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Liu J, Zhu Y, Tan JK, Ismail AH, Ibrahim R, Hassan NH. Factors Associated with Frailty in Older Adults in Community and Nursing Home Settings: A Systematic Review with a Meta-Analysis. J Clin Med 2024; 13:2382. [PMID: 38673654 PMCID: PMC11050860 DOI: 10.3390/jcm13082382] [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: 02/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Frailty is a globally recognized issue. However, there is a lack of evidence exploring factors associated with frailty among older residents in community and nursing-home settings. Methods: To explore the prevalence and factors associated with frailty among older adults in community and nursing-home settings, we conducted a systematic search following the PRISMA guidelines across Web of Science, MEDLINE, EMBASE, PubMed, and Cochrane databases up until January 2024, selecting 38 studies which encompassed 150,642 participants. Results: Our findings showed higher frailty prevalence in nursing homes compared to communities. Frailty was significantly associated with sociodemographic (living alone, poor self-reported health), physiological (poor sleep, low activity of daily living), behavioral (physical inactivity) and disease (chronic conditions, depression) factors in both community and nursing-home settings. Conclusions: There are numerous factors associated with frailty in older adults in nursing-home and community settings. These factors underscore the significance of promptly identifying high-risk individuals and devising appropriate interventions to mitigate frailty among them.
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Affiliation(s)
- Jia Liu
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Yuezhi Zhu
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (Y.Z.); (J.K.T.)
| | - Azera Hasra Ismail
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
| | - Roszita Ibrahim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Nor Haty Hassan
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (J.L.); (A.H.I.)
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Han CJ, Rosko AE, Spakowicz DJ, Hammer MJ, Von Ah D. Associations of frailty with symptoms, and HRQOL in older cancer survivors after cancer treatments: a systematic review and meta-analyses. Qual Life Res 2024; 33:583-598. [PMID: 37897643 DOI: 10.1007/s11136-023-03537-4] [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] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Frailty in older adult cancer survivors after cancer treatments is associated with various health outcomes. However, there is less agreement on how frailty affects symptoms and health-related quality of life (HRQOL). This systematic review and meta-analysis aimed to evaluate the current literature on frailty, symptoms, and HRQOL, as well as the associations of frailty with these factors in older adult cancer survivors with chemotherapy. METHODS A review was conducted on peer-reviewed publications from 2008 to 2023, using seven electronic databases. Meta-analyses were performed using random effects models to determine pooled effect estimates for frailty prevalence, symptom severity, and HRQOL scores. RESULTS A total of 26 studies involving older cancer survivors were included in the analysis. Most of these studies were conducted in Western countries and focused on White survivors, particularly those with breast cancer. The mean pooled prevalence of frailty was 43.5%. Among frail survivors, the most common symptoms reported after cancer treatments were pain (36.4%), neuropathy (34.1%), and fatigue (21.3%). Frailty was associated with higher pooled mean symptom severity (B = 1.23, p = 0.046) and lower functional HRQOL (B = - 0.31, p = 0.051, with marginal significance) after cancer treatments. CONCLUSION Frail older cancer survivors are at high risk of adverse symptoms and poor HRQOL after cancer treatment. Further research on screening for frailty is needed to prevent older adults from developing worse symptoms burden and maintain HRQOL. It is also essential to understand the mechanisms of the associations between frailty, symptoms and HRQOL in this population.
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Affiliation(s)
- Claire J Han
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA.
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA.
| | - Ashley E Rosko
- Division of Hematology, The Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Daniel J Spakowicz
- Division of Medical Oncology, Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Marilyn J Hammer
- Dana-Farber Cancer Institute, and Member of the Faculty, Medical Oncology Harvard Medical School, Boston, MA, USA
| | - Diane Von Ah
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
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Xu L, Tao X, Lou Y, Engström M. Sleep quality, frailty and overall health among community-dwelling older people: A longitudinal study. J Adv Nurs 2024; 80:328-338. [PMID: 37438957 DOI: 10.1111/jan.15790] [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: 10/10/2022] [Revised: 05/18/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
AIMS The aims of the study were to describe sleep quality among community-dwelling older people; determine the association between sleep quality (total and multidimensional), frailty and overall health; study frailty as a mediator in the association between sleep quality and overall health. DESIGN This longitudinal, correlative study used data from 2020 to 2022. METHODS A total of 181 community-dwelling older people in a city in Southeast China were assessed twice. Sleep quality was measured using the Pittsburgh Sleep Quality Index at Time 1 (year 2020); frailty was measured using the FRAIL scale, and overall health was measured using the EuroQol visual analogue scale at Time 1 and 2 (1 year later). Associations and indirect effects were examined using linear regression analyses using the PROCESS Macro (Model 4). RESULTS Poor sleep quality (higher scores) was associated with increased frailty over time (total scale), as well as subjective sleep quality, sleep duration, sleep efficiency and daytime dysfunction. Mediation analyses indicated that frailty change had an indirect effect on the association between sleep quality total score Time (T) 1 and overall health T2 and between the dimensions subjective sleep quality, sleep duration, sleep efficiency and daytime dysfunction and overall health. All analyses were adjusted for age, multimorbidity and overall health T1. CONCLUSIONS Poor sleep quality is a common problem associated with poor overall health after 1 year, and the progression of frailty mediates this association. IMPACT The findings provide a better understanding of the association between sleep quality and overall health and elucidate the mediating effect of frailty. Regular screening and effective treatment by healthcare providers for sleep problems and frailty in older people are necessary to improve their overall health and enhance healthy ageing. PATIENT OR PUBLIC CONTRIBUTION Participants in the study provided the data used for all data analysis in the manuscript. Patient or public were not involved in data analysis, interpretation or manuscript preparation. Staff in the community health centre helped with data collection.
