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Ha B, Han M, So WY, Kim S. Sex differences in the association between sleep duration and frailty in older adults: evidence from the KNHANES study. BMC Geriatr 2024; 24:434. [PMID: 38755549 PMCID: PMC11100248 DOI: 10.1186/s12877-024-05004-2] [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: 12/10/2023] [Accepted: 04/23/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Frailty is a pervasive clinical syndrome among the older population. It is associated with an increased risk of diverse adverse health outcomes including death. The association between sleep duration and frailty remains unclear. Therefore, the aim of this study was to investigate the relationship between sleep duration and frailty in community-dwelling Korean older adults and to determine whether this relationship is sex-dependent. METHODS Data on 3,953 older adults aged ≥ 65 years were obtained from the 7th (2016-2018) Korea National Health and Nutrition Examination Survey (KNHANES). Frailty was defined using the Fried phenotype with criteria customized for the KNHANES dataset. Self-reported sleep duration was classified as short sleep duration (≤ 6 h), middle sleep duration (6.1-8.9 h), and long sleep duration (≥ 9 h). Complex samples multivariate logistic regression analysis was conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The percentage of male participants with short, middle, and long sleep durations was 34.9%, 62.1%, and 16.8%, respectively, while that of female participants was 26.1%, 59.2%, and 14.7%. The prevalence of frailty in the middle sleep duration group was lower than that in the short and long sleep duration groups in both men (short, 14.7%; middle, 14.2%; long, 24.5%; p < 0.001) and women (short, 42.9%; middle, 27.6%; long, 48.6%; p < 0.001). Both short (OR = 2.61, 95% CI = 1.91 - 4.83) and long (OR = 2.57, 95% CI = 1.36 - 3.88) sleep duration groups had a significantly higher OR for frailty than the middle sleep duration group even after adjusting for confounding variables among women, but not among men. CONCLUSION Short and long sleep durations were independently associated with frailty in community-dwelling Korean older adult women. Managing sleep problems among women should be prioritized, and effective interventions to prevent frailty should be developed accordingly.
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Affiliation(s)
- Beomman Ha
- Armed Forces Medical Command, Seongnam-si, 13574, Republic of Korea
| | - Mijin Han
- Chungbuk National University Hospital, Cheongju-si, 28644, Republic of Korea
| | - Wi-Young So
- Department of Sports Medicine, College of Humanities, Korea National University of Transportation, 50 Daehak-ro, Chungbuk, Chungju-si, 27469, Republic of Korea.
| | - Seonho Kim
- Department of Nursing and Research Institute of Nursing Science, College of Medicine, Chungbuk National University, Cheongju-si, 28644, Republic of Korea.
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Deng Z, Hu Y, Duan L, Buyang Z, Huang Q, Fu X, Luo H, Hou T. Causality between sleep traits and the risk of frailty: a Mendelian randomization study. Front Public Health 2024; 12:1381482. [PMID: 38784581 PMCID: PMC11112029 DOI: 10.3389/fpubh.2024.1381482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Background Research based on observation has demonstrated a relationship between sleep traits and frailty; however, it remains uncertain if this correlation indicates causation. The purpose of this study was to look at the causal relationship that exists between frailty and sleep traits. Method Using summaries from a genome-wide association study of self-reported sleep features and frailty index, we performed a bidirectional Mendelian randomization (MR) analysis. Examining the causal relationships between seven sleep-related traits and frailty was the goal. The major method used to calculate effect estimates was the inverse-variance weighted method, supplemented by the weighted median and MR-Egger approaches. The study investigated pleiotropy and heterogeneity using several methodologies, such as the MR-Egger intercept, the MR-PRESSO approach, and the Cochran's Q test. We took multivariate Mendelian randomization and genetic correlations between related traits to enhance the confidence of the results. Furthermore, we used MRlap to correct for any estimation bias due to sample overlap. Results Insomnia, napping during the day, and sleep apnea syndrome exhibited a positive connection with the frailty index in forward MR analysis. Conversely, there is a negative link between getting up in the morning, snoring and sleep duration with the frailty index. During the reverse MR analysis, the frailty index exhibited a positive correlation with insomnia, napping during the day, and sleep apnea syndrome, while demonstrating a negative correlation with sleep duration. There was no direct correlation between snoring, chronotype, and frailty. In MVMR analyses, the causal effect of sleep characteristics on frailty indices remained consistent after adjusting for potential confounders including BMI, smoking, and triglycerides. Conclusion The findings of our investigation yield novel evidence that substantiates the notion of a bidirectional causal connection between sleep traits and frailty. Through the optimization of sleep, it is potentially feasible to hinder, postpone, or even reverse the state of frailty, and we proposed relevant interventions.
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Affiliation(s)
- Zhen Deng
- Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yifan Hu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lincheng Duan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ziding Buyang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Huang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xuedan Fu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hong Luo
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianshu Hou
- Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, China
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Huang Q, Lin H, Xiao H, Zhang L, Chen D, Dai X. Sleeping more than 8 h: a silent factor contributing to decreased muscle mass in Chinese community-dwelling older adults. BMC Public Health 2024; 24:1246. [PMID: 38711104 DOI: 10.1186/s12889-024-18520-y] [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: 12/12/2023] [Accepted: 04/04/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Muscle mass loss is an age-related process that can be exacerbated by lifestyle, environmental and other factors, but can be mitigated by good sleep. The objective of this study was to investigate the correlation between varying time lags of sleep duration and the decline in muscle mass among individuals aged 60 years or older by using real-world health monitoring data obtained from wearable devices and smart home health monitoring devices. METHODS This study included 86,037 observations from 2,869 participants in the Mobile Support System database. Missing data were supplemented by multiple imputation. The investigation utilized generalized estimating equations and restricted cubic spline curve to examine the relationship between sleep duration and low muscle mass. Various lag structures, including 0, 1, 2, 0-1, 0-2, and 1-2 months, were fitted, and the interaction effect of observation time with sleep duration was estimated for each lag structure. Additionally, subgroup analyses were conducted. The models were adjusted for various covariates, including gender, age, body mass index, footsteps, smoking status, drinking status, marital status, number of chronic diseases, number of medications, diabetes mellitus, hyperlipidemia, coronary artery disease, respiratory disease, and musculoskeletal disease and an interaction term between time and sleep duration. RESULTS The results of the generalized estimating equation showed a significant correlation (p < 0.001) between sleep duration of 8 h or more and low muscle mass in older adults, using 6-7 h of sleep as a reference. This effect was seen over time and prolonged sleep accumulated over multiple months had a greater effect on muscle mass loss than a single month. The effect of long sleep duration on muscle mass loss was significantly greater in females than in males and greater in the over-75 than in the under-75 age group. Restricted cubic spline plots showed a non-linear relationship between sleep duration and low muscle mass (p < 0.001). CONCLUSIONS This study found an association between sustained nighttime sleep of more than eight hours and decreased muscle mass in older adults, especially older women.
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Affiliation(s)
- Qiongyu Huang
- Key Laboratory of Sports and Physical Health, Ministry of Education, Beijing Sport University, No.48, Xinxi Road, 100084, Beijing, China
| | - Hongsheng Lin
- Key Laboratory of Sports and Physical Health, Ministry of Education, Beijing Sport University, No.48, Xinxi Road, 100084, Beijing, China
| | - Han Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Liuwei Zhang
- Key Laboratory of Sports and Physical Health, Ministry of Education, Beijing Sport University, No.48, Xinxi Road, 100084, Beijing, China
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
| | - Xiaotong Dai
- Key Laboratory of Sports and Physical Health, Ministry of Education, Beijing Sport University, No.48, Xinxi Road, 100084, Beijing, China.
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Tanaka Y, Baba-Mori N, Yonaga T, Mochizuki K, Igarashi S, Ando T, Kohda T, Ito Y, Soejima K, Sakurai D. Sleep status of older adults with sleep apnoea syndrome may vary by body mass index. FRONTIERS IN AGING 2024; 5:1331448. [PMID: 38751649 PMCID: PMC11094249 DOI: 10.3389/fragi.2024.1331448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
Obesity and ageing are the most important risk factors for sleep apnoea syndrome (SAS); however, the role of body mass index (BMI) on sleep status in healthy older adults is unclear. To explore sleep parameters according to BMI among active older adults, we cross-sectionally examined the relationship between sleep-related parameters and BMI in 32 Japanese adults aged from 83 to 95 years without long-term care who were unaware of having SAS. Correlation and linear regression analyses were performed. Moderate or severe SAS prevalence was high in both those with low (68.8%) and high (68.8%) BMI. A higher increase in apnoea-hypopnoea index (AHI) was negatively correlated with sleep depth in the high-BMI group. In the low-BMI group, the number of awakenings and age were positively correlated with AHI. Older adults may have SAS regardless of their BMI, and the sleep status of patients with SAS may vary by BMI.
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Affiliation(s)
- Yuji Tanaka
- New Industry Creation Hatchery Center, Tohoku University, Sendai, Japan
| | - Naana Baba-Mori
- Department of Advanced Biomedical Research, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Takaaki Yonaga
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kazuki Mochizuki
- Laboratory of Food and Nutritional Sciences, Department of Local Produce and Food Sciences, Faculty of Life and Environmental Sciences, University of Yamanashi, Yamanashi, Japan
| | - Satoshi Igarashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Takashi Ando
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Takashi Kohda
- Laboratory of Embryology and Genomics, Faculty of Life and Environmental Sciences, University of Yamanashi, Yamanashi, Japan
| | - Yasumi Ito
- Faculty of Engineering, University of Yamanashi, Yamanashi, Japan
| | - Kenzo Soejima
- Department of Respiratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
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Zheng Y, Feng J, Yu Y, Ling M, Wang X. Advances in sarcopenia: mechanisms, therapeutic targets, and intervention strategies. Arch Pharm Res 2024; 47:301-324. [PMID: 38592582 DOI: 10.1007/s12272-024-01493-2] [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: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
Sarcopenia is a multifactorial condition characterized by loss of muscle mass. It poses significant health risks in older adults worldwide. Both pharmacological and non-pharmacological approaches are reported to address this disease. Certain dietary patterns, such as adequate energy intake and essential amino acids, have shown positive outcomes in preserving muscle function. Various medications, including myostatin inhibitors, growth hormones, and activin type II receptor inhibitors, have been evaluated for their effectiveness in managing sarcopenia. However, it is important to consider the variable efficacy and potential side effects associated with these treatments. There are currently no drugs approved by the Food and Drug Administration for sarcopenia. The ongoing research aims to develop more effective strategies in the future. Our review of research on disease mechanisms and drug development will be a valuable contribution to future research endeavors.
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Affiliation(s)
- Youle Zheng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Jin Feng
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Yixin Yu
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Min Ling
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
- MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, 430070, Hubei, China.
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Lv X, Peng W, Jia B, Lin P, Yang Z. Longitudinal association of sleep duration with possible sarcopenia: evidence from CHARLS. BMJ Open 2024; 14:e079237. [PMID: 38521528 PMCID: PMC10961493 DOI: 10.1136/bmjopen-2023-079237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES There are limited data on the relationship between sleep duration and possible sarcopenia. Hence, this study aimed to investigate the associations of sleep duration with possible sarcopenia and its defining components based on the China Health and Retirement Longitudinal Study (CHARLS). DESIGN A retrospective cohort study. SETTING This study was conducted on participants aged over 45 years applying the 2011 baseline and 2015 follow-up survey from CHARLS covering 450 villages, 150 counties and 28 provinces. PARTICIPANTS Data from 5036 individuals (2568 men and 2468 women) free of possible sarcopenia at baseline were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES The dose-response relationship between sleep duration and possible sarcopenia. RESULTS During 4 years of follow-up, 964 (19.14%) participants developed possible sarcopenia. Compared with participants who slept 6-8 hours per night, those with shorter sleep duration (<6 hours per night) were independently associated with 22% (OR, 1.22; 95% CI, 1.04 to 1.44) increased risk of developing possible sarcopenia and 27% (OR, 1.27; 95% CI, 1.04 to 1.57) increased risk of developing low handgrip strength after controlling for potential confounders. Long sleep duration (>8 hours per night) was not significantly associated with incident possible sarcopenia. The plots of restricted cubic splines exhibited an atypical inverse J-shaped association between sleep duration and possible sarcopenia. Subgroup analysis showed a stronger association between sleep duration and possible sarcopenia in participants aged 45-59 years and composed of male populations. CONCLUSIONS Short sleep duration was a potential risk factor for possible sarcopenia and low handgrip strength. The improvement of sleep duration should be considered a target in early preventive and administrative strategies against the development of handgrip strength decline and further reduced the occurrence of sarcopenia.
