocturia, urgency, urge incontinence, and the PSQI were significantly associated with indoor fall events. Multivariate logistic regression analyses showed that OAB symptoms and sleep disturbance were significantly associated with fall events. CONCLUSIONS The effect of OAB symptoms and sleep disturbance on indoor fall events was significant. The causal relationship between OAB and falls needs further study.
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Affiliation(s)
- Sakae Konishi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Mika Kumagai
- Department of Active Life Promotion Sciences, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazutaka Okita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiromichi Iwamura
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Active Life Promotion Sciences, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Prevalence and associated factors of poor sleep quality among Chinese older adults living in a rural area: a population-based study. Aging Clin Exp Res 2020; 32:125-131. [PMID: 30919262 PMCID: PMC6974488 DOI: 10.1007/s40520-019-01171-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 03/08/2019] [Indexed: 12/13/2022]
Abstract
Objective To investigate the prevalence and associated factors of poor sleep quality among community-dwelling elderly population in a rural area of Northern China. Methods We conducted a cross-sectional survey in August–December 2014 and recruited 2195 participants who were aged 65 years or older and living in Yanlou Town of Yanggu County in western Shandong Province, China. Data on demographics, health-related behaviors, and clinical conditions were collected through structured interviews. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality and patterns. Poor sleep quality was defined as a PSQI score > 7. We employed multiple logistic models to relate poor sleep quality to various factors. Results The overall prevalence rates of poor sleep quality were 33.8% in the total sample, 39.2% in women and 26.3% in men (P < 0.01). The most common abnormal sleep domains were prolonged sleep latency (39.7%), decreased sleep duration (31.0%), and reduced habitual sleep efficiency (28.8%). Multiple logistic regression analyses revealed that poor sleep quality was significantly associated with female sex (OR = 1.76, 95% CI 1.46–2.12) and clinical comorbidities such as hypertension (OR = 1.28, 95% CI 1.06–1.54), coronary heart disease (OR = 1.60, 95% CI 1.27–2.00), and chronic obstructive pulmonary disease (OR = 1.82, 95% CI 1.34–2.49). Conclusions The sleep disorders were highly prevalent among the elderly in rural China. Modifiable risk factors such as cardiometabolic risk factors and disorders were associated with poor sleep quality, which might be potential targets for interventions to improve sleep quality in elderly population.
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Marron L, Segurado R, Kenny RA, McNicholas T. The association between benzodiazepine use and falls, and the impact of sleep quality on this association: data from the TILDA study. QJM 2020; 113:31-36. [PMID: 31424520 DOI: 10.1093/qjmed/hcz217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/10/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults. AIM This study assesses the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50. DESIGN Cross-sectional analysis of data from wave 1 of The Irish Longitudinal Study on Ageing. METHODS Participants were classed as BZD users or non-users and asked if they had fallen in the last year, and whether any falls were unexplained. Sleep quality was assessed via self-reported trouble falling asleep, daytime somnolence and early-rising. Logistic regression assessed for an association between BZD use and falls, and the impact of sleep quality on this association was assessed by categorizing based on BZD use and sleep quality variables. RESULTS Of 8175 individuals, 302 (3.69%) reported taking BZDs. BZD use was associated with falls, controlling for confounders [Odds Ratio (OR) 1.40; 1.08, 1.82; P-value 0.012]. There was no significant association between BZDs and unexplained falls, controlling for confounders [OR 1.41; 95% Confidence Interval (CI) 0.95, 2.10; P-value 0.09]. Participants who use BZDs and report daytime somnolence (OR 1.93; 95% CI 1.12, 3.31; P-value 0.017), early-rising (OR 1.93; 95% CI 1.20, 3.11; P-value 0.007) or trouble falling asleep (OR 1.83; 95% CI 1.12, 2.97; P-value 0.015), have an increased odds of unexplained falls. CONCLUSION BZD use is associated with falls, with larger effect size in those reporting poor sleep quality in community dwelling older adults. Appropriate prescription of medications such as BZDs is an important public health issue.