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Affiliation(s)
- Lijuan Xu
- Medicine College, Lishui University, Lishui, China
| | - Xuemei Tao
- Medicine College, Lishui University, Lishui, China
| | - Yan Lou
- Medicine College, Lishui University, Lishui, China
| | - Maria Engström
- Department of Caring Science, Faculty of Health and Occupational Studies, University of Gävle, Gävle, China
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Sharma SD, Cook MJ, Antonio L, Gielen E, Bartfai G, Casanueva FF, Huhtaniemi IT, Maggi M, Punab M, Rastrelli G, Slowikowska-Hilczer J, Tournoy J, Vanderschueren D, Wu FC, O'Neill TW. Does testosterone influence the association between sleep and frailty in men: results from the European Male Aging Study. BMC Geriatr 2023; 23:813. [PMID: 38057724 PMCID: PMC10702097 DOI: 10.1186/s12877-023-04450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/01/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Previous studies have suggested an association between sleep disturbance and frailty. The mechanism is unknown, although it has been suggested that hormonal factors may play a role. METHODS The aim was to determine the association between sleep duration, sleep quality and frailty, and to determine whether testosterone influenced this association. Males aged 40-79 years were recruited from eight European centres to the European Male Aging Study (EMAS). Subjects completed an interviewer-assisted questionnaire including questions regarding sleep quality and duration. Sleep quality was scored 0-20 and categorised as 0-4, 5-9, 10-14, and 15-20, with higher scores indicating poorer quality. A 39-component frailty index (FI) was constructed. Total testosterone levels were measured. The association between sleep duration, sleep quality and the FI was assessed using negative binomial regression, with adjustment for putative confounders including testosterone level. RESULTS Two thousand three hundred ninety-three participants contributed data to the analysis. The mean age was 63.3 years and mean sleep duration was 7.01 h. The mean frailty index was 0.15. Mean testosterone levels declined with decreasing sleep quality. After adjustment, compared to those with a sleep score of 0-4, the FI was 57% (95% CI 38%, 78%) higher among those with a sleep score of 15-20. After adjustment compared to those with normal sleep duration (6-9 h), those with a short (< 6 h) and long (≥ 9 h) sleep duration had a 16% (95% CI 6%, 28%) and 11% (95% CI 0%, 23%) higher FI, respectively. Adjustment for testosterone did not influence the strength of either association. CONCLUSION Frailty is associated with impaired sleep quality and sleep duration. The association cannot, however, be explained by variation in testosterone levels.
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Affiliation(s)
- Seema D Sharma
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK.
| | - Michael J Cook
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK
| | - Leen Antonio
- Department of Clinical and Experimental Medicine, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Louvain, Belgium
- Department of Endocrinology, University Hospitals Leuven, Louvain, Belgium
| | - Evelien Gielen
- Centre for Metabolic Bone Diseases, Department of Geriatrics, University Hospitals Leuven, Louvain, Belgium
| | - Gyorgy Bartfai
- Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary
| | - Felipe F Casanueva
- Department of Medicine, CIBER de Fisiopatología Obesidad y Nutricion, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), Instituto Salud Carlos III, CB06/03, Santiago de Compostela, Spain
| | - Ilpo T Huhtaniemi
- Institute of Reproductive and Developmental, Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, London, UK
| | - Mario Maggi
- Andrology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Margus Punab
- Andrology Clinic, Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Giulia Rastrelli
- Andrology Unit, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | | | - Jos Tournoy
- Department of Geriatrics, University Hospitals Leuven, Louvain, Belgium
- Department of Public Health and Primary Care, KU Leuven, Louvain, Belgium
| | - Dirk Vanderschueren
- Department of Clinical and Experimental Medicine, KU Leuven, Laboratory of Clinical and Experimental Endocrinology, Louvain, Belgium
- Department of Endocrinology, University Hospitals Leuven, Louvain, Belgium
| | - Frederick C Wu
- Department of Endocrinology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology Medicine and Health, University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
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Kestler-Peleg M, Greenblatt-Kimron L, Even-Zohar A, Lavenda O. Parental Self-Efficacy Among Israeli Older Adults. Can J Aging 2023; 42:631-641. [PMID: 37272522 DOI: 10.1017/s0714980823000144] [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] [Indexed: 06/06/2023] Open
Abstract
Parental self-efficacy (PSE) is a central aspect of parenting research. Although parenting continues in older ages, few studies have focused on PSE among older adults. In line with the parenting determinant model, the study examined the associations between psychological distress, social support, loneliness, and PSE in older age.The study used a quantitative cross-sectional survey, including 362 Israeli parents age 65 years and above. Participants were asked to complete questionnaires of psychological distress, social support, loneliness, PSE, and background information.Results revealed that higher PSE was associated with lower psychological distress, higher social support, and a lower sense of loneliness in older adults. The research model explained 36.9 per cent of the variance in PSE among older adults.Mental state and social conditions are important for PSE of older adults; therefore, professionals should ensure the availability of diverse solutions to enable, maintain, and promote well-being through social and familial engagement in this population.