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Affiliation(s)
- Xiaoling Lv
- Zhejiang Provincial Key Lab of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Bingbing Jia
- Zhejiang Provincial Key Lab of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Ping Lin
- Department of Geriatrics, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - Zhouxin Yang
- Zhejiang Provincial Key Lab of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, Zhejiang, China
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Wullems JA, Degens H, Verschueren SMP, Morse CI, Grant DM, Onambélé-Pearson GL. Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults. PLoS One 2024; 19:e0294555. [PMID: 38394127 PMCID: PMC10889859 DOI: 10.1371/journal.pone.0294555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/03/2023] [Indexed: 02/25/2024] Open
Abstract
Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.
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Affiliation(s)
- Jorgen A. Wullems
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Lithuanian Sports University, Kaunas, Lithuania
| | - Sabine M. P. Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher I. Morse
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dale M. Grant
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gladys L. Onambélé-Pearson
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
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Xue X, Zhao LB, Zhao Z, Xu WH, Cai WM, Chen SH, Li TJ, Nie TY, Rui D, Qian XS, Liu L. Effect of Continuous Positive Airway Pressure on Incident Frailty in Elderly Patients with Obstructive Sleep Apnea: A Study Based on Propensity Score Matching. Clin Interv Aging 2024; 19:255-263. [PMID: 38380228 PMCID: PMC10878137 DOI: 10.2147/cia.s446129] [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] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024] Open
Abstract
Background The concomitant rise in the prevalence of obstructive sleep apnea (OSA) and frailty among the elderly population has been linked to an increase in mortality rates. Despite continuous positive airway pressure (CPAP) being the gold standard treatment for OSA, its impact on incident frailty remains inadequately explored. Methods In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA. Results During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15-0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19-0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14-0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19-0.75; P = 0.007). Conclusion CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.
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Affiliation(s)
- Xin Xue
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
- National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Li-Bo Zhao
- Department of Vasculocardiology, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Zhe Zhao
- Department of Vasculocardiology, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Wei-Hao Xu
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, People’s Republic of China
| | - Wei-Meng Cai
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Shao-Hua Chen
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Tian-Jiao Li
- Medical College, Yan’ an University, Yan’ an, People’s Republic of China
| | - Ting-Yu Nie
- Medical College, Yan’ an University, Yan’ an, People’s Republic of China
| | - Dong Rui
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Xiao-Shun Qian
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
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Hawley AL, Baum JI. Nutrition as the foundation for successful aging: a focus on dietary protein and omega-3 polyunsaturated fatty acids. Nutr Rev 2024; 82:389-406. [PMID: 37319363 DOI: 10.1093/nutrit/nuad061] [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] [Indexed: 06/17/2023] Open
Abstract
Skeletal muscle plays a critical role throughout the aging process. People living with sarcopenia, a progressive and generalized loss of skeletal muscle mass and function, often experience diminished quality of life, which can be attributed to a long period of decline and disability. Therefore, it is important to identify modifiable factors that preserve skeletal muscle and promote successful aging (SA). In this review, SA was defined as (1) low cardiometabolic risk, (2) preservation of physical function, and (3) positive state of wellbeing, with nutrition as an integral component. Several studies identify nutrition, specifically high-quality protein (eg, containing all essential amino acids), and long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), as positive regulators of SA. Recently, an additive anabolic effect of protein and n-3 PUFAs has been identified in skeletal muscle of older adults. Evidence further suggests that the additive effect of protein and n-3 PUFAs may project beyond skeletal muscle anabolism and promote SA. The key mechanism(s) behind the enhanced effects of intake of protein and n-3 PUFAs needs to be defined. The first objective of this review is to evaluate skeletal muscle as a driver of cardiometabolic health, physical function, and wellbeing to promote SA. The second objective is to examine observational and interventional evidence of protein and n-3 PUFAs on skeletal muscle to promote SA. The final objective is to propose mechanisms by which combined optimal intake of high-quality protein and n-3 PUFAs likely play a key role in SA. Current evidence suggests that increased intake of protein above the Recommended Dietary Allowance and n-3 PUFAs above the Dietary Guidelines for Americans recommendations for late middle-aged and older adults is required to maintain skeletal muscle mass and to promote SA, potentially through the mechanistical target of rapamycin complex 1 (mTORC1).
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Affiliation(s)
- Aubree L Hawley
- School of Human and Environmental Sciences, University of Arkansas, Fayetteville, AR, USA
| | - Jamie I Baum
- Center for Human Nutrition, Department of Food Science, University of Arkansas System Division of Agriculture, Fayetteville, AR, USA
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10
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Aksu S, Çaman T, Özdemir İ, Bek S, Kutlu G. Lower handgrip strength in short-sleeper individuals with obstructive sleep apnea. Sleep Med 2023; 112:352-358. [PMID: 37977019 DOI: 10.1016/j.sleep.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a frequently observed and remarkably incapacitating disorder worldwide. As a multisystem disorder, OSA has been linked to a plethora of clinical parameters though physical parameters like muscle strength have been scantily studied. Hand grip strength (HGS) is a practical marker of physical function that has been associated with mortality and an array of clinical outcomes as well as physiological parameters like sleep duration. A few seminal studies have observed no link between HGS and OSA severity while no studies evaluated the relationship between objectively determined sleep duration and HGS in OSA. OBJECTIVE The present study aimed to evaluate the HGS indices among both OSA severity groups and objectively determined sleep duration groups in OSA. METHODS 111 treatment-naïve mostly middle-aged individuals with OSA (86 males) were recruited in a tertiary sleep center. Three OSA severity groups were determined by the Apnea-Hypopnea Index while three sleep duration groups were objectively determined by Total Sleep Time (TST). Dominant and non-dominant maximum and average HGS were calculated using a digital hand dynamometer. RESULTS Short-sleeper individuals with OSA were found to have lower HGS indices than intermediate or sufficient sleepers with OSA while no differences in HGS indices among OSA severity groups were observed. All HGS indices correlated with TST. CONCLUSIONS Future insights can be gleaned from the present results regarding the conceivably transdiagnostic relationship between sleep duration and HGS as well as the potential use of HGS as a marker in OSA.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Tuğçe Çaman
- Department of Neurology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - İnan Özdemir
- Department of Neurology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Semai Bek
- Department of Neurology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Gülnihal Kutlu
- Department of Neurology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
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11
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Aslam MA, Ma EB, Huh JY. Pathophysiology of sarcopenia: Genetic factors and their interplay with environmental factors. Metabolism 2023; 149:155711. [PMID: 37871831 DOI: 10.1016/j.metabol.2023.155711] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
Sarcopenia is a geriatric disorder characterized by a progressive decline in muscle mass and function. This disorder has been associated with a range of adverse health outcomes, including fractures, functional deterioration, and increased mortality. The pathophysiology of sarcopenia is highly complex and multifactorial, involving both genetic and environmental factors as key contributors. This review consolidates current knowledge on the genetic factors influencing the pathogenesis of sarcopenia, particularly focusing on the altered gene expression of structural and metabolic proteins, growth factors, hormones, and inflammatory cytokines. While the influence of environmental factors such as physical inactivity, chronic diseases, smoking, alcohol consumption, and sleep disturbances on sarcopenia is relatively well understood, there is a dearth of studies examining their mechanistic roles. Therefore, this review emphasizes the interplay between genetic and environmental factors, elucidating their cumulative role in exacerbating the progression of sarcopenia beyond their individual effects. The unique contribution of this review lies in synthesizing the latest evidence on the genetic factors and their interaction with environmental factors, aiming to inform the development of novel therapeutic or preventive interventions for sarcopenia.
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Affiliation(s)
- Muhammad Arif Aslam
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
| | - Eun Bi Ma
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea
| | - Joo Young Huh
- College of Pharmacy, Chonnam National University, Gwangju, Republic of Korea.
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12
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Piovezan RD, Jadczak AD, Tucker G, Visvanathan R. Daytime Sleepiness Predicts Mortality in Nursing Home Residents: Findings from the Frailty in Residential Aged Care Sector Over Time (FIRST) Study. J Am Med Dir Assoc 2023; 24:1458-1464.e4. [PMID: 37062370 DOI: 10.1016/j.jamda.2023.03.007] [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: 12/20/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES Excessive daytime sleepiness is an increasingly frequent condition among older adults with comorbidities and living in nursing homes (NHs). This study investigated associations between participants' characteristics and excessive daytime sleepiness (EDS); the ability of the Epworth Sleepiness Scale (ESS) scores, EDS, and EDS severity levels to predict mortality at 12 months of follow-up; and the optimal cut-off for ESS to predict mortality among NH residents. DESIGN Prospective and cross-sectional analysis in a prospective study. SETTING AND PARTICIPANTS Older adults permanently residing in 12 NHs from South Australia. METHODS Baseline characteristics including the ESS were collected and mortality at 12 months was assessed. Logistic regression analyzed associations between participants' characteristics and EDS (ESS >10). Kaplan-Meier cumulative survival estimates followed by log-rank and adjusted Cox proportional hazards models explored associations of ESS scores, EDS, and EDS severity levels with time-to-incident death. Receiver operator curve analysis assessed the best cut-off for ESS to predict mortality risk. RESULTS A total of 550 participants [mean (SD) age, 87.7 (7.2) years; 968 (50.9%) female]. Malnutrition [adjusted odds ratio (aOR) 2.02, 95% confidence interval (CI) 1.13‒3.61], myocardial infarction (aOR 1.91, 95% CI 1.20‒3.03), heart failure (aOR 2.85, 95% CI 1.68‒4.83), Parkinson's disease (aOR 2.16, 95% CI 1.04‒4.47) and severe dementia (aOR 8.57, 95% CI 5.25‒14.0) were associated with EDS. Kaplan-Meier analyses showed reduced survival among participants with EDS (log-rank test: χ2 = 25.25, P < .001). EDS predicted increased mortality risk (HR 1.63, 95% CI 1.07-2.51, P = .023). ESS score of 10.5 (>10) was the best cut point predicting mortality risk (area under the curve = 0.62). CONCLUSIONS AND IMPLICATIONS EDS predicts mortality risk and is associated with age-related comorbidities in NH residents. Screening for EDS is a simple strategy to identify NH residents at higher risk of adverse outcomes, triggering an assessment for reversibility or conversations about end-of-life care.
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Affiliation(s)
- Ronaldo D Piovezan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia.
| | - Agathe D Jadczak
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Graeme Tucker
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, the Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia
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13
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Liu QW, Mao CJ, Lu ZH, Shi RF, Zhang YC, Zhao P, Liu CF. Sarcopenia is associated with non-motor symptoms in Han Chinese patients with Parkinson's Disease: a cross-sectional study. BMC Geriatr 2023; 23:494. [PMID: 37587447 PMCID: PMC10428605 DOI: 10.1186/s12877-023-04188-3] [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: 02/04/2022] [Accepted: 07/20/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Sarcopenia is commonly seen in the older adults and increases in incidence with age, also in Parkinson's disease (PD). Although research has indicated that the development of sarcopenia in patients with PD may be related to both motor symptoms and non-motor symptoms (NMS), the precise relationship between the two conditions remains unclear. Therefore, we aimed to investigate the incidence of sarcopenia in patients with PD and its association with NMS. METHODS The study included 123 patients with PD and 38 age- and sex-matched healthy controls (HC). All participants were evaluated for sarcopenia using the 2019 Asian Sarcopenia Diagnostic Criteria, and patients with PD underwent standard assessments of motor symptoms and NMS. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were used to examine the association between sarcopenia and NMS in patients with PD. RESULTS The incidence of sarcopenia was significantly higher in patients with PD than in HC (26.8% vs. 10.4%, p = 0.046). Multiple logistic regression analysis revealed that poorer sleep quality (odds ratio [OR]: 1.245; 95% confidence interval [CI]: 1.011-1.533; p = 0.040) and fatigue (OR: 1.085, 95% CI: 1.006-1.170, p = 0.034) were independently associated with sarcopenia. ROC analysis indicated that the optimal cut-off value for Pittsburgh Sleep Quality Index (PSQI) scores was 10, with 72.7% sensitivity and 74.4% specificity (area under the curve [AUC] = 0.776, 95% CI: 0.683-0.868, p < 0.001). The optimal cut-off value for Fatigue Severity Scale (FSS) scores was 39, with 87% sensitivity and 50% specificity (AUC = 0.725, 95% CI: 0.629 -0.820, p < 0.001). Joint use of FSS and PSQI scores increased the predictive value for sarcopenia(AUC = 0.804, 95% CI: 0.724-0.885, p < 0.001). CONCLUSION Patients with PD are more susceptible to sarcopenia than healthy older adults, and fatigue and poorer sleep are positively associated with sarcopenia. Further longitudinal studies are needed to clarify the causal relationships.