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Affiliation(s)
- L Marron
- UCD School of Public Health, Physiotherapy and Sports Science, Woodview House University College Dublin Belfield, Dublin 4, D04 V1W8, Ireland
- Department of Public Health, Health Service Executive, Dr. Steevens' Hospital, Dublin 8, D08 W2AB, Ireland
| | - R Segurado
- UCD School of Public Health, Physiotherapy and Sports Science, Woodview House University College Dublin Belfield, Dublin 4, D04 V1W8, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College, Dublin 2, D02 PN40, Ireland
- Department of Medical Gerontology, Trinity College, Dublin 2, D02 PN40, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital, James's St, Dublin 8, D08 RT2X, Ireland
| | - T McNicholas
- The Irish Longitudinal Study on Ageing (TILDA), Lincoln Gate, Trinity College, Dublin 2, D02 PN40, Ireland
- Department of Medical Gerontology, Trinity College, Dublin 2, D02 PN40, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital, James's St, Dublin 8, D08 RT2X, Ireland
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Kulakci Altintas H, Korkmaz Aslan G. Incidence of falls among community-dwelling older adults in Turkey and its relationship with pain and insomnia. Int J Nurs Pract 2019; 25:e12766. [PMID: 31313430 DOI: 10.1111/ijn.12766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 03/06/2019] [Accepted: 06/05/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to determine the incidence of falls among community-dwelling older adults and the impact of pain and insomnia on falls. METHODS This cross-sectional study recruited 659 older adults. Pain was assessed by the Geriatric Pain Measure, and insomnia was assessed by the Insomnia Severity Index. The history of falls was assessed within the last 12 months. Risk factors for falls were determined using logistic regression analysis. RESULTS The incidence of falls within the last year was 37.2%. Based on the analyses, pain and insomnia were found to be risk factors for falls. CONCLUSION In this study, falls were observed as a common problem among community-dwelling older adults, and pain and insomnia were determined as risk factors for falls. Therefore, pain and insomnia should be addressed when prevention of falls among community-dwelling older adults are planned by health care professionals including nurses.
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Creasy SA, Crane TE, Garcia DO, Thomson CA, Kohler LN, Wertheim BC, Baker LD, Coday M, Hale L, Womack CR, Wright KP, Melanson EL. Higher amounts of sedentary time are associated with short sleep duration and poor sleep quality in postmenopausal women. Sleep 2019; 42:zsz093. [PMID: 30994175 PMCID: PMC6612671 DOI: 10.1093/sleep/zsz093] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/12/2019] [Indexed: 12/21/2022] Open
Abstract
STUDY OBJECTIVES To evaluate the associations between sedentary time, total (total-PA), light (light-PA), moderate (MOD-PA), and vigorous (VIG-PA) physical activity with indices of sleep in postmenopausal women. METHODS Baseline self-reported data from the Women's Health Initiative Observational Study (n = 75 074) were used in this cross-sectional analysis. Total-PA, light-PA, MOD-PA, and VIG-PA were categorized by metabolic equivalents of the activity (MET-hour [hr]/week [wk]) and were estimated using validated questionnaires. Sedentary time was categorized by hr/day and was estimated via questionnaire. Logistic regression was used to examine the associations between these variables and short sleep (≤6 hr/night), long sleep (≥10 hr/night), poor sleep quality, and insomnia symptoms after adjustment for age, race, socioeconomic status, body mass index, health status, depressive symptoms, smoking status, alcohol use, hormone therapy, and comorbidities. RESULTS Higher sedentary time (>11 hr/day) was associated with higher odds of short sleep (odds ratio [OR] = 1.80, 95% confidence interval [CI]: 1.72-1.88), poor sleep quality (OR = 1.85, 95% CI: 1.74-1.97), and insomnia symptoms (OR = 1.56, 95% CI: 1.49-1.64). Light-PA (>0 MET-hr/wk) was associated with lower odds of short sleep (OR = 0.96, 95% CI: 0.92-1.00), and higher amounts of total-PA (OR = 0.90, 95% CI: 0.84-0.97), light-PA (OR = 0.94, 95% CI: 0.89-1.00), and MOD-PA (OR = 0.91, 95% CI: 0.86-0.97) were associated with lower odds of poor sleep quality. CONCLUSIONS Our findings suggest that higher levels of light and moderate intensity physical activity are associated with better sleep quality, whereas higher amounts of sedentary time are associated with short sleep and lower quality sleep. Future studies should investigate the directionality of these associations and potential causal pathways.