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Affiliation(s)
| | | | | | - Osnat Lavenda
- School of Social Work, Ariel University, Ariel, Israel
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Alshanberi AM. Frailty in Kingdom of Saudi Arabia-Prevalence and Management, Where Are We? Healthcare (Basel) 2023; 11:1715. [PMID: 37372833 DOI: 10.3390/healthcare11121715] [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: 04/30/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
A recent report from the United Nations state that the percentage of elderly individuals in the Kingdom of Saudi Arabia (KSA) will witness a sharp increase in the next three decades (5.6% in 2017 to 23% by 2050). This situation will lead to an increased prevalence of comorbidities and hence, will require close monitoring and constant care of such individuals who are prone to suffer from complications such as arthritis, cardiovascular disorders, diabetes, neurological disorders, etc. Frailty is one such age-related phenomenon which enhances the risk of falling, functional restrictions and greater vulnerability to adverse consequences, which tend to lead to institutionalization. Such factors highlight the importance of the urgent awareness for circumventing the progression of frailty toward a compromised health status. This concise report is an attempt to sum up the relevant research articles published with regard to frailty and concomitant diseases in the last 5 years. It also sums up the research on frailty in the KSA elderly population, till date. This article reflects the opinions of an author on tackling such issues through a well-directed mechanism involving interdisciplinary transitional care and geriatric co-management.
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Affiliation(s)
- Asim Muhammed Alshanberi
- Department of Community Medicine and Pilgrims Health Care, Umm Alqura University, Makkah 24382, Saudi Arabia
- Medicine Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
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Lorber M, Kmetec S, Davey A, Mlinar Reljić N, Fekonja Z, Kegl B. Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4937. [PMID: 36981847 PMCID: PMC10049428 DOI: 10.3390/ijerph20064937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Poor sleep quality is prevalent among older adults, but limited data document associations between frailty and quality of life comparing individuals living in the community with those in nursing homes. This cross-sectional study (conducted between August and November 2019) included 831 older adults (mean age 76.5 years) from Slovenia's community and nursing home settings. The results showed comorbidity in 38% of community-dwelling older adults and 31% of older adults in nursing homes. The prevalence of frailty among community-dwelling older adults was 36.5%, and among older adults in a nursing home was 58.5%. A total of 76% of community-dwelling older adults and 95.8% of nursing home residents reported poor sleep quality. Sleep quality and frailty predict 42.3% of the total variability of quality of life for older adults in nursing homes and 34.8% for community-dwelling older adults. The study's results indicate that the quality of life can be affected by factors (e.g., worse sleep quality and frailty) among older adults, regardless of being a resident or from the community. Understanding how sleep quality is affected by social, environmental, and biological factors can help improve sleep quality and potentially the quality of life of older adults.