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Affiliation(s)
- Qiu-Wan Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Cheng-Jie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
| | - Zhao-Hui Lu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Rong-Fang Shi
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Ying-Chun Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Ping Zhao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
- Institute of Neuroscience, Soochow University, Suzhou, 215004, China.
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14
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Li X, He J, Sun Q. Sleep Duration and Sarcopenia: An Updated Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1193-1206.e5. [PMID: 37295459 DOI: 10.1016/j.jamda.2023.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES In adults, short and long sleep duration has been associated with sarcopenia risk. Studies have shown that various factors, including biological and psychological factors, could be the underlying cause of the association between aberrant sleep duration and sarcopenia risk. In this study, we have qualitatively and quantitatively summarized previously published studies on sleep duration to assess the relationship between sleep duration and sarcopenia risk in adults. This would aid in enhancing our understanding of recent advancements in this field and the association between sleep duration and sarcopenia risk. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS In this review, we included studies evaluating the association between the duration of sleep and sarcopenia in adults in observational studies. METHODS Five electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Web of Science) were searched to April 20, 2023, to identify studies related to sarcopenia and sleep duration. Next, we calculated the odds ratios (ORs) for sarcopenia prevalence based on the adjusted data from individual studies. Statistical analyses were performed using Stata 11.0. RESULTS Sarcopenia prevalence was high (18%) in adults with long sleep duration. Our results showed a significant association between short duration of sleep and high sarcopenia prevalence in older adults (OR 1.2, 95% CI 1.02-1.41, I2 = 56.6%). Furthermore, a significant association was observed between all participants with long-duration sleep and high sarcopenia prevalence (OR 1.53, 95% CI 1.34-1.75, I2 = 56.8%). We also observed significant heterogeneity in the adjusted ORs. CONCLUSIONS AND IMPLICATIONS There was a correlation between sarcopenia and short or long sleep duration, especially in older adults. In adults with a long duration of sleep, sarcopenia prevalence was relatively high.
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Affiliation(s)
- Xiaoyan Li
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie He
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Qiuhua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
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15
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Singh SK, Jaiswal AK, Verma M. Is there a ubiquitous association between sleep disorder and frailty? findings from LASI (2017-18). BMC Geriatr 2023; 23:429. [PMID: 37438687 DOI: 10.1186/s12877-023-04148-x] [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: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Relatively little is known about how sleep disorders affect frailty of seniors. The study uses Fried's frailty index, to investigate the relationship between sleep disorder and frailty among older Indian adults. METHODS The study analysed Longitudinal Ageing Study in India (2017-18) data which uses a multistage stratified area probability cluster sampling design. The association between frailty was studied for which the total sample size was 31,902. The principal dependent variable was frailty. Descriptive statistics and cross-tabulation were presented in the study. A binary logistic regression analysis was used to fulfil the study objectives to find the possible association. RESULTS The prevalence of frailty in India was 21.3 percent. Older adults with sleep disorder had 66 percent higher likelihood to be frail than their counterparts. The benefits of physical activity in containing frailty is huge, the association were quite high. Poor Self-rated health was significantly associated with higher frailty (OR = 1.73; CI = 1.47-2.04). CONCLUSIONS Frailty is an enormously growing public health issue and has bi-directional relation with sleep disorders. The study has clinical relevance since sleep complaints offer a means for identifying those who are vulnerable to frailty and through appropriate intervention, the causes of sleep disorder would help to delay and in some cases reverse frailty.
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Affiliation(s)
- S K Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Ajit K Jaiswal
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - Madhur Verma
- Assistant Professor of Community/Family Medicine, All India Institute of Medical Sciences Bathinda (Punjab), Punjab, India
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Ganipineni VDP, Idavalapati ASKK, Tamalapakula SS, Moparthi V, Potru M, Owolabi OJ. Depression and Hand-Grip: Unraveling the Association. Cureus 2023; 15:e38632. [PMID: 37159619 PMCID: PMC10163904 DOI: 10.7759/cureus.38632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 05/11/2023] Open
Abstract
This review article explores the association between hand-grip strength and depression. A total of 14 studies were carefully considered to provide a comprehensive analysis of the topic. The studies reveal a consistent association between low hand-grip strength and depressive symptoms, independent of age, gender, and chronic disease status. The evidence suggests that hand-grip strength assessment could be a useful tool for identifying individuals at risk of depression, particularly older adults and those with chronic diseases. Incorporating physical activity and strength training into treatment plans can contribute to better mental health outcomes. Hand-grip strength assessment can also be used as a monitoring tool to track changes in physical and mental health over time in individuals with depression. Healthcare professionals should consider the relationship between hand-grip strength and depression when evaluating patients and developing treatment plans. The findings from this comprehensive clinical review have important clinical implications and highlight the importance of considering physical health factors in the context of mental health.
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Affiliation(s)
- Vijay Durga Pradeep Ganipineni
- Department of General Medicine, SRM Medical College Hospital and Research Center, Chennai, IND
- Department of General Medicine, Andhra Medical College/King George Hospital, Visakhapatnam, IND
| | | | | | - Vagdevi Moparthi
- Department of Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND
| | - Monica Potru
- Department of Medicine, Guntur Medial College, Guntur, IND
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17
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Lee K. Sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea in relation to handgrip strength. Arch Gerontol Geriatr 2023; 110:104987. [PMID: 36889010 DOI: 10.1016/j.archger.2023.104987] [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: 01/09/2023] [Revised: 02/12/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE This cross-sectional study aimed to evaluate whether weekday sleep duration, weekend catch-up sleep, and risk of obstructive sleep apnea are individually and in combination associated with handgrip strength. METHODS Data from the Korea National Health and Nutrition Examination Survey 2019, including weekday sleep duration, weekend catch-up sleep, STOP-BANG scores, relative handgrip strength (handgrip strength divided by body mass index), and confounding factors (sociodemographic factors, health behaviors, and health and nutritional status), were evaluated in 3678 Korean adults aged 40 to 80 years. Adequate (vs. inadequate) sleep parameters were defined as weekday sleep duration (6-7 vs. ≤ 5 or ≥ 8 h), weekend catch-up sleep (presence vs. absence), and risk of obstructive sleep apnea (low vs. high based on STOP-BANG scores). Sex-specific quintiles of relative handgrip strength were categorized as high (highest 5th quintile) or low (lower 1st to 4th quintiles). A complex-sample logistic regression analysis was performed. RESULTS After adjusting for other sleep parameters and confounding variables, each adequate sleep parameter individually and collectively was associated with high relative handgrip strength (adjusted odds ratios [95% confidence interval], 1.43 [1.09, 1.89] for 6-7 h weekday sleep duration; 1.44 [1.10, 1.90] for low risk of obstructive sleep apnea; 1.72 [1.23, 2.40] for any two parameters; 1.81 [1.18, 2.79] for all parameters). The combination of adequate weekend catch-up sleep and obstructive sleep apnea risk had the highest odds ratio for high relative handgrip strength (2.36 [1.45, 3.83]). CONCLUSIONS Adequate weekday sleep duration, weekend catch-up sleep, and low obstructive sleep apnea risk were individually and in combination associated with high handgrip strength.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, College of Medicine, Inje University, 75, Bokji-ro, Busanjin-gu, Busan, Republic of Korea, (47392), 82-51-890-6229, 82-51-894-7554.
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18
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Alzahrani MA, Alasmari MM, Altokhais MI, Alkeraithe FW, Alghamdi TA, Aldaham AS, Hakami AH, Alomair S, Hakami BO. Is There a Relationship Between Waking Up from Sleep and the Onset of Testicular Torsion? Res Rep Urol 2023; 15:91-98. [PMID: 36855423 PMCID: PMC9968432 DOI: 10.2147/rru.s404073] [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: 01/08/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Testicular torsion is a serious urologic emergency that can present with unusual or atypical history and examination. Classical pain from testicular torsion is of sudden onset, significantly severe, and is accompanied by nausea and vomiting. However, in some patients, the initial scrotal pain appears to considerably subside within the next few hours. In others, testicular torsion tends to occur while sleeping, and many patients recount a history of being woken up from sleep by intense pain. Furthermore, some patients in this subset can resume normal activities and even sleep through the night with little or no discomfort, without a perceived need for pain medications. Other patients initially experience mild pain, which worsens over time. Consequently, these patients are less likely to be evaluated immediately. In view of these atypical cases, the question remains unanswered regarding sleep as a predisposing factor for testicular torsion. This narrative review focuses on exploring the association between sleep and testicular torsion.
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Affiliation(s)
- Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia,Correspondence: Meshari A Alzahrani, Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, 11952, Saudi Arabia, Tel +966569990693, Fax +966164042500, Email
| | | | - Moataz I Altokhais
- Department of Urology, King Khalid University Hospital, Riyadh, Saudi Arabia
| | | | - Talal A Alghamdi
- Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Alwaleed H Hakami
- College of Medicine and Surgery, Jazan University, Jazan, Saudi Arabia
| | - Saud Alomair
- College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Basel O Hakami
- Department of Urology, King Faisal Medical City for Southern Region (KFMC), Abha, Saudi Arabia
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Liu S, Zhuang S, Li M, Zhu J, Zhang Y, Hu H. Relationship between sarcopenia and sleep status in female patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23:94-107. [PMID: 36403982 DOI: 10.1111/psyg.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/09/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep disorders and sarcopenia could contribute to the development of Alzheimer's disease (AD), which are risk factors that rapidly deteriorate cognitive functions. However, few studies have evaluated the relationship between sarcopenia and sleep disorders in female AD patients, who have a higher prevalence than male patients. This study aimed to investigate the relationship between sarcopenia and sleep status in female patients with mild to moderate AD. METHODS This cross-sectional study recruited 112 female outpatients aged between 60 and 85 years. Demographic characteristics, appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were assessed. Sarcopenia was diagnosed according to criteria of the Asian Working Group for Sarcopenia. Pittsburgh Sleep Quality Index (PSQI) assessed sleep variables. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) assessed cognitive function. Binary logistic regression models explored the relationship between sleep variables and cognitive function and sarcopenia, adjusting for potential cofounders. RESULTS The outpatients were divided into 36 AD patients with sarcopenia (ADSa) and 76 AD patients without sarcopenia (ADNSa), with a prevalence of 32.1%. ADSa had lower ASMI, weaker grip strength, slower gait speed, a higher incidence of poor sleep quality and poorer cognitive function. Multivariate binary logistic regression analysis showed that high total scores of PSQI (odds ratio (OR) = 1.13), poor sleep quality (OR = 2.73), poor subjective sleep quality (OR = 1.83), low MMSE (OR = 0.77) and MoCA (OR = 0.76) scores were associated with high odds of sarcopenia. Compared to sleep time ≤ 15 min, >60 min (OR = 5.01) were associated with sarcopenia. Sleep duration <6 h (OR = 3.99), 8-9 h (OR = 4.48) and ≥9 h (OR = 6.33) were associated with sarcopenia compared to 7-8 h. CONCLUSIONS More sleep symptoms and cognitive impairment exist in female patients with sarcopenia. The higher total scores of PSQI, poorer subjective sleep quality, longer sleep latency, excessive and insufficient sleep duration and poorer cognitive function are associated with higher odds of sarcopenia in female patients with mild to moderate AD.
