Fall Risk in Elderly with Insomnia in Western Romania-A Retrospective Cross-Sectional Study

Sleep quality, daytime sleepiness, and risk of falling: results from an exploratory cross-sectional study

PURPOSE

There is growing recognition of the importance of managing sleep disorders in the elderly, particularly given their complexity within a multidimensional framework. The aim of the present study is to investigate whether sleep quality and daytime sleepiness are associated with the risk of falls in older adults.

METHODS

This study included patients aged 75 years or older who were consecutively evaluated at the Geriatric Service, University Hospital of Monserrato, Cagliari, Italy. Participants underwent geriatric assessment, including sleep analysis using the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS), as well as an assessment of risk of falls with Performance Oriented Mobility Assessment (POMA).

RESULTS

The study included 206 subjects, of whom 70.4% were women, with a median age of 83 years. A total of 141 participants (68.4%) had poor sleep quality, and 43 (20.9%) had excessive daytime sleepiness (EDS). Among people at high risk of falls, 85 participants had bad sleep quality, and 24 a satisfying one (χ2: 8.23, p = 0.0029); additionally, 77 participants did not exhibit daytime sleepiness, while 32 did (χ2: 9.03, p = 0.0027). To further explore these results, we designed logistic regressions, considering dichotomized PSQI and dichotomized ESS as independent variables, and dichotomized POMA as the dependent variable, and finally adjusted them for confounders. The adjusted model for PSQI yielded OR: 2.04 (95%CI 1.02-4.10), and the adjusted model for ESS yielded OR: 2.56 (95%CI 1.17-5.91).

CONCLUSIONS

Our study demonstrated that an increased estimated risk of falling is associated with poor sleep quality and EDS in older adults, independently of the confounders.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study

OBJECTIVE

To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life.

METHOD

A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables.

RESULTS

Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables.

CONCLUSION

LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Analysis of the Level of Adiponectin and Selected Cytokines in Patients with Knee Osteoarthritis

Background and Objectives: Knee osteoarthritis (KOA) is a degenerative disease that is continuously targeting people of different ages, but especially the elderly population, the number of which tends to increase continuously at the global level. Apart from age, excess weight can influence the evolution of the disease, with obesity being associated with a weak inflammation stage and an imbalance between pro-inflammatory and anti-inflammatory cytokines. The present work aimed to analyze specific biomarkers, namely ACRP-30, IL-10, TNF-α, and IL-6, in knee synovial fluid, and correlate them with KOA patients' clinical data, radiographic changes, and functional and pain scores. Materials and Methods: 24 subjects with KOA and over 50 years of age participate in the present study. Synovial fluid was harvested using ultrasound guidance from the target knees of the enrolled KOA patients, and the levels of ACRP-30, IL-10, TNF-α, and IL-6 were measured using enzyme-linked immunosorbent assays (ELISA). All patients underwent a supine X-ray at the target knee and were classified using Kellgren-Lawrence (K-L) grading. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was used to assess self-reported physical function, pain, and stiffness. Results: The obtained results highlighted a significant correlation between age and adiponectin level (p = 0.0451, r = -0.412). Also, the IL-10 values are lower in cases where the intensity of the pain is more pronounced (p = 0.0405, r = -0.421). In addition, analyzing the data by gender, it was observed that in the case of males, stiffness is more related to age (p = 0.0079, r = 0.7993), compared to women (p = 0.0203, r = 0.6223). In the case of women, the progression of the disease tends to increase more intensively the WOMAC score's total values (p = 0.00031, r = 0.8342), compared with men (p = 0.0289, r = 7013). Regarding interleukins and BMI, significant correlations were observed only in the case of men. Conclusions: A significant correlation between age and adiponectin, and adiponectin and IL-6, suggests that advanced age may contribute to adiponectin reduction. Comparing men with women, it was observed that men's age is more related to rigidity, and IL-6 and IL-10 are directly correlated to BMI; in addition, women seem to be more sensitive to pain and stiffness.

Elderly Individuals Residing in Nursing Homes in Western Romania Who Have Been Diagnosed with Hearing Loss are at a Higher Risk of Experiencing Cognitive Impairment

Purpose

The objective of this research was to determine if there is any correlation between the severity of neurocognitive disorder and hearing impairment in the elderly.

Patients and Methods

This is a population-based observational study that included subjects aged ≥ 65 years. They were evaluated for the existence of cardiovascular risk factors, diabetes, stroke, alcohol abuse, and smoking. Hearing impairment was diagnosed by an audiologist, using behavioral audiometric examination. These evaluations might have been performed in response to concerns about hearing loss, or they could have been a routine component of yearly comprehensive health screenings that included a Mini-Mental State Examination 2nd Edition (MMSE-2) test. According to the results of the MMSE-2 scale, we divided the individuals into two groups, Group I for those who had cognitive impairment and severe neurocognitive disorder, and Group II for those who did not have cognitive impairment.

Results

The study enrolled 203 patients with a mean age of 77 ± 7.5 years (range 65-98), 99 (48%) were males. When comparing the two groups, group I patients presented more often cardiovascular risk factors, stroke, diabetes, and impaired hearing. The univariable logistic regression found that cognitive impairment was significantly more frequent in the elderly with cardiovascular disease, diabetes, and stroke (p<0.0001). The multivariate regression analysis found that stroke (p<0.0001) diabetes (p=0.0008), cardiovascular disease (p=0.0004), and impaired hearing (p=0.0011) were significantly linked to cognitive impairment. The occurrence of hearing impairment in the elderly was related to having an MMSE-2 score of 14 or below.

Conclusion

According to the findings of this research, the elderly who have trouble hearing in addition to other conditions might have an increased risk for severe neurocognitive disorder.