[Association of sleep with anxiety in the elderly aged 60 years and older in China]

Association between quality of life, sleep quality and mental disorders in Iranian older adults

Aging as a major challenge can affect the development and growth of countries all around the world. This study aimed to identify the subgroups of the elderly based on the quality of life (Qol), sleep quality, and common mental disorders and assess the role of demographic characteristics on the membership of participants in each latent class. This cross-sectional study was conducted on 1064 people over the age of 60 years. The sample was selected through cluster sampling in northern Iran. All participants completed six sets of checklists and questionnaires. Data analysis was performed using latent class analysis. Three latent classes were identified; namely, (1) healthy (66.8%), (2) anxious and with poor sleep quality (28.6%), and unhealthy (4.6%). Being Female significantly increased the odds of membership in classes 2 and 3 compared to class 1. Furthermore, living in urban areas increased the odds of belonging to class 2 and class 3 compared to class 1. Illiteracy was also shown to increase the odds of being in class 3 in comparison to class 1. Results from the present indicate that the co-occurrence of health problems in 33.2% of the elderly was observed in various forms. The results of this study can be used in prioritizing health programs for the elderly and emphasizing high-risk groups.

The mediation role of sleep quality in the relationship between cognitive decline and depression

Objectives

Associations between cognitive decline and depression have been inconclusive. We examined 1) whether sleep quality mediates these relationships and 2) which factor of sleep quality mediates these relationships.

Methods

This study utilized baseline data from the 2018 West China Health and Aging Trend study (WCHAT), a large cohort data-set that including participants aged over 50 years old. We defined depression using the 15-item Geriatric Depression Scale (GDS-15). Cognitive status was measured using the Short Portable Mental Status Questionnaire (SPMSQ) and sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Direct relationships between cognitive decline, sleep quality and depression were assessed using multiple linear regression. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of specific aspects of sleep (e.g., quality, duration) in the relationship between cognitive decline and depression.

Results

Of 6828 participants aged 50 years old or older, the proportion of depression was 17.4%. Regression analysis indicated a total association between cognitive scores (β = 0.251, 95% CI 0.211 to 0.290, p < 0.001) and depression status. After adjusted PSQI scores, the association between cognitive scores and depression status was still significant (β = 0.242, 95% CI 0.203 to 0.281, p < 0.001), indicating a partial mediation effect of sleep quality. Mediation analysis verified sleep quality partially mediate the associations between cognitive decline and depression (indirect effect estimate = 0.0308, bootstrap 95% CI 0.023 to 0.040; direct effect estimate = 0.3124, bootstrap 95% CI 0.269 to 0.350). And daytime dysfunction had a highest mediation effect with a proportion of mediation up to 14.6%.

Conclusions

Sleep quality partially mediated the relationship between cognitive decline and depression. Daytime dysfunction had a highest mediation effect. Further research is necessary to examine the effects of sleep quality on the relationship of cognitive decline and depression.

Intervention Effect of Group Reminiscence Therapy in Combination with Physical Exercise in Improving Spiritual Well-Being of the Elderly

Background

To explore the intervention degree and improvement effect of group reminiscence therapy in combination with physical exercise on spiritual well-being of the elderly after the outbreak of the COVID-19 epidemic.

Methodology

In 2020, overall, 130 elderly people were selected from communities in Xiangtan City and Changsha City of Hunan Province, China and randomly divided into two groups, with 65 people in each group. One group was the experimental group that participated in the exercise intervention for 8 weeks as the objects of group reminiscence therapy intervention in combination with physical exercise. The other group was the control group that listened to 4 routine health lectures. Spirituality Index of Well-Being, ULS Loneliness Scale and Brief Resilience Scale were used to evaluate the effect of the intervention.

Results

Before the intervention, there was no significant difference between the experimental group and the control group, but after 8 weeks of exercise intervention, the score of loneliness was lower in the experimental group than in the control group (P<0.05), the scores of spiritual well-being and resilience were significantly higher in the experimental group than in the control group (P<0.05); and the differences before and after the intervention were significantly higher in the experimental group than the control group (P<0.05).

Conclusion

Group reminiscence therapy in combination with physical exercise could improve spiritual well-being and mental health of the elderly.

Impact of sleep quality on post-stroke anxiety in stroke patients

OBJECTIVE