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Affiliation(s)
- Shanwen Liu
- Department of Neurology and Suzhou Clinical Research Centre of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
| | - Sheng Zhuang
- Department of Neurology and Suzhou Clinical Research Centre of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
| | - Meng Li
- Department of Imaging, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
| | - Jiangtao Zhu
- Department of Imaging, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
| | - Yingchun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
| | - Hua Hu
- Department of Neurology and Suzhou Clinical Research Centre of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China
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The prevalence of sleep loss and sleep disorders in young and old adults. AGING BRAIN 2023; 3:100057. [PMID: 36911264 PMCID: PMC9997161 DOI: 10.1016/j.nbas.2022.100057] [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: 06/27/2022] [Revised: 10/28/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
The ability to sleep declines with age. The National Sleep Foundation, USA has recommended a minimum sleep amount for all ages. Individuals who experience sleep lesser than the recommended amount could be sleep-deprived. Several factors like stress, altered circadian cycle, medical conditions, etc. cause sleep deficiency. Almost 50-60 % of elderly population suffer from sleep disorders such as sleep apnea, restless legs syndrome, REM sleep behavior disorder, etc. Chronic sleep deprivation may further lead to the development of diseases such as Alzheimer's and Parkinson's. This paper reviews the prevalence of sleep disorders and consequences of sleep loss in young and old adults.
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Lu L, He X, Song Y, Zhuang M, Wu X, Chen N. Prevalence and risk factors of sarcopenia without obesity and sarcopenic obesity among Chinese community older people in suburban area of Shanghai: A cross-sectional study. Front Aging Neurosci 2022; 14:1034542. [PMID: 36605360 PMCID: PMC9807613 DOI: 10.3389/fnagi.2022.1034542] [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: 09/01/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives The aim of the present study was to explore the prevalence and risk factors of sarcopenia without obesity (S) and sarcopenic obesity (SO) among community-dwelling older people in the Chongming District of Shanghai, China, according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus as the diagnostic criteria of sarcopenia. Methods In this cross-sectional study, a total of 1,407 subjects aged ≥65 years were included, where the mean age of the subjects was 71.91 ± 5.59 years and their mean body mass index (BMI) was 24.65 ± 3.32 kg/m2. According to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus, sarcopenia was defined as a low appendicular skeletal muscle mass index (≤7.0 kg/m2 in males and ≤5.7 kg/m2 in females), decreased handgrip strength (<28.0 kg in males and <18.0 kg in females), and/or low gait speed (<1.0 m/s) or poor 5-time chair stand test (5CST) (≥12s). The SO met both the diagnostic criteria for sarcopenia and obesity, meanwhile obesity was defined as an increased percentage of body fat (PBF) (≥25% in males and ≥35% in females). Univariate and multiple logistic regression analyses were performed to explore the risk factors of both S and SO. Results The prevalence of S and SO was 9.74% (M: 9.29%, F: 10.05%) and 9.95% (M: 13.94%, F: 7.14%). Lower BMI (OR = 0.136, 95% CI: 0.054-0.340, p < 0.001), lower hip circumference (OR = 0.858, 95% CI: 0.816-0.903, p < 0.001), farming (OR = 1.632, 95% CI: 1.053-2.530, p = 0.028), higher high-density lipoprotein cholesterol (HDL-C) level (OR = 2.235, 95% CI: 1.484-3.367, p < 0.001), and a sleep duration <7 h (OR = 0.561, 95% CI: 0.346-0.909, p = 0.019) were risk factors for S. While aging (70-74 y, OR = 1.923, 95% CI: 1.122-3.295, p = 0.017; 75-79 y, OR = 3.185, 95% CI: 1.816-5.585, p < 0.001; ≥80 y, OR = 7.192, 95% CI: 4.133-12.513, p < 0.001), male (OR = 1.981, 95% CI: 1.351-2.904, p < 0.001), higher BMI (OR = 4.865, 95% CI: 1.089-21.736, p = 0.038), higher monocyte level (OR = 4.203, 95% CI: 1.340-13.181, p = 0.014), and a sleep duration >9 h (OR = 1.881, 95% CI: 1.117-3.166, p = 0.017) were risk factors for SO. Conclusion Our study showed the high prevalence of S and SO among community-dwelling older people in the Chongming District. The SO was more prevalent in males. Behavioral factors and lifestyle (such as farming and sleep duration) were associated more with the development of S, while age and male gender were associated more with the development of SO.
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Affiliation(s)
- Linqian Lu
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xiangfeng He
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Yanping Song
- Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Min Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Xie Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China,*Correspondence: Xie Wu ✉
| | - Nan Chen
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China,Department of Rehabilitation, Xinhua Hospital Chongming Branch, Shanghai, China,School of Kinesiology, Shanghai University of Sport, Shanghai, China,Nan Chen ✉
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22
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Morwani-Mangnani J, Giannos P, Belzer C, Beekman M, Eline Slagboom P, Prokopidis K. Gut microbiome changes due to sleep disruption in older and younger individuals: a case for sarcopenia? Sleep 2022; 45:6743463. [PMID: 36183306 PMCID: PMC9742900 DOI: 10.1093/sleep/zsac239] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/09/2022] [Indexed: 11/05/2022] Open
Abstract
Major hallmarks of functional loss, loss of metabolic and musculoskeletal health and (multi)morbidity with aging are associated with sleep disturbances. With poor sleep shifts in gut microbial composition commonly manifest, which could mediate the pro-inflammatory state between sleep disturbances and sarcopenia. This systematic review presents the recent evidence on how sleep disturbances throughout the lifespan associate with and contribute to gut microbial composition changes, proposing a mechanism to understand the etiology of sarcopenia through sleep disturbances. The relationship between disturbed sleep and clinically relevant gut microbiota composition on health aspects of aging is discussed. A search was performed in PubMed, Cochrane Library, Scopus, Web of Science using keywords including (microbio* OR microflora) AND (sleep OR sleep disorder). Six cross-sectional population-based studies and five experimental clinical trials investigating healthy individuals with ages ranging from 4 to 71 were included. The cross-sectional studies reported similarities in associations with sleep disturbance and gut microbial diversity. In older adults, shorter sleep duration is associated with an increase in pro-inflammatory bacteria whereas increasing sleep quality is positively associated with an increase of beneficial Verrucomicrobia and Lentisphaerae phyla. In young adults, the effect of sleep disruption on gut microbiome composition, specifically the ratio of beneficial Firmicutes over Bacteroidetes phyla, remains contradictory and unclear. The findings of this review warrant further research in the modulation of the gut microbiome linking poor sleep with muscle-catabolic consequences throughout the lifespan.
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Affiliation(s)
- Jordi Morwani-Mangnani
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Panagiotis Giannos
- Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, UK
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Marian Beekman
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P Eline Slagboom
- Section of Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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23
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de Sá Souza H, de Melo CM, Piovezan RD, Miranda REEPC, Carneiro-Junior MA, Silva BM, Thomatieli-Santos RV, Tufik S, Poyares D, D’Almeida V. Resistance Training Improves Sleep and Anti-Inflammatory Parameters in Sarcopenic Older Adults: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16322. [PMID: 36498393 PMCID: PMC9736460 DOI: 10.3390/ijerph192316322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Sleep and exercise have an important role in the development of several inflammation-related diseases, including sarcopenia. Objective: To investigate the effects of 12 weeks of resistance exercise training on sleep and inflammatory status in sarcopenic patients. Methods: A randomized controlled trial comparing resistance exercise training (RET) with a control (CTL) was conducted. Outcomes were obtained by physical tests, polysomnography, questionnaires, isokinetic/isometric dynamometry tests, and biochemical analysis. Results: Time to sleep onset (sleep latency) was reduced in the RET group compared to the CTL group (16.09 ± 15.21 vs. 29.98 ± 16.09 min; p = 0.04) after the intervention. The percentage of slow-wave sleep (N3 sleep) was increased in the RET group (0.70%, CI: 7.27−16.16 vs. −4.90%, CI: 7.06−16.70; p = 0.04) in an intention to treat analysis. Apnea/hour was reduced in the RET group (16.82 ± 14.11 vs. 7.37 ± 7.55; p = 0.001) and subjective sleep quality was improved compared to the CTL (−1.50; CI: 2.76−6.14 vs. 0.00; CI: 1.67−3.84 p = 0.02) in an intention-to-treat analysis. Levels of interleukin-10 (IL-10) (2.13 ± 0.80 vs. 2.51 ± 0.99; p < 0.03) and interleukin-1 receptor antagonist (IL-1ra) (0.99 ± 0.10 vs. 0.99 ± 0.10 ng/mL; p < 0.04; delta variation) were increased in the RET group. Conclusions: RET improves sleep parameters linked to muscle performance, possibly due to an increase in anti-inflammatory markers in older sarcopenic patients.
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Affiliation(s)
- Helton de Sá Souza
- Department of Physical Education, Universidade Federal de Viçosa, Viçosa 36570-900, MG, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Camila Maria de Melo
- Department of Nutrition, Universidade Federal de Lavras, Lavras 37200-000, MG, Brazil
| | - Ronaldo Delmonte Piovezan
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide 5000, Australia
| | | | | | - Bruno Moreira Silva
- Department of Physiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | | | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Dalva Poyares
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
| | - Vânia D’Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo 04023-062, SP, Brazil
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24
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Sleep, circadian biology and skeletal muscle interactions: Implications for metabolic health. Sleep Med Rev 2022; 66:101700. [PMID: 36272396 DOI: 10.1016/j.smrv.2022.101700] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/07/2022]
Abstract
There currently exists a modern epidemic of sleep loss, triggered by the changing demands of our 21st century lifestyle that embrace 'round-the-clock' remote working hours, access to energy-dense food, prolonged periods of inactivity, and on-line social activities. Disturbances to sleep patterns impart widespread and adverse effects on numerous cells, tissues, and organs. Insufficient sleep causes circadian misalignment in humans, including perturbed peripheral clocks, leading to disrupted skeletal muscle and liver metabolism, and whole-body energy homeostasis. Fragmented or insufficient sleep also perturbs the hormonal milieu, shifting it towards a catabolic state, resulting in reduced rates of skeletal muscle protein synthesis. The interaction between disrupted sleep and skeletal muscle metabolic health is complex, with the mechanisms underpinning sleep-related disturbances on this tissue often multifaceted. Strategies to promote sufficient sleep duration combined with the appropriate timing of meals and physical activity to maintain circadian rhythmicity are important to mitigate the adverse effects of inadequate sleep on whole-body and skeletal muscle metabolic health. This review summarises the complex relationship between sleep, circadian biology, and skeletal muscle, and discusses the effectiveness of several strategies to mitigate the negative effects of disturbed sleep or circadian rhythms on skeletal muscle health.
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25
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Mochón-Benguigui S, Carneiro-Barrera A, Dote-Montero M, Castillo MJ, Amaro-Gahete FJ. Sleep and Anabolic/Catabolic Hormonal Profile in Sedentary Middle-Aged Adults: The FIT-AGEING Study. Int J Mol Sci 2022; 23:ijms232314709. [PMID: 36499035 PMCID: PMC9739476 DOI: 10.3390/ijms232314709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Sleep quality plays an important role in the modulation of several aging markers. This influence could be explained by aging-induced hormonal changes. Indeed, poor sleep quality has been associated with the development of several endocrine-related health complications. This study examined the relationship of both subjective and objective sleep quantity and quality, with basal levels of selected plasma anabolic and catabolic hormones in sedentary middle-aged adults. A total of 74 volunteers (52.7% women; aged 53.7 ± 5.1) were recruited for this study. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI; higher scores indicate worse sleep quality), and objective sleep quality parameters (total sleep time [TST], wake after sleep onset [WASO], and sleep efficiency [SE]) were measured using a wrist-worn accelerometer. Basal levels of plasma dehydroepiandrosterone sulphate (DHEAS), total testosterone, sex hormone binding globulin (SHBG), somatotropin, and cortisol levels, were determined. Free testosterone was calculated from the total testosterone and SHBG levels. No associations of global PSQI score, TST, WASO, and SE with DHEAS, free testosterone, and somatotropin plasma levels were found, neither in men nor in women (all p ≥ 0.05). Global PSQI score was inversely related to cortisol plasma levels in women (p = 0.043). WASO was positively associated with cortisol plasma levels, while SE was negatively associated with cortisol plasma levels in women (all p ≤ 0.027). Sleep quality is not related to levels of plasma anabolic hormones, but to levels of catabolic hormones, in sedentary middle-aged adults. Therefore, these results suggest that potential changes in aging biomarkers associated with sleep disturbances, could be mediated by age-related changes in the catabolic endocrine system.