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Affiliation(s)
- Seth A Creasy
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Tracy E Crane
- College of Nursing, University of Arizona, Tucson, AZ
| | - David O Garcia
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Lindsay N Kohler
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | - Betsy C Wertheim
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | - Laura D Baker
- Department of Gerontology and Geriatric Medicine, Wake Forest University, Winston-Salem, NC
| | - Mace Coday
- Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis TN
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY
| | - Catherine R Womack
- Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis TN
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Edward L Melanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Health Care System, Aurora, CO
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Serum 25-hydroxyvitamin D3 levels and poor sleep quality in a Japanese population: the DOSANCO Health Study. Sleep Med 2019; 57:135-140. [DOI: 10.1016/j.sleep.2019.01.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/30/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
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Overcash J, Tan A, Patel K, Noonan A. Factors Associated With Poor Sleep in Older Women Diagnosed With Breast Cancer. Oncol Nurs Forum 2018; 45:359-371. [DOI: 10.1188/18.onf.359-371] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The deterioration of locomotive components, which comprise bones, joints, and intervertebral discs, and muscles and nerves, can lead to symptoms such as pain, limitations in the range of joint mobility, malalignment, impaired balance, and difficulty walking. Locomotive syndrome (LoS) was proposed by the Japanese Orthopedic Association in 2007 as a concept for people who are at a high risk of developing a musculoskeletal ambulation disability attributed to locomotor organs. Although many international articles related to LoS have been published, an international consensus of this concept seems to be lacking. This review article on LoS introduces the concept, the related assessment methods, and the condition's prevalence based on the most up-to-date literature, and discusses discrimination from frailty and sarcopenia, relevance to musculoskeletal problems, management plan, and future directions. Familiarity with recent evidence would be useful for the health care providers in an aging society to educate individuals with LoS or pre-LoS and to maintain their well-being and prevent them from requiring long-term care.
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Affiliation(s)
- Tatsunori Ikemoto
- Department of Orthopaedic Surgery, Aichi Medical University, Yazako Karimata, Nagakute, Aichi, Japan
| | - Young-Chang Arai
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Yazako Karimata, Nagakute, Aichi, Japan
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Lohman MC, Crow RS, DiMilia PR, Nicklett EJ, Bruce ML, Batsis JA. Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample. J Epidemiol Community Health 2017; 71:1191-1197. [PMID: 28947669 PMCID: PMC5729578 DOI: 10.1136/jech-2017-209769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data. METHODS Data from five annual rounds (2011-2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level. RESULTS Participants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality. CONCLUSION The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted.
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Affiliation(s)
- Matthew C Lohman
- Department of Psychiatry, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire, USA
| | - Rebecca S Crow
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire, USA
- Dartmouth-Hitchcock Medical Center, Section of General Internal Medicine, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Research, Lebanon, New Hampshire, USA
| | - Peter R DiMilia
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Research, Lebanon, New Hampshire, USA
| | - Emily J Nicklett
- University of Michigan School of Social Work, Ann Arbor, Michigan, USA
| | - Martha L Bruce
- Department of Psychiatry, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire, USA
| | - John A Batsis
- Department of Psychiatry, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
- Dartmouth Centers for Health and Aging, Lebanon, New Hampshire, USA
- Dartmouth-Hitchcock Medical Center, Section of General Internal Medicine, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Research, Lebanon, New Hampshire, USA
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