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Affiliation(s)
- Mateja Lorber
- Faculty of Health Sciences, University of Maribor, Zitna Ulica 15, 2000 Maribor, Slovenia
| | - Sergej Kmetec
- Faculty of Health Sciences, University of Maribor, Zitna Ulica 15, 2000 Maribor, Slovenia
| | - Adam Davey
- College of Health Sciences, University of Delaware, 210 South College Avenue, Newark, NJ 19716, USA
| | - Nataša Mlinar Reljić
- Faculty of Health Sciences, University of Maribor, Zitna Ulica 15, 2000 Maribor, Slovenia
| | - Zvonka Fekonja
- Faculty of Health Sciences, University of Maribor, Zitna Ulica 15, 2000 Maribor, Slovenia
| | - Barbara Kegl
- Faculty of Health Sciences, University of Maribor, Zitna Ulica 15, 2000 Maribor, Slovenia
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Zhang B, Wang X, Liu S, Zhang M, He X, Zhu W, Ding H. The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality. BMC Public Health 2023; 23:449. [PMID: 36890457 PMCID: PMC9993696 DOI: 10.1186/s12889-023-15157-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 01/30/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Mental health imbalance are the main cause of anxiety, depression and happiness reduction in the older. Self-assessment living standard and sleep quality are both influencing factors of mental health. Meantime, self-assessment living standard has an impact on sleep quality. But there's no research on the relationship between the three, we conducted this study to explore the relationship between self-assessment living standard and mental health and the mediating role of sleep quality among the older in rural areas of China. METHODS Using typical field sampling method, M County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires enclosing respondents' sociodemographics information, 12 Items General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Scale (PSQI), face-to-face interviews were used to collect data. Bootstrap test was used for data analysis. RESULTS The results showed that the age of the respondents ranged from 60 to 99 years, with an average age of (66.53 ± 6.77) years, the proportion of the older with a tendency to mental health problems was 24.7%. Most of the older people's self-assessment living standard was normal (average score was 2.89 ± 0.726), accounting for 59.3% of the total. The average sleep quality score was (6.97 ± 4.066), and 2.5% of the respondents reported serious sleep problems. older with low self- assessment living standards were more likely to report a higher propensity for psychological problems (β = 0.420, P < 0.001) and poorer sleep quality (β = 0.608, P < 0.001) than older with high self- assessment living standards. Mental health of the older may be related to sleep quality (β = 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (β = 0.071, P < 0.001). CONCLUSION Mental health is associated with self-assessment living standard, with this association mediated by sleep quality. A reasonable mechanism needs to be established to improve self-assessment living standard and sleep quality.
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Affiliation(s)
- Beibei Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Xianwen Wang
- School of Public Health and Health Management, Anhui Medical College, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Song Liu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Min Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Xinran He
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Weizheng Zhu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China
| | - Hong Ding
- Department of Health Service Management, School of Health Management, Anhui Medical University, Hefei, Anhui, China.
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Effects of different sleep disorders on frailty in the elderly: a systematic review and meta-analysis of observational studies. Sleep Breath 2023; 27:91-101. [PMID: 35416613 DOI: 10.1007/s11325-022-02610-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/10/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
STUDY OBJECTIVES Frailty is frequently reported following sleep disorders; however, the extent to which sleep disorders influence frailty remains unclear. In the current study, we performed a meta-analysis to evaluate the quantitative effects of different sleep disorders on frailty in the elderly. METHODS We conducted a systematic search of several databases, including PubMed, Web of Science, Embase, and Scopus, to retrieve articles published from May 2009 to June 2021. The data outcomes are expressed as the odds ratio (OR) and 95% confidence interval (CI). RESULTS Eighteen studies were included, with 39669 participants. Older adults with sleep disorders were found to have a higher risk of frailty (pooled OR = 1.49, 95%CI = 1.35-1.64, p < 0.01). Specifically, daytime sleepiness (pooled OR = 1.69, 95%CI = 1.09-2.61, p < 0.01), short sleep duration (pooled OR = 1.36, 95%CI = 1.20-1.54, p = 0.45), long sleep duration (pooled OR = 1.99, 95%CI = 1.39-2.85, p = 0.02), sleep latency extension (pooled OR = 1.38, 95%CI = 1.19-1.60, p = 0.72), and sleep disordered breathing (pooled OR = 1.30, 95%CI = 1.11-1.53, p = 0.37) were correlated with frailty. CONCLUSIONS The risk of frailty differs between older adults with sleep disorders and controls, suggesting that the relationships between different sleep disorders and frailty vary. These results highlight the need to monitor sleep disorders of the elderly and conduct intervention to prevent or delay the frailty process.
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A two-mediator serial mediation chain of the association between social isolation and impaired sleep in old age. Sci Rep 2022; 12:22458. [PMID: 36577767 PMCID: PMC9797554 DOI: 10.1038/s41598-022-26840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
Poor sleep is a long-term public health issue that has become increasingly prevalent among socially isolated older adults. However, research on the mechanisms explaining the link between social isolation and impaired sleep (IS) remains limited, particularly in low- and middle-income countries. This study explored the serial mediating effects of loneliness and mental distress on the association of social isolation with IS among Ghanaian older adults. We analyzed data from 1201 adults aged ≥ 50 from Ghana's AgeHeaPsyWel-HeaSeeB study (mean age = 66.14, SD = 11.85, age range = 50-111; women = 63.28%). Measures included the UCLA 3-item Loneliness Scale, modified Berkman-Syme Social Network Index, Sleep Quality Scale, and Mental Distress Questionnaire. We used bootstrapping techniques from Hayes' PROCESS macro program to estimate the hypothesized serial mediation. Social isolation was significantly associated with IS (β = 0.242, p < 0.001). Crucially, social isolation indirectly predicted IS via three significant mediating pathways. Loneliness accounted for 17.6% (β = 0.054, CI = 0.096, 0.016), mental distress accounted for 6.5% (β = 0.020, 95% CI = 0.004, 0.040), and loneliness and mental distress accounted for 32.2% (β = 0.099, 95% CI = 0.065, 0.138) of the overall effect. The total mediating effect was 56.4%. These findings suggest that the social isolation-sleep link is respectively and serially explained by loneliness and mental distress. Social integrative interventions for sleep quality in old age should target mental and emotional well-being.