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Affiliation(s)
- Sol Mochón-Benguigui
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Almudena Carneiro-Barrera
- Department of Psychology, Universidad Loyola Andalucía, 41704 Seville, Spain
- Sleep and Health Promotion Laboratory, Mind, Brain and Behavior Research Centre, University of Granada, 18011 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Manuel Dote-Montero
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Manuel J. Castillo
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Francisco J. Amaro-Gahete
- EFFECTS-262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18016 Granada, Spain
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
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26
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Yang M, Zhang Y, Zhao WY, Ge ML, Sun XL, Jia SL, Dong BR. Association of sleep duration with sarcopenic obesity in multi-ethnic older adults: findings from the WCHAT Study. BMC Geriatr 2022; 22:899. [PMID: 36434541 PMCID: PMC9701023 DOI: 10.1186/s12877-022-03543-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Sarcopenic obesity is a prevalent geriatric syndrome, characterized by concurrence of sarcopenia and obesity. Sleep duration is linked to both obesity and sarcopenia. However, little was known regarding the association of sleep duration with sarcopenic obesity. In this study, we aimed to examine the association of sleep duration with sarcopenic obesity in multi-ethnic community-dwelling older adults. METHODS Sarcopenia was defined according to the criteria established by Asian Working Group for Sarcopenia (AWGS) 2019. Obesity was defined as body fat percentage above the 60th percentile specified by sex. Sarcopenic obesity was defined as concurrence of obesity and sarcopenia. Sleep duration was collected by a self-reported questionnaire and was further divided into 5 groups: "<6 h", "6-7 h", "7-8 h", "8-9 h" (reference group) and "≥9 h" (long sleep). Logistic regressions were adopted to examine the association. RESULTS 2256 multi-ethnic adults aged 60 and over from the West China Health and Aging Trend (WCHAT) study were involved for present study. Overall, 6.25% of the participants were classified as sarcopenic obesity. In the fully adjusted model, long sleep duration (≥ 9 h) was significantly associated with sarcopenic obesity compared with reference group (OR = 1.81, 95%CI = 1.10-2.98, P = 0.019). However, in subgroup analysis, this association can only be observed in male (OR 1.98, 95% CI = 1.02-3.87, P = 0.043) not in female (OR = 1.83, 95%CI = 0.85-3.94, P = 0.118). Regarding ethnic difference, Han older adults with long sleep duration (≥ 9 h) presented increased risk of sarcopenic obesity while ethnic minorities did not. CONCLUSION This study disclosed that long sleep duration significantly increased the risk of sarcopenic obesity among older adults. And our findings highlight the critical role of assessing sleep duration to identify individuals at risk of sarcopenic obesity.
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Affiliation(s)
- Mei Yang
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Yan Zhang
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Wan-yu Zhao
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Mei-ling Ge
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Xue-lian Sun
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Shu-li Jia
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
| | - Bi-rong Dong
- grid.13291.380000 0001 0807 1581National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China ,grid.13291.380000 0001 0807 1581Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, GuoXueXiang 37, 610041 Chengdu, China
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27
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Hu Z, Yang A, Tian Y, Song X. Daytime napping, comorbidity profiles, and the risk of sarcopenia in older individuals. Front Physiol 2022; 13:1000593. [PMID: 36388101 PMCID: PMC9663836 DOI: 10.3389/fphys.2022.1000593] [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: 07/22/2022] [Accepted: 10/17/2022] [Indexed: 01/24/2023] Open
Abstract
Appropriate daytime napping is associated with the decreased risk of cerebro-cardiovascular diseases, but whether daytime napping affects sarcopenia remains to be explored. Our study plans to examine the associations between sarcopenia with daytime napping and comorbidity. The study population came from the China Health and Retirement Longitudinal Study 2011-2015. Latent class analysis (LCA) was used to identify comorbidity profiles based on 14 doctor-diagnosed chronic diseases. Subsequently, smooth function and restricted cubic spline with three binomial regression models determined the associations between sarcopenia with daytime napping and comorbidity profiles. About 18.7% (2,894) and 5.4% (832) of 15,404 individuals were diagnosed with sarcopenia and severe sarcopenia. LCA delineated four classes as the best fit as follows: dominant heart diseases or risks (class 1, N = 2,203), dominant chronic lung diseases (class 2, N = 740), minimal or least diseases (class 3, N = 10,612, reference), and dominant digestive diseases and rheumatism (class 4, N = 1849). Compared with the reference group (class 3), the multivariate-adjusted ORs (95% CIs) of sarcopenia in model 3 were 0.72 (0.60-0.88) for class 1, 1.17 (0.92-1.51) for class 2, and 0.92 (0.77-1.09) for class 4. Smooth function and restricted cubic spline suggested that individuals who napped about 60 min seemingly had the lowest risk of sarcopenia. Individuals who napped for 1-59 min (adjusted OR = 0.80, 95% CI: 0.68-0.94) and 60-119 min (adjusted OR = 0.83, 95% CI: 0.72-0.95) had the significantly lower risk of sarcopenia but not severe sarcopenia than those who did not nap. Insufficient and excessive daytime napping might be associated with the increased risk of sarcopenia, especially in individuals with a dominant chronic lung disease profile.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital at Zhijiang, Zhijiang, China,*Correspondence: Zhigang Hu, ; Xinyu Song,
| | - Ailan Yang
- Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital at Zhijiang, Zhijiang, China
| | - Yufeng Tian
- Department of Teaching Office, Three Gorges University, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China,*Correspondence: Zhigang Hu, ; Xinyu Song,
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28
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Zhong J, Xie W, Wang X, Dong X, Mo Y, Liu D, Yao X, Liu B, Deng W, Su Y, Li Y, Wang X. The Prevalence of Sarcopenia among Hunan Province Community-Dwelling Adults Aged 60 Years and Older and Its Relationship with Lifestyle: Diagnostic Criteria from the Asian Working Group for Sarcopenia 2019 Update. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1562. [PMID: 36363519 PMCID: PMC9699421 DOI: 10.3390/medicina58111562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/13/2022] [Accepted: 10/27/2022] [Indexed: 01/04/2024]
Abstract
Background and Objectives: This study aims to detect the prevalence of sarcopenia in community-dwelling older adults in Hunan Province, discuss factors related to lifestyle, and provide a reliable basis for the prevention and treatment of sarcopenia. Materials and Methods: In this study, a total of 1040 community-dwelling adults ≥ 60 years were examined for sarcopenia using a cluster stratified random sampling method, which was defined using the diagnostic criteria recommended by the Asian Working Group for Sarcopenia (AWGS) from September 2019 to March 2020. Multivariate logistic regression analysis was applied to determine the correlation between sarcopenia and smoking, drinking, nutritional status, physical activity, and sleep quality. Results: A total of 27.1% of the older adults were diagnosed with sarcopenia, with rates of 26.2% in men and 25.2% in women. Multiple logistic regression showed that advanced age (OR = 2.480, 95% CI: 1.730, 3.553), the risk of malnutrition (OR = 2.085, 95% CI: 1.440, 3.019), and malnutrition (OR = 1.212, 95% CI: 0.304, 4.834) were risk factors for sarcopenia. No falls in the previous year (OR = 0.616, 95% CI: 1.885, 1.209), normal weight (OR = 0.228, 95% CI: 0.109, 0.475), overweight (OR = 0.030, 95% CI: 0.013, 0.069), moderate physical activity (OR = 0.593, 95% CI: 0.377, 0.933), or high physical activity (OR = 0.417, 95% CI: 0.230, 0.755) were identified as protective factors for sarcopenia. Conclusions: The prevalence of sarcopenia was high among older adults in the community in Hunan Province. In addition, we found that lifestyle is an important factor in sarcopenia.
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Affiliation(s)
- Jing Zhong
- Deparment of Nephrology, The Third Xiangya Hospital, Central South University, Changsha 410013, China
| | - Wenqing Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiaoqin Wang
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xin Dong
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yihan Mo
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Dan Liu
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Xuemei Yao
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Beibei Liu
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Wenyu Deng
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yidong Su
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
| | - Yusheng Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiuhua Wang
- Xiang Ya Nursing School, Central South University, Changsha 410013, China
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Zhu Y, Fan J, Lv J, Guo Y, Pei P, Yang L, Chen Y, Du H, Li F, Yang X, Avery D, Chen J, Chen Z, Yu C, Li L. Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study. BMC Med 2022; 20:354. [PMID: 36266610 PMCID: PMC9585775 DOI: 10.1186/s12916-022-02557-0] [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] [Received: 06/19/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the effects of maintaining healthy sleep patterns on frailty transitions. METHODS Based on 23,847 Chinese adults aged 30-79 in a prospective cohort study, we examined the associations between sleep patterns and frailty transitions. Healthy sleep patterns included sleep duration at 7 or 8 h/d, without insomnia disorder, and no snoring. Participants who persisted with a healthy sleep pattern in both surveys were defined as maintaining a healthy sleep pattern and scored one point. We used 27 phenotypes to construct a frailty index and defined three statuses: robust, prefrail, and frail. Frailty transitions were defined as the change of frailty status between the 2 surveys: improved, worsened, and remained. Log-binomial regression was used to calculate the prevalence ratio (PR) to assess the effect of sleep patterns on frailty transitions. RESULTS During a median follow-up of 8.0 years among 23,847 adults, 45.5% of robust participants, and 10.8% of prefrail participants worsened their frailty status, while 18.6% of prefrail participants improved. Among robust participants at baseline, individuals who maintained sleep duration of 7 or 8 h/ds, without insomnia disorder, and no-snoring were less likely to worsen their frailty status; the corresponding PRs (95% CIs) were 0.92 (0.89-0.96), 0.76 (0.74-0.77), and 0.85 (0.82-0.88), respectively. Similar results were observed among prefrail participants maintaining healthy sleep patterns. Maintaining healthy sleep duration and without snoring, also raised the probability of improving the frailty status; the corresponding PRs were 1.09 (1.00-1.18) and 1.42 (1.31-1.54), respectively. Besides, a dose-response relationship was observed between constantly healthy sleep scores and the risk of frailty transitions (P for trend < 0.001). CONCLUSIONS Maintaining a comprehensive healthy sleep pattern was positively associated with a lower risk of worsening frailty status and a higher probability of improving frailty status among Chinese adults.
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Affiliation(s)
- Yunqing Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 100191, Beijing, China
| | - Junning Fan
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 100191, Beijing, China
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 100191, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Yu Guo
- Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Feifei Li
- NCDs Prevention and Control Department, Qingdao CDC, Qingdao, 266033, Shandong, China
| | - Xiaoming Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Daniel Avery
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, 100022, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 100191, Beijing, China.
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China.
