Associations of poor sleep quality, chronic pain and depressive symptoms with frailty in older patients: is there a sex difference?

The relationship between sleep quality and quality of life in middle-aged and older inpatients with chronic diseases: Mediating role of frailty and moderating role of self-esteem

OBJECTIVE

This study aimed to investigate the influence of sleep quality on the quality of life in middle-aged and older inpatients with chronic diseases (MAOICDs) while examining the mediating role of frailty and the moderating role of self-esteem.

METHODS

This study utilized a cross-sectional design. Between October 2021 and February 2022, we administered questionnaires to 319 subjects at the Second Hospital of Zhejiang University School of Medicine, Zhejiang Province, China. The questionnaire consisted of the General Information Scale, the Cumulative Disease Rating Scale, the Sleep Quality Questionnaire, the Frailty Scale, the Self-Esteem Scale, and the Quality of Life Questionnaire. Data were analyzed using SPSS 25.0 software and PROCESS3.5 macros for descriptive statistics, correlation analysis, and tests for mediating and moderating effects.

RESULTS

The results of this study suggest that sleep quality is negatively related to quality of life and mediated by frailty. Self-esteem plays a moderating role in the relationship between frailty and quality of life.

CONCLUSION

Frailty mediates the relationship between sleep quality and quality of life. Meanwhile, self-esteem plays a moderating role in the relationship between frailty and life quality. Specifically, the correlation between frailty and life quality becomes stronger at higher levels of self-esteem. Therefore, to improve the life quality of MAOICDs, interventions should focus not only on enhancing sleep quality and reducing frailty but also on helping patients maintain an appropriate level of self-esteem.

Depressive Symptoms, Sleep Quality, and Pain Are Associated With Frailty in Nursing Home Residents During the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has caused severe effects on older adults. Depressive symptoms, poor sleep quality, and pain are common in older adults with frailty. However, it is unknown the relationship between these symptoms and frailty in nursing home residents and the difference of importance between pain intensity and pain impact on frailty during the COVID-19 Pandemic. Therefore, this study aims to explore the associations between depressive symptoms, poor sleep quality, pain intensity, and pain impact with frailty in older adults living in nursing homes.

METHODS

In this cross-sectional population-based study, 172 older adults living in nursing homes from Changsha in China were included. We collected data on depressive symptoms, sleep quality, pain, and frailty using the Patient Health Questionnaire, the Pittsburgh Sleep Quality, the Brief Pain Inventory-short form, and the FRAIL-NH Scale. Generalized linear regression models were used to explore the interaction association between these symptoms with frailty.

RESULTS

Most older adults were between 80 and 90 years old. Approximately 11.6% of older adults experienced one of the following symptoms: depressive symptoms, poor sleep quality, pain intensity, or pain impact. Moreover, 76.7% of older adults experienced at least two of these symptoms. The most common overlapping symptoms were depressive symptoms and poor sleep quality (14.5%). Among nursing home residents, the most common sites of pain were the lower limbs, followed by the back. There was a strong correlation between depressive symptoms, sleep quality, pain intensity, pain impact, and frailty. After adjusting for covariates, the interaction term between any two or three symptoms of depressive symptoms, poor sleep quality, pain intensity, and pain impact was found to be associated with a higher likelihood of frailty in older adults residing in nursing homes (p< .05).

CONCLUSIONS

Depressive symptoms, poor sleep quality, pain intensity, and pain impact are common among nursing home residents. Furthermore, these symptoms interacted with each other. In future studies, multidisciplinary interventions aimed at releasing these symptoms and reducing the adverse outcome of frailty are needed.

A pathway model of chronic pain and frailty in older Chinese cancer patients: The mediating effect of sleep

This study aimed to explore the association between chronic pain, sleep quality, and frailty, and whether sleep quality will mediate the relationship between chronic pain and frailty. A cross-sectional study was conducted between June 2020 and July 2021 among 308 patients in Nantong city. The relationship between chronic pain and frailty was tested using linear regression. The bootstrap method was used to examine mediating effect of sleep quality. Chronic pain was significantly correlated with frailty (r=0.271, P<.001). Sleep quality played a partially mediating role between chronic pain and frailty (β=0.160, R²=32%, P<.001). Interventions to scientifically manage chronic pain and improve sleep quality may be effective in reducing the incidence of frailty in elderly cancer patients.