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Chen M, Lu C, Zha J. Long Sleep Duration Increases the Risk of All-Cause Mortality Among Community-Dwelling Older Adults With Frailty: Evidence From NHANES 2009-2014. J Appl Gerontol 2022; 42:1078-1088. [PMID: 36560922 DOI: 10.1177/07334648221147917] [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: 12/24/2022] Open
Abstract
Objectives: The aim of this study was to determine the effect of sleep duration on all-cause mortality among older adults with frailty. Methods: The prospective cohort study included 5705 community participants aged 60 or above in the National Health and Nutrition Examination Survey (NHANES). Health indicators were selected in the NHANES to obtain the frailty index and sleep duration. The risk of all-cause mortality was estimated by a Cox proportional hazard model. Results: During the follow-up, long sleep duration was associated with higher all-cause mortality (adjusted HR = 1.28, 95% CI 1.03-1.59). The hazard of all-cause mortality was the lowest from the beginning of sleep until sleep duration reached 5.8 hours among older adults with frailty. Discussion: Long sleep duration was associated with higher all-cause mortality among older adults with frailty. There was a U-shaped relationship between sleep duration and all-cause mortality.
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Affiliation(s)
- Mingzhuang Chen
- Divison of Medical Affairs, 117556The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chao Lu
- First Affiliated Hospital, 91594Anhui University of Science and Technology, Huainan, China
| | - Jingru Zha
- Office of Party, 117556The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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12
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Seo EJ, Won MH, Son YJ. Association of sleep duration and physical frailty with cognitive function in older patients with coexisting atrial fibrillation and heart failure. Nurs Open 2022; 10:3201-3209. [PMID: 36560851 PMCID: PMC10077387 DOI: 10.1002/nop2.1570] [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: 08/23/2022] [Revised: 11/15/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
AIM To investigate the associations of sleep duration and physical frailty with cognitive function in older patients with both atrial fibrillation and heart failure. DESIGN This study used a cross-sectional, secondary data analysis design. METHOD We included outpatients aged ≥ 65 years with coexisting atrial fibrillation and heart failure in South Korea. We used a sample of 176 patients (men = 100) with HF among 277 data from the parent study. The data were collected through a self-report, structured questionnaire and electronic medical record. RESULTS Our main finding showed that long sleep duration and physically frail status were significant predictors of cognitive impairment in older adults with both atrial fibrillation and heart failure. Healthcare providers should be aware of the importance of assessing sleep duration and physical activity in older adults with both atrial fibrillation and heart failure to prevent or delay cognitive impairment.
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Affiliation(s)
- Eun Ji Seo
- Ajou University College of Nursing and Research Institute of Nursing Science, Suwon, Korea
| | - Mi Hwa Won
- Wonkwang University, Department of Nursing 460 Iksandaero, Iksan, Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Self-reported sleep quality and mental health mediate the relationship between chronic diseases and suicidal ideation among Chinese medical students. Sci Rep 2022; 12:18835. [PMID: 36336709 PMCID: PMC9637738 DOI: 10.1038/s41598-022-23207-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/26/2022] [Indexed: 11/08/2022] Open
Abstract
High prevalence and strong associations of chronic disease, poor sleep quality, poor mental health, and suicidal ideation (SI) have been reported worldwide. However, the underlying mechanism remains unexamined. The participants were 2646 Chinese medical college students with an average age of 20.13 years. Pittsburgh Sleep Quality Index, the Kessler Psychological Distress Scale, and SI was evaluated. The lifetime SI, past 12-month SI, and chronic disease prevalence rates were 10.0%, 8.4%, and 4.6%, respectively. The results of logistic regression analysis in this study found that chronic disease, self-reported poor sleep quality, poor mental health, gender and scholarship were associated with lifetime SI. Similar results were also found for 12-month SI with an exception of region. This result indicated that the effects of chronic diseases on the SI were mediated by self-reported sleep quality and mental health. Physical diseases, sleep-related concerns, and mental health issues need to be addressed through a multidisciplinary team approach and various delivery systems to prevent SI among medical college students.