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, 100191, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
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Piovezan RD, Yu S, Hirotsu C, Marques-Vidal P, Haba-Rubio J, Tucker G, Adams R, Visvanathan R, Heinzer R. Associations of indicators of sleep impairment and disorders with low muscle strength in middle-aged and older adults: The HypnoLaus cohort study. Maturitas 2022; 164:52-59. [DOI: 10.1016/j.maturitas.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
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Lee H, Kim S, Kim BS, Kim M, Yang J, Bae H, Won CW. Sexual Difference in Effect of Long Sleep Duration on Incident Sarcopenia after Two Years in Community-Dwelling Older Adults. Ann Geriatr Med Res 2022; 26:264-274. [PMID: 36200291 PMCID: PMC9535369 DOI: 10.4235/agmr.22.0093] [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: 08/19/2022] [Accepted: 09/21/2022] [Indexed: 11/01/2022] Open
Abstract
Background: Sarcopenia, a progressive and generalized skeletal muscle disorder involving an accelerated loss of muscle mass and muscle function, is a common condition in older individuals. This study aimed to determine whether sleep latency and duration were independently associated with incident sarcopenia and to explore sex differences in these associations. Methods: This 2-year longitudinal analysis of cohort study data included community-dwelling participants of the 2016–2017 Korea Frailty and Aging Cohort Study aged 70–84 years at baseline survey who completed the 2-year follow-up survey. Logistic regression was used to calculate the odds ratios (ORs) for sarcopenia and sarcopenia components. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia guidelines. Results: Among 1,353 non-sarcopenic participants in the baseline survey, 1,160 (85.8%) and 193 (14.2%) were classified as non-sarcopenic and sarcopenic, respectively, after 2 years. Long sleep duration (>8 hours per night) was associated with incident sarcopenia in male—OR=2.41 (95% confidence interval [CI], 1.13–5.17) after adjusting for confounding factors. Long sleep duration was specifically associated with the development of low skeletal muscle mass and low muscle strength in male—adjusted OR=2.16 (95% CI, 1.02–4.61) and adjusted OR=2.70 (95% CI, 1.13–6.43), respectively. In female, compared to normal sleep duration, the adjusted ORs for long and short sleep duration for sarcopenia were 2.093 (95% CI, 0.753–5.812; p=0.157) and 0.852 (95% CI, 0.520–1.393; p=0.522), respectively, which were not significant.Conclusion: In male, long sleep duration was associated with incident sarcopenia, specifically the development of low muscle mass and low muscle strength, but not with low physical performance.
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Affiliation(s)
- Hyona Lee
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Byung Sung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, Kyung Hee University, Seoul, Korea
| | - Jisoo Yang
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hanhee Bae
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
- Corresponding Author: Chang Won Won, MD, PhD Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Kyungheedaero 23, Dongdaemun-gu, Seoul, 02447, Korea E-mail:
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Xu X, Zhou X, Liu W, Ma Q, Deng X, Fang R. Evaluation of the correlation between frailty and sleep quality among elderly patients with osteoporosis: a cross-sectional study. BMC Geriatr 2022; 22:599. [PMID: 35854210 PMCID: PMC9295528 DOI: 10.1186/s12877-022-03285-z] [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: 12/06/2021] [Accepted: 07/11/2022] [Indexed: 02/08/2023] Open
Abstract
Background The incidence of osteoporosis increases with age. Frailty is a distinct characteristic seen in older osteoporosis patients. Poor sleep quality is common in elderly individuals. However, there are few studies on the correlation between frailty and sleep quality in elderly patients with osteoporosis in China. Methods This cross-sectional study was conducted from December 8, 2020, to April 30, 2021. A total of 247 patients who met the inclusion and exclusion criteria were recruited in outpatient departments at West China Hospital. A self-designed demographic data questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Frailty Phenotype scale were used to evaluate the sleep quality and frailty of the participants. Multivariate logistic regression was performed to evaluate the factors affecting frailty and sleep quality in osteoporosis patients. Results A total of 231 valid questionnaires were statistically analysed. The mean frailty score was 3.2 ± 1.6 and a total of 152 (65.8%) were frailty. The mean PSQI score was 11.9 ± 4.5 and a total of 183 (79.2%) patients had poor sleep quality (PSQI > 7). Multiple logistic regression showed that female, pain, polypharmacy, activities of daily living status (ADLs), and sleep quality were independent influencing factors for frailty, while comorbidity, ADLs and frailty status were independent influencing factors for sleep quality. Conclusion We found that frailty and sleep quality were prevalent and that frailty was positively correlated with the PSQI score in elderly patients with osteoporosis in China. The higher the frailty score is, the worse the sleep quality. It means the frailer old patients were, the worse their sleep quality, and poor sleep quality may increase the risk of frailty in elderly patients with osteoporosis. To manage elderly patients with osteoporosis effectively, medical staff should pay attention to frailty, sleep quality and its influencing factors.
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Affiliation(s)
- Xiaoru Xu
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoping Zhou
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjing Liu
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Ma
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xuexue Deng
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Ronghua Fang
- West China School of Nursing/Department of International Medical Center, West China Hospital, Sichuan University, Chengdu, China.
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Fan Y, Zhang B, Huang G, Zhang G, Ding Z, Li Z, Sinclair J, Fan Y. Sarcopenia: Body Composition and Gait Analysis. Front Aging Neurosci 2022; 14:909551. [PMID: 35912078 PMCID: PMC9326397 DOI: 10.3389/fnagi.2022.909551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/20/2022] [Indexed: 12/30/2022] Open
Abstract
BackgroundAge-induced sarcopenia negatively affects walking stability and increases the risk of falls, which is the leading cause of accidental death in the elderly.ObjectiveThis study aimed to analyze and contrast body composition and gait characteristics in those with sarcopenia in relation to healthy controls to shed some light on the prevention of falls in elderly patients with sarcopenia.Materials and MethodsIn this study, 68 community dwellers were scanned by the Hologic QDR-4500A Dual-energy X-ray absorptiometry (DXA). The appendicular lean mass index (ALMI) results were used to distinguish the normal participants from those with sarcopenia: 24 in the sarcopenia group, and 44 into the normal group. The participants were asked to undergo gait analysis on a plantar pressure measurement system. Statistical analysis was conducted to contrast both groups' gait and butterfly parameters from their gait test, and then a gait forward dynamics method was performed to quantify the analysis for both groups.ResultsThe ALMI of the female was not related to their age (r = 0.06) while that of the male was weakly related (r = 0.17). Body mass index (BMI) from both groups was normal, although with a statistically greater BMI from the normal group compared with sarcopenia (p < 0.001). Greater values and significant differences were found in step length and stride length from the normal elderly group (p < 0.01), and so was the length of the gait line and single support line (p < 0.05). Gait forward dynamics analysis results showed no motor neural or musculoskeletal disorders in their gait performance from the sarcopenia group.ConclusionFor the elderly, age did not largely affect the ALMI, BMI, or T-score, but BMI and ALMI were strongly correlated. In this study, significant differences were found in certain gait parameters between the elderly with sarcopenia and the normal elderly, which were related to absolute muscle strength, suggesting that sarcopenia was a disease mainly caused by decreased muscle mass. In addition, when abnormities were identified in step length, stride length, length of gait line, or length of single support line, it is proposed to take a DXA scan to confirm whether the elderly suffer from sarcopenia.
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Affiliation(s)
- Yuxuan Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Bo Zhang
- College of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Guohao Huang
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Guoying Zhang
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Zhiyuan Ding
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Zhiyu Li
- College of Foreign Studies, Jinan University, Guangzhou, China
| | - Jonathan Sinclair
- Research Centre for Applied Sport, Physical Activity and Performance, School of Sport and Health Sciences, University of Central Lancashire, Preston, United Kingdom
| | - Yifang Fan
- Foot Research Laboratory, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
- *Correspondence: Yifang Fan
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da Silva RP, Martinez D, Uribe Ramos JM, Martins EF, Tedesco-Silva LM, Lopez P, Cadore EL. TheHE effectsEFFECTS ofOF resistanceRESISTANCE exerciseEXERCISE onON obstructiveOBSTRUCTIVE sleepSLEEP apneaAPNEA severitySEVERITY andAND bodyBODY waterWATER contentCONTENT inIN olderOLDER adultsADULTS: A randomizedRANDOMIZED controlledCONTROLLED trialTRIAL. Sleep Med 2022; 95:37-46. [DOI: 10.1016/j.sleep.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 11/15/2022]
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Huang WC, Lin CY, Togo F, Lai TF, Hsueh MC, Liao Y, Park H, Kumagai S. Nonlinear associations between sleep patterns and sarcopenia risks in older adults. J Clin Sleep Med 2022; 18:731-738. [PMID: 34608860 PMCID: PMC8883095 DOI: 10.5664/jcsm.9698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Despite considering it as a common geriatric condition, sarcopenia is linked to various behavioral factors that may be changeable. As sleep is one of the important routines in physiological homeostasis, further investigating the underlying relationships of sleep behavior with sarcopenia is urgently needed. We examined the association between sleep parameters (ie, sleep duration, bedtime, wake time, or midsleep time) and sarcopenia risks in older adults, in the total sample and age group subsamples. METHODS A total of 1,068 older adults in Taiwan were included. Data on bedtime, wake time, and sleep duration were collected through telephone interview. Midsleep time was calculated by the midpoint of bedtime and wake time. Sarcopenia was screened by the SARC-F questionnaire composed of 5 questions (the strength, assistance in walking, rising from a chair, climbing stairs, and falls) as well as higher scores was related to greater risks. Generalized additive models were conducted to examine the nonlinear relationships between sleep parameters and sarcopenia risks. RESULTS The covariate-adjusted analysis showed that a reverse J-shaped relationship for sleep duration and sarcopenia risk (P < .001) and a significant association for wake time and the SARC-F score (P = .009) in total sample, with considering age-related interaction. No associations were found in the other sleep parameters (bedtime and midsleep time) and sarcopenia in older adults. Similar associations were observed between wake time and the SARC-F score across age groups, while diverse associations of sleep duration with the SARC-F score were found in different age groups. CONCLUSIONS The sleep pattern is significantly associated with sarcopenia risks in aging adults. Improving inappropriate sleep behaviors in older adults is suggested to prevent a decline in muscle function and promote healthy aging. CITATION Huang W-C, Lin C-Y, Togo F, et al. Nonlinear associations between sleep patterns and sarcopenia risks in older adults. J Clin Sleep Med. 2022;18(3):731-738.
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Affiliation(s)
- Wan-Chi Huang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ting-Fu Lai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan,Address correspondence to: Yung Liao, PhD, Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan; ; and Hyuntae Park, PhD, Department of Health Care Science, Dong-A University, 37, 550-Gil Nakdongdaero, Saha, Busan 604-714, Korea;
| | - Hyuntae Park
- Department of Health Care Science, Dong-A University, Busan, Korea,Address correspondence to: Yung Liao, PhD, Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan; ; and Hyuntae Park, PhD, Department of Health Care Science, Dong-A University, 37, 550-Gil Nakdongdaero, Saha, Busan 604-714, Korea;
| | - Shuzo Kumagai
- Kumagai Institute of Health Policy, Fukuoka, Japan,Institute of Convergence Bio-Health, Dong-A University, Busan, Korea
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Sun-Suslow N, Balon E, Montoya JL, Saloner R, Campbell LM, Serrano V, Ellis RJ, Moore DJ. Frailty Syndrome Is Associated with Poorer Self-Reported Sleep Quality Among Older Persons with Human Immunodeficiency Virus. AIDS Res Hum Retroviruses 2022; 38:87-96. [PMID: 34779233 PMCID: PMC8861916 DOI: 10.1089/aid.2020.0158] [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] [Indexed: 02/03/2023] Open
Abstract
Older people with HIV (PWH) experience heightened risk for the acquisition of cumulative, multisystem decline, that is, frailty syndrome. Frailty relates to poorer sleep quality in the general older adult population; however, this association has yet to be explored among PWH. A cross-sectional analysis of 285 PWH ≥50 years of age (mean age 60.5 ± 7.0) examined the relationship between frailty (Fried frailty phenotype) and self-reported sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Three separate multivariable linear regression models examined global PSQI as a function of (1) frailty phenotype, (2) total number of frailty symptoms, or (3) specific individual frailty symptoms. Models covaried for demographic and biopsychosocial risk factors, including age, sex, race/ethnicity, education, premorbid verbal IQ estimate, current depressive symptoms, and diagnosis of a substance abuse disorder. Compared to nonfrail (B = 0.151; p = .021) and prefrail (B = 0.144; p = .021), frail phenotype was related to poorer sleep quality (increased global PSQI; F(5,278) = 11.34, p < .001; R2 = 0.17). Increased number of frailty symptoms (B = 0.144; p = .019; F(4,276) = 12.719, p < .001; R2 = 0.16) and exhaustion was associated with increased global PSQI scores (B = 0.218, p < .001; F(6,247) = 10.436, p < .001; R2 = 0.19). In all models, older age, female sex, and elevated current depressive symptoms were associated with poorer sleep quality. In older PWH, greater frailty symptoms related to poorer sleep quality, independent of psychosocial risk factors for poor sleep. Frailty and poor sleep individually have adverse effects on health and everyday functioning; thus, establishing this association may better aid providers to screen for and treat problems with sleep quality and/or frailty among PWH.
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Affiliation(s)
- Ni Sun-Suslow
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Emily Balon
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Jessica L. Montoya
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Rowan Saloner
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Laura M. Campbell
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Vanessa Serrano
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Ronald J. Ellis
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - David J. Moore
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Umehara T, Kaneguchi A, Yamasaki T, Matsuura A, Kito N, Tanaka H, Yamaoka K. Interactive effects of exercise and sleep on frailty severity in community-dwelling older adults: a cross-sectional study. J Rural Med 2022; 17:21-28. [PMID: 35047098 PMCID: PMC8753256 DOI: 10.2185/jrm.2021-041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/02/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives: This study examined the effects of the interaction between
exercise and sleep on frailty severity in community-dwelling older adults. Materials and Methods: This was a cross-sectional study. Data were collected
in July 2019. In total, 2021 adults participated who responded to a questionnaire. Among
them, 672 participants (317 men and 355 women) with valid responses were included in the
analysis. Ordinal logistic regression analysis was performed to examine the association
between frailty severity and the interaction between exercise and sleep. The dependent
variable represents three different levels of frailty. The independent variables included
basic information and interaction between exercise and sleep. Results: The results of ordinal logistic regression analysis (odds ratio
[OR]) showed that the period from the start of exercise (OR=0.96), age (OR=1.00 for
participants in their 60 s, OR=1.65 for those in their 70s, and OR=3.13 for those aged
>80 years), poor subjective health perception (OR=2.12), poor quality of sleep
(OR=1.88), stress (OR=1.62), and exercise–sleep interaction (OR=1.00 based on
good-exercise–good-sleep interaction, OR=3.09 poor-exercise–good-sleep interaction, and
OR=3.50 poor-exercise–poor-sleep interaction) significantly contributed to the model. The
Nagelkerke coefficient of determination adjusted for degrees-of-freedom (R2),
which represents the contribution rate of the regression equation, was 0.334. Conclusions: Our results suggest that a combination of good exercise and
good sleep is needed to prevent frailty progression in community-dwelling older
adults.
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Affiliation(s)
- Takuya Umehara
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Akinori Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Takahiro Yamasaki
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Akihiro Matsuura
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan
| | - Nobuhiro Kito
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
| | - Hideki Tanaka
- Well-being and Wellness Center, Hiroshima International University, Japan.,Department of Psychology, Faculty of Health Science, Hiroshima International University, Japan
| | - Kaoru Yamaoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Japan.,Well-being and Wellness Center, Hiroshima International University, Japan
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Stich FM, Huwiler S, D'Hulst G, Lustenberger C. The Potential Role of Sleep in Promoting a Healthy Body Composition: Underlying Mechanisms Determining Muscle, Fat, and Bone Mass and Their Association with Sleep. Neuroendocrinology 2022; 112:673-701. [PMID: 34348331 DOI: 10.1159/000518691] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022]
Abstract
Sleep plays an essential role in human life. While sleep is a state elicited by the brain, its vital role reaches beyond maintaining brain health. Unhealthy sleeping habits have been associated with increased risk for inflammation, obesity, or diabetes. Evidence is emerging that sleep guides processes playing an important role in promoting the regulation of endocrine function involved in tissue regeneration and tissue remodelling. Thereby, sleep presumably is a critical factor contributing to the balance of core body tissues: bone, fat, and muscle mass. Given the increasing prevalence of various chronic diseases and comorbidities due to unhealthy lifestyle choices, sleep could be a key target to promote a healthy body composition up until old age. Here, we review the potential role of sleep and its underlying brain oscillations in body core tissues turnover. Specifically, we discuss potential underlying mechanisms linking sleep to body composition, both during rest and under challenging conditions. Among other described pathways, we highlight the possible role of the growth hormone that was found to be involved in the homeostasis of all core body tissues and has been strongly linked to brain activity dominating deep sleep, the so-called slow waves. Finally, we formulate important questions to be addressed in future research on the effect of sleep on body composition and specifically emphasize the importance of intervention studies to move from correlative to causal evidence.
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Affiliation(s)
- Fabia M Stich
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Stephanie Huwiler
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Gommaar D'Hulst
- Laboratory of Exercise and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
- Sleep & Health Zurich, University Center of Competence, University of Zurich, Zurich, Switzerland
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Han P, Hou L, Liang Z, Chen W, Li J, Cheng Y, Zhou W, Zeng S, Pan J, Xu L, Wang Y, Chen Y, Guo Q. Both Short and Long Sleep Durations are Risk Factors for Sarcopenia in Suburban-Dwelling Older Chinese Individuals: A 3-Year Longitudinal Study. Nat Sci Sleep 2022; 14:1089-1096. [PMID: 35698588 PMCID: PMC9188392 DOI: 10.2147/nss.s361925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/19/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Few longitudinal studies have explored exploring the relationship between sleep duration and sarcopenia. Evidence concerning the relationship between sleep duration and sarcopenia is limited and inconsistent. The purpose of this 3-year prospective study was to explore whether sleep duration was associated with sarcopenia onset in suburb-dwelling older Chinese individuals. METHODS This was a prospective study that included 754 Chinese suburb-dwelling men and women aged ≥60 years (men n=327, mean age 65.24± 4.87 years) who were not initially diagnosed with sarcopenia. We defined sarcopenia using the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. Self-reported sleep duration was a component of the interview measured by trained interviewers. Subjects were categorized into 3 groups at baseline [short: <6 h, medium: 6-8 h, and long: >8 h]. RESULTS The incidence of sarcopenia during the 3-year follow-up was 12.2%. Multivariate logistic regression analyses showed that after adjustments for potential confounders long sleep duration was independently associated with sarcopenia incidence from baseline through the 3-year follow-up: when using the 6-8 h sleep duration group as a reference, the adjusted ORs for sarcopenia of the groups who slept <6 and >8 hours were 2.74 (95% CI 1.05-7.13) and 1.84 (95% CI 1.07-3.14). CONCLUSION Both short and long sleep durations were associated with a greater incidence of sarcopenia. Thus, sleep duration should be considered when developing prevention and management strategies for sarcopenia.
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Affiliation(s)
- Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China.,Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, People's Republic of China
| | - Lin Hou
- Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, People's Republic of China.,Child Mental Health and Rehabilitation Center, Shenzhen Maternity & Child Health Care Hospital, Shenzhen, People's Republic of China
| | - Zhenwen Liang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Wuxiong Chen
- Department of Rehabilitation Medicine, Shanghai Health Rehabilitation Hospital, Shanghai, People's Republic of China
| | - Junxue Li
- Department of Rehabilitation Medicine, Shanghai Health Rehabilitation Hospital, Shanghai, People's Republic of China
| | - Yazhou Cheng
- Department of Rehabilitation Medicine, Shanghai Health Rehabilitation Hospital, Shanghai, People's Republic of China
| | - Wenjing Zhou
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Siya Zeng
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Jiangtao Pan
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Lanshan Xu
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Yi Wang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Yangyi Chen
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, People's Republic of China.,College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China.,Department of Rehabilitation Medicine, TEDA International Cardiovascular Hospital, Cardiovascular Clinical College of Tianjin Medical University, Tianjin, People's Republic of China
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40
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Chen S, Wang Y, Wang Z, Zhang X, Deng C, Ma B, Yang J, Lu Q, Zhao Y. Sleep Duration and Frailty Risk among Older Adults: Evidence from a Retrospective, Population-Based Cohort Study. J Nutr Health Aging 2022; 26:383-390. [PMID: 35450995 DOI: 10.1007/s12603-022-1766-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Frailty and sleep duration complaints are both prevalent and often coexist among older adults. The purpose of this study was to examine the prospective association between sleep duration and frailty risk in a nationally representative cohort study. DESIGN Prospective cohort study, ten-year follow-up. SETTING Community-based setting in 23 provinces of China. PARTICIPANTS A total of 7623 older adults age 65 and over without frailty at baseline were included in the analysis. MEASUREMENTS The participants were divided into three groups according to self-reported sleep duration: short (≤6 hours per day), middle (>6 but <10 hours per day) and long (≥10 hours per day). Frailty was measured according to the accumulation of health deficits by the construction of a frailty index of 38 items with 0.25 as the cutoff. A Cox proportional hazard model, a competing risk model and a generalized estimating equation (GEE) model with multiple adjustments were performed to evaluate the association between sleep duration and frailty risk. RESULTS During a median follow-up period of 4.4 years (IQR 2.9-9.0), 2531 (33.2%) individuals developed frailty. Compared with participants with middle sleep duration, the risk of frailty was increased among participants with long sleep duration (HR 1.26, 95% CI 1.14-1.38) in the fully adjusted Cox proportional hazard model. However, short sleep duration was insignificantly associated with frailty risk. The competing risk model and the GEE model yielded similar results. CONCLUSION Long sleep duration is significantly associated with frailty incidence among older adults even after adjustment for confounding factors. This study provides reinforcing longitudinal evidence for the need to design sleep quality improvement interventions in health care programs to prevent frailty among older adults.
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Affiliation(s)
- S Chen
- Qi Lu, MD, School of Nursing, Tianjin Medical University, Tianjin, 300070, China. Tel:86-23542855. Email address: ; Yue Zhao, PhD, Professor, School of Nursing, Tianjin Medical University, Tianjin, 300070, China. Tel:86-23542855. Email address:
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Szlejf C, Suemoto CK, Drager LF, Griep RH, Fonseca MJM, Diniz MFHS, Lotufo PA, Benseãor IM. Association of sleep disturbances with sarcopenia and its defining components: the ELSA-Brasil study. Braz J Med Biol Res 2021; 54:e11539. [PMID: 34878063 PMCID: PMC8647897 DOI: 10.1590/1414-431x2021e11539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/21/2021] [Indexed: 11/22/2022] Open
Abstract
Sarcopenia and sleep problems share common physiopathology. We aimed to investigate the association of sleep disturbances with sarcopenia and its defining components in Brazilian middle-aged and older adults. In this cross-sectional analysis of the second wave of the ELSA-Brasil study, we included data from 7948 participants aged 50 years and older. Muscle mass was evaluated by bioelectrical impedance analysis and muscle strength by hand-grip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health criteria. Sleep duration and insomnia complaint were self-reported. Short sleep duration was considered as ≤6 h/night and long sleep duration as >8 h/night. High risk of obstructive sleep apnea (OSA) was assessed using the STOP-Bang questionnaire. Possible confounders included socio-demographic characteristics, lifestyle, clinical comorbidities, and use of sedatives and hypnotics. The frequencies of sarcopenia, low muscle mass, and low muscle strength were 1.6, 21.1, and 4.1%, respectively. After adjustment for possible confounders, high risk of OSA was associated with low muscle mass (OR=2.17, 95%CI: 1.92-2.45). Among obese participants, high risk of OSA was associated with low muscle strength (OR=1.68, 95%CI: 1.07-2.64). However, neither short nor long sleep duration or frequent insomnia complaint were associated with sarcopenia or its defining components. In conclusion, high risk of OSA was associated with low muscle mass in the whole sample and with low muscle strength among obese participants. Future studies are needed to clarify the temporal relationship between both conditions.
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Affiliation(s)
- C Szlejf
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - C K Suemoto
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Divisão de Geriatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L F Drager
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Unidade de Hipertensão, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - R H Griep
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - M J M Fonseca
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - M F H S Diniz
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - P A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - I M Benseãor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Medicina Interna, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Cai Q, Li M, Li Q. Sleep‐based therapy: A new treatment for amyotrophic lateral sclerosis. BRAIN SCIENCE ADVANCES 2021. [DOI: 10.26599/bsa.2021.9050010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a worldwide problem with no effective treatment. Patients usually die of respiratory failure. The basic pathological process of ALS is the degeneration and necrosis of motor neurons. Neuroglial cell dysfunction is considered closely related to the development of ALS. Sleep plays an important role in repairing the nervous system, and sleep disorders can worsen ALS. Herein, we review the pathogenesis of ALS and the neuroprotective mechanism of sleep‐based therapy. Sleep‐based therapy could be a potential strategy to treat ALS.