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Gao T, Han S, Mo G, Sun Q, Zhang M, Liu H. A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey. Front Med (Lausanne) 2022; 9:955834. [DOI: 10.3389/fmed.2022.955834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChildhood hunger not only directly affects the physical and mental health of children and adolescents but also has a long-term negative effect on later health outcomes. In this cross-sectional study, we used a nationally representative Chinese sample to examine the relationship between hunger in childhood and frailty in older adults.Materials and methodsThe data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey. The frailty index with 44 health deficits was used to identify frailty. Childhood hunger was measured by the question “Did you often go to bed hungry as a child?” Insurance status was categorized as New Rural Cooperative Medical Scheme (NRCMS), Urban Basic Medical Insurance Scheme (UBMIS), others, and no insurance. Multivariate logistic regression analysis was performed to estimate the adjusted relationship between childhood hunger and frailty.ResultsA total of 7,342 older people aged 65 years and older were analyzed in this study. Older people who experienced childhood hunger were more likely to have frailty than those who did not (OR = 1.13, 95% CI: 1.02–1.26), after adjustment for sociodemographic characteristics, family/social support, socioeconomic status, insurance status, and health behaviors. The association of childhood hunger with frailty was found in the 65–79 years group (OR = 1.21, 95% CI: 1.03–1.43), women (OR = 1.25, 95% CI: 1.08–1.45), individuals with rural residence (OR = 1.16, 95% CI: 1.03–1.31), agricultural work (OR = 1.16, 95% CI: 1.00–1.34), financial dependence (OR = 1.18, 95% CI: 1.02–1.37), and those participating in NRCMS (OR = 1.35, 95% CI: 1.16–1.56). Participants with hunger in childhood who were 80 years or older (OR = 0.80, 95% CI: 0.65–0.98) had lower odds of frailty. NRCMS (OR = 1.42, 95% CI: 1.02–1.98) showed increased odds of childhood hunger-related frailty.ConclusionExposure to hunger during childhood is linked to frailty among older adults, and age, financial support, and insurance status may mediate this relationship. Targeted interventions and policies to address frailty in older adults should be implemented.
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Yu X, Shi Z, Wang D, Niu Y, Xu C, Ma Y, Liu H, Guo H, Li M, Zhang Y. Prevalence and associated factors of frailty among community dwelling older adults in Northwest China: a cross-sectional study. BMJ Open 2022; 12:e060089. [PMID: 35914908 PMCID: PMC9345078 DOI: 10.1136/bmjopen-2021-060089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of the comprehensive frailty and its associated factors among community dwelling older adults. DESIGN A cross-sectional study. SETTING Six community healthcare centres in Xi'an City, Northwest China. PARTICIPANTS A total of 2647 community dwelling older adults completed the study between March and August 2021. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the prevalence of frailty, measured with the Comprehensive Frailty Assessment Instrument. The secondary outcomes were potential factors associated with frailty, measured with a social-demographic and health-related information sheet, the Short-Form Mini-Nutritional Assessment and the Pittsburgh Sleep Quality Index. RESULTS The participants averaged 27.77±10.13 in the total score of the Comprehensive Frailty Assessment Instrument. According to the cut-off points defining the classification of frailty, the majority of the participants were with mild (n=1478, 55.8%) or high (n=390, 14.8%) frailty. Multivariate stepwise linear regression analysis demonstrated that older age, lower educational level, empty nesters, higher level of self-perceived medical burden, abnormal body weight, physical inactivity, medication taking, increased number of clinic visit, undernutrition and poor sleep quality are associated with higher total score in the Comprehensive Frailty Assessment Instrument, indicating higher level of frailty. Multivariate multinomial logistic regression analysis exhibited similar findings but further captured female gender as a risk factor for the presence of mild and high frailty compared with no-low frailty. CONCLUSION The prevalence of the comprehensive frailty and frailty in the physiological, psychological, social and environmental domains is high. A variety of social-demographic, health-related and behavioural factors were associated with the comprehensive frailty. Further investigations on frailty prevalence and its associated factors based on comprehensive assessments are desirable.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Zhengyan Shi
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yaqi Niu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Cuixiang Xu
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yunmiao Ma
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hongmei Liu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Hua Guo
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Minjie Li
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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16
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Yu X, Wang N, Wang D, Ma Y, Liu H, Fu J, Xu C, Sun Y, Zhang Y. Consistency in the prevalence and associated factors of frailty determined by two instruments among hospitalised older adults: A cross-sectional study. J Clin Nurs 2022; 32:2813-2826. [PMID: 35650678 DOI: 10.1111/jocn.16386] [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: 06/08/2021] [Revised: 04/17/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate the consistency in the prevalence and associated factors of frailty determined by the physical-originated Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale and the multidimensional Tilburg Frailty Indicators (TFI) scale. BACKGROUND Accurate assessment of frailty and the identification of its associated factors could guide the development and implementation of holistic and individualised treatment plan. However, recommendations regarding the selection of frailty assessment tools are inconclusive. DESIGN This is a cross-sectional study, the reporting of which followed the STROBE guidelines. METHODS A total of 1220 older adults were recruited from a university affiliated tertiary hospital in Xi'an City, Northwest China, and administrated with a social-demographic and health-related information sheet, the FRAIL, the TFI, the Short-Form Mini-Nutritional Assessment, the Pittsburgh Sleep Quality Index and the 5-level EuroQol 5 dimensions questionnaire. Descriptive statistics and binary logistic regression analysis were used to investigate the prevalence of frailty and its associated factors. RESULTS The prevalence of physical-originated and multidimensional frailty was 55.2% and 77.6%, respectively. The consistency between the two scales was low. Taking the combined use of the two instruments as the reference, the TFI and FRAIL could identify 89.99% and 64.02% of the participants with frailty. Polypharmacy, health-related quality of life and sleep quality were found to be associated with both physical-originated and multidimensional frailty. Nutritional status and level of physical activity were additionally identified as the independent associated factors of multidimensional frailty. CONCLUSIONS The prevalence of frailty among hospitalised older adults is high. There is low consistency between the FRAIL and TFI in detecting frailty. The TFI exhibited higher sensitivity in detecting individuals with frailty and its associated factors. RELEVANCE TO CLINICAL PRACTICE The findings of this study supported a single use of the TFI for the assessment of frailty in the hospital setting.