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Affiliation(s)
- Qing Cai
- Department of Curative Anesthesia, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Mengya Li
- Department of Curative Anesthesia, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Qifang Li
- Department of Curative Anesthesia, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
- Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
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Sato M, Betriana F, Tanioka R, Osaka K, Tanioka T, Schoenhofer S. Balance of Autonomic Nervous Activity, Exercise, and Sleep Status in Older Adults: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412896. [PMID: 34948506 PMCID: PMC8701130 DOI: 10.3390/ijerph182412896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/16/2022]
Abstract
While older people are frequently known to experience sleep disturbances, there are also many older people who have a good quality of sleep. However, little is known about the balance of autonomic nervous activity, exercise habits, and sleep status in healthy older adults. This study reviews the literature regarding balance of the autonomic nervous activity, exercise, and sleep in healthy older adults. Relevant articles were searched from electronic databases using the combination of the following keywords: "Autonomic nervous activity", "sleep status", "sleep", "healthy older adults", "aging", "heart rate variability (HRV)" and "exercise". Articles were included if they met inclusion criteria: (1) Published in English, (2) Article types: research and review articles, (3) Main outcome was related to the autonomic nervous activity, lifestyle, sleep, and/or healthy aging, and (4) Fully accessed. From 877 articles that were identified, 16 articles were included for review. Results showed that the autonomic nervous activity changes with increasing age, particularly a constant decline in cardiac vagal modulation due to the significant decrease in the nocturnal parasympathetic activity. In addition, the autonomic nervous activity was also related to sleep status and lifestyle, particularly the capability to exercise. In preparing older people toward a healthy aging, maintaining good sleep quality and exercise is suggested.
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Affiliation(s)
- Miki Sato
- Department of Clinical Nursing, Kochi Medical School, Kochi University, Nankoku 783-8505, Japan;
- Correspondence: ; Tel.: +81-88-880-2555
| | - Feni Betriana
- Graduate School of Health Sciences, Tokushima University, Tokushima 770-8509, Japan; (F.B.); (R.T.)
| | - Ryuichi Tanioka
- Graduate School of Health Sciences, Tokushima University, Tokushima 770-8509, Japan; (F.B.); (R.T.)
| | - Kyoko Osaka
- Department of Clinical Nursing, Kochi Medical School, Kochi University, Nankoku 783-8505, Japan;
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Graduate School, Tokushima University, Tokushima 770-8509, Japan;
- Anne Boykin Institute, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Savina Schoenhofer
- Anne Boykin Institute, Florida Atlantic University, Boca Raton, FL 33431, USA;
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Lee S, Chung JH, Kim JH. Association Between Sleep Quality and Falls: A Nationwide Population-Based Study from South Korea. Int J Gen Med 2021; 14:7423-7433. [PMID: 34744453 PMCID: PMC8566001 DOI: 10.2147/ijgm.s331103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/05/2021] [Indexed: 01/06/2023] Open
Abstract
Purpose There are few large studies evaluating the association between sleep quality and the risk of falls. We aimed to determine the independent effect of poor sleep quality on an increased risk of falls using a large-sample dataset. Methods We conducted a retrospective, cross-sectional study using population-based data from the 2018 Korean Community Health Survey on 201,700 participants. Sociodemographic, mental health-related, and physical health-related variables as well as sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) were compared between 2499 fallers who have experienced at least one fall during the past 12 months and 199,201 non-fallers. Multivariable logistic regression was performed to identify sleep quality variables significantly associated with an increased risk of falls. Results Fallers had poorer sleep quality (PSQI score >5) and higher scores for global PSQI and individual PSQI components than did non-fallers (all p < 0.001). Multivariable logistic regression adjusted for potential confounders including socioeconomic, physical health-related, and mental health-related variables showed that an increased risk of falls was associated with poor sleep quality (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.19–1.42). Subgroup analyses by age revealed that poor sleep quality was significantly associated with an increased risk of falls in all three adult age groups. Multivariable logistic regression using the seven PSQI components revealed that an increased risk of falls was associated with short sleep duration (OR 1.14, CI 1.09–1.20), increased sleep disturbances (OR 1.30, CI 1.16–1.46), and increased daytime dysfunctions (OR 1.21, CI 1.08–1.13). Conclusion Poor sleep quality caused by short sleep duration may be a principal risk factor of falls in adult populations. Increased sleep disturbances and daytime dysfunctions may also contribute to an increased risk of falls. Our results have clinical and public health perspectives that increasing sleep duration and reducing daytime dysfunctions and sleep disturbances could mitigate unintentional falls.
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Affiliation(s)
- Sujin Lee
- Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Noguchi T, Nojima I, Inoue-Hirakawa T, Sugiura H. Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study. Phys Ther Res 2021; 24:153-162. [PMID: 34532211 DOI: 10.1298/ptr.e10085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We examined the association between social frailty and subjective sleep quality among community-dwelling adults. METHODS This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable. RESULTS Data from 300 older adults were analyzed, 51.0% of whom were female. The participants' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005). CONCLUSION The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan.,Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Ippei Nojima
- Department of Physical Therapy, Shinshu University School of Health Sciences, Japan
| | - Tomoe Inoue-Hirakawa
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Japan
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Low lean mass is associated with lower urinary tract symptoms in US men from the 2005-2006 national health and nutrition examination survey dataset. Aging (Albany NY) 2021; 13:21421-21434. [PMID: 34475271 PMCID: PMC8457570 DOI: 10.18632/aging.203480] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/14/2021] [Indexed: 02/05/2023]
Abstract
We investigated the relationship between low lean mass (LLM) and lower urinary tract symptoms (LUTS) using the 2005–2006 National Health and Nutrition Examination Survey (NHANES) dataset. We enrolled 959 men with an average age of 52.08 ± 7.91 years and performed weighted multiple regression analysis to determine the independent relationship between exposure variables (LLM, alternate LLM) and outcomes variables (urinary hesitancy, incomplete emptying, urinary frequency, nocturia, daytime LUTS, clinical LUTS) after adjusting for confounding factors. The prevalence of urinary hesitancy (OR = 7.76, P < 0.0001), incomplete emptying (OR = 2.49, P = 0.0070), urinary frequency (OR = 3.28, P < 0.0001), daytime LUTS (OR = 3.88, P < 0.0001) and clinical LUTS (OR = 8.11, P < 0.0001) was significantly higher among men with LLM compared to men without LLM. Moreover, alternate LLM (ALLM) was positively associated with urinary hesitancy (OR = 17.97, P < 0.0001), incomplete emptying (OR = 4.68, P = 0.0003), daytime LUTS (OR = 2.47, P = 0.0136) and clinical LUTS (OR = 12.18, P < 0.0001). These findings demonstrate that both LLM and ALLM were associated with a higher risk of LUTS in men aged ≥ 40 years, which suggested that early management and treatment of lean mass loss may improve or alleviate LUTS.
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Pires GN, Ishikura IA, Xavier SD, Petrella C, Piovezan RD, Xerfan EMS, Andersen ML, Tufik S. Sleep in Older Adults and Its Possible Relations With COVID-19. Front Aging Neurosci 2021; 13:647875. [PMID: 34177550 PMCID: PMC8226324 DOI: 10.3389/fnagi.2021.647875] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, older adults have been found to be a highly vulnerable group, with a higher prevalence of severe cases and negative outcomes. Research has focused on the reasons why older adults are at greater risk; Sleep-related factors have been suggested as one possible explanation for this. An individual's sleep pattern undergoes significant changes over the course of their life. In older adults a specific sleep profile can be observed, one characterized by advanced sleep timing, a morningness preference, longer sleep-onset latency, shorter overall sleep duration, increased sleep fragmentation, reduced slow-wave sleep and, increased wake time after sleep onset. Additionally, an increased prevalence of sleep disorders can be observed, such as obstructive sleep apnea and insomnia. Previous research has already linked sleep disorders (especially sleep apnea) with COVID-19, but few studies have focused specifically on the older population. We believe that the intrinsic sleep patterns of older adults, and the prevalence of sleep disorders in this population, may be important factors that could explain why they are at a greater risk of negative COVID-19 outcomes. In this review, we discuss the relationship between sleep and COVID-19 among older adults, focusing on three different aspects: (1) Sleep-related issues that might increase the likelihood of getting infected by SARS-COV-2; (2) Sleep disturbances that might increase the predisposition to worse COVID-19 prognosis and outcomes; and (3) COVID-19-related aspects affecting community-dwelling older adults, such as social isolation, quarantine, and home confinement, among others, that might impact sleep.
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Affiliation(s)
- Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Sandra Doria Xavier
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Otolaryngology, Santa Casa de São Paulo, São Paulo, Brazil
| | - Caetano Petrella
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Ellen Maria Sampaio Xerfan
- Programa de Pós-Graduação em Medicina Translacional, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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The relationship between insomnia symptoms and frailty in community-dwelling older persons: a path analysis. Sleep Med 2021; 84:237-243. [PMID: 34175659 DOI: 10.1016/j.sleep.2021.05.039] [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] [Received: 01/28/2021] [Revised: 05/02/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The relationship between sleep and frailty in older age is complex. Most previous studies focused on sleep duration, while insomnia, a common sleep problem in older adults, has not been adequately examined and the factors implicated in its association with frailty were under-explored. METHODS A community-based sample of 345 prefrail and frail older adults were recruited and completed the measures on insomnia symptoms (Pittsburgh Sleep Quality Index) and frailty status (FRAIL Scale). The relationship between insomnia symptoms and frailty, with potential mediators including physical performance (Short Physical Performance Battery), depression (Patient Health Questionnaire-9), and level of physical activity (Physical Activity Scale for the Elderly), were tested in path analysis adjusting for age, gender, body mass index and sleep medications. RESULTS The prevalence of sleep-onset insomnia was higher in frail participants than their prefrail counterparts (48% vs. 34%, aOR = 1.73; 95% CI 1.09, 2.76; p = 0.02), but there was no significant difference in the prevalence of sleep-maintenance insomnia (61% vs. 54%). The association between sleep-onset insomnia and frailty was explained by reduced physical performance (standardized coefficient = 0.11; 95% BCa CI [0.002, 0.233]), but not depression and level of physical activity. Sleep-maintenance insomnia was not associated with frailty. CONCLUSIONS Insomnia symptoms are prevalent in frail and prefrail older adults. Sleep-onset insomnia is associated with poorer physical performance, which is further linked to a higher risk for frailty in older persons. The findings highlight the importance of timely assessing and managing insomnia among older adults at risk of frailty.
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Prokopidis K, Dionyssiotis Y. Effects of sleep deprivation on sarcopenia and obesity: A narrative review of randomized controlled and crossover trials. J Frailty Sarcopenia Falls 2021; 6:50-56. [PMID: 34131601 PMCID: PMC8173530 DOI: 10.22540/jfsf-06-050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/12/2022] Open
Abstract
Shortened and fragmented sleeping patterns occupying modern industrialized societies may promote metabolic disturbances accompanied by increased risk of weight gain and skeletal muscle degradation. Short-term sleep restriction may alter energy homeostasis by modifying dopamine brain receptor signaling, leading to hyperpalatable food consumption and risk of increased adiposity. Concomitantly, the metabolic damage caused by lower testosterone and higher cortisol levels may stimulate systemic inflammation, insulin resistance, and suppress pathways involved in muscle protein synthesis. These changes may lead to dysregulated energy balance and skeletal muscle metabolism, increasing the risk of sarcopenic obesity, an additional public health burden. Future trials controlling for food intake and exploring further the influence of sleep deprivation on anabolic and catabolic signaling, and gut peptide interaction with energy balance are warranted.
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Affiliation(s)
- Konstantinos Prokopidis
- Imperial College London, Department of Metabolism, Digestion and Reproduction, London, United Kingdom
| | - Yannis Dionyssiotis
- 1 Physical Medicine and Rehabilitation Department, National Rehabilitation Center EKA, Athens, Greece
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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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