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Affiliation(s)
- Xingfeng Yu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Nana Wang
- The Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Dan Wang
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yunmiao Ma
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Hongmei Liu
- The Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Jia Fu
- The Surgery Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Cuixiang Xu
- The Central Laboratory, Shaanxi Provincial People's Hospital, Xi'an, P. R. China.,Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Yang Sun
- The Medical Department, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
| | - Yulian Zhang
- The Director's Office, Shaanxi Provincial People's Hospital, Xi'an, P. R. China
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Xiao S, Shi L, Xue Y, Zheng X, Zhang J, Chang J, Lin H, Zhang R, Zhang C. The relationship between activities of daily living and psychological distress among Chinese older adults: A serial multiple mediation model. J Affect Disord 2022; 300:462-468. [PMID: 34954333 DOI: 10.1016/j.jad.2021.12.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have shed light on the mechanisms underlying the link between activities of daily living (ADL) and psychological distress. This study aimed to explore the multiple mediating roles of loneliness and sleep quality in this relationship among Chinese older adults. METHODS A total of 3250 older adults completed the Barthel Index, UCLA 20-item Loneliness Scale, Pittsburgh Sleep Quality Index, and Depression, Anxiety, and Stress Scale Questionnaire. Serial multiple mediation analysis was conducted using Hayes' PROCESS macro. RESULTS ADL was found to directly impact psychological distress through three significant mediation pathways: (1) loneliness (B=-0.124, 95% CI=-0.140, -0.109), which accounted for 23.98% of the total effect, (2) sleep quality (B=-0.050, 95% CI=-0.063, -0.039), which accounted for 9.67% of the total effect, and (3) loneliness and sleep quality (B=-0.015, 95% CI=-0.020, -0.012), accounting for 2.91% of the total effect. The total mediating effect was 36.56%. LIMITATIONS The cross-sectional design we used limited causal interpretations. Future studies could examine longitudinal changes in outcome measures. CONCLUSIONS These findings highlight the role of loneliness and sleep quality as serial mediators of the relationship between ADL and psychological distress. Thus, for the early detection and prevention of psychological distress, it is necessary to conduct loneliness and sleep quality interventions for older adults with ADL limitations.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ruibin Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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18
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Alqahtani BA. Association between Physical Frailty and Sleep Quality among Saudi Older Adults: A Community-Based, Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12741. [PMID: 34886467 PMCID: PMC8656802 DOI: 10.3390/ijerph182312741] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023]
Abstract
(1) Background: Prevalence of poor sleep quality and its association with frailty status among the aging population of Saudi Arabia has not been studied. Therefore, the main objective of the current study was to estimate the prevalence of poor sleep quality and investigate the association between poor sleep quality and frailty in Saudi older adults; (2) Methods: A total of 270 (mean age 69.9 ± 6.2) older adults from the Riyadh region were involved in the study. To measure sleep quality, the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) was used. The Fried's frailty index was utilized to assess frailty. Using multiple logistic regression models, the association between sleep quality and frailty status was evaluated using the Odds Ratio and confidence intervals (CI 95%); (3) Results: The pre-frailty and frailty status were prevalent among older adults who had poor sleep quality, 37% and 37.6% (p < 0.001), retrospectively. Poor sleep quality (PSQI > 5) was independently associated with both frailty (OR = 2.13) and prefrailty groups (OR = 1.67); (4) Conclusions: our study demonstrated a significant association between frailty and poor sleep quality. However, a longitudinal future study needs to be established to confirm this association and establish the causality relationship.
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Affiliation(s)
- Bader A Alqahtani
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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19
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Wang Y, Fu P, Li J, Jing Z, Wang Q, Zhao D, Zhou C. Changes in psychological distress before and during the COVID-19 pandemic among older adults: the contribution of frailty transitions and multimorbidity. Age Ageing 2021; 50:1011-1018. [PMID: 33710264 PMCID: PMC7989653 DOI: 10.1093/ageing/afab061] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Indexed: 12/11/2022] Open
Abstract
AIM To investigate changes in psychological distress in community-dwelling older adults before and during the coronavirus disease 2019 (COVID-19) pandemic and the contribution of frailty transitions and multimorbidity in predicting the psychological distress. METHODS Prospective repeated-measures cohort study on a sample of participants aged 60 and over. A total of 2, 785 respondents at the baseline (May 2019) were followed during the COVID-19 (August 2020). The changes in psychological distress before and during the COVID-19 were assessed using generalised estimation equations with adjusting for sex, age, education, economic status, marital status, tea drinking status, smoking status, alcohol drinking status, sedentary time, sleep quality and activities of daily living. RESULTS The psychological distress of older people has significantly increased in August 2020 compared with May 2019. Both older adults who remained frail and transitioned into frail state reported more psychological distress during the COVID-19. Similarly, both pre-existing multimorbidity and emerging multimorbidity groups were associated with more psychological distress. The group of frailty progression who reported new emerging multimorbidity showed more increase in psychological distress in comparison with those who remained in the non-frail state who reported no multimorbidity. CONCLUSION Psychological distress has increased among the community-dwelling older adults during the COVID-19 pandemic, and sustained and progressive frail states as well as multimorbidity were all associated with a greater increase of psychological distress. These findings suggest that future public health measures should take into account the increased psychological distress among older people during the COVID-19 pandemic, and the assessment of frailty and multimorbidity might help in warning of psychological distress.
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Affiliation(s)
- Yi Wang
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Peipei Fu
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jie Li
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Zhengyue Jing
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qiong Wang
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Corresponding Author: Tel: (+86) 531 8838 1567 Fax: (+86) 531 8838 2553
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Dasdemir Ilkhan G, Celikhisar H. The effect of incontinence on sleep quality in the elderly. Int J Clin Pract 2021; 75:e13965. [PMID: 33368941 DOI: 10.1111/ijcp.13965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study was conducted to determine the frequency of incontinence in elderly people living in nursing homes and the effect of incontinence on the quality of life and sleep quality. MATERIAL AND METHOD This study was carried out with a total of 1150 individuals aged 65 and over, living in four nursing homes. Pittsburg Sleep Quality Index (PSQI), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and Incontinence Quality of Life Scale (IQOL) were used as data collection tools. The data were collected after obtaining ethics committee and institutional approvals and written consents of the elderly participants. RESULTS The mean age of 1150 elderly individuals included in the study was 75.49 ± 8.62 years. The mean PSQI score of the elderly was 8.33 ± 4.16 and 83.5% of them had poor sleep quality. It was determined that 87.0% of the elderly woke up at night and the most common reason for waking up was the need to use the toilet (60.0%). It was found that the mean ICIQ-SF score of the individuals was 10.65 ± 4.40 and 80.9% of them had bothersome urinary incontinence. The average IQOL score of individuals with incontinence was 63.39 ± 11.26. CONCLUSION It was determined that almost all of the elderly people included in the present study had sleep problems and 20.0% had incontinence. It was found that sleep quality is not affected by incontinence in the elderly, but the quality of life decreases because of incontinence.
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Affiliation(s)
- Gulay Dasdemir Ilkhan
- Chest Diseases Department, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Hakan Celikhisar
- Department of Chest Diseases, Izmir Metropolitan Municipality Esrefpasa Hospita, Izmir, Turkey
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21
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Liu X, Wang C, Qiao X, Si H, Jin Y. Sleep quality, depression and frailty among Chinese community-dwelling older adults. Geriatr Nurs 2021; 42:714-720. [PMID: 33836251 DOI: 10.1016/j.gerinurse.2021.02.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 01/22/2023]
Abstract
We aimed to explore the relationship between sleep quality and frailty, and depression as a mediator and its interaction with sleep quality on frailty. This was a cross-sectional study among 936 Chinese community-dwelling adults aged≥60 years. Sleep quality, frailty and depression were measured by the Pittsburgh Sleep Quality Index (PSQI), the Frailty Phenotype and the 5-item Geriatric Depression Scale (GDS-5), respectively. We found that depression mediated the association between poor sleep quality and physical frailty, attenuating the association between poor sleep and physical frailty by 51.9%. Older adults with both poor sleep quality and depression had higher risk of frailty than those with poor sleep quality or depression alone. These results implicate multidisciplinary care for frail older adults with poor sleep quality.
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Affiliation(s)
- Xinyi Liu
- School of Nursing, Shandong University, 250012 Jinan, China
| | - Cuili Wang
- School of Nursing, Peking University, 100191 Beijing, China.
| | - Xiaoxia Qiao
- School of Nursing, Peking University, 100191 Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, 100191 Beijing, China
| | - Yaru Jin
- School of Nursing, Peking University, 100191 Beijing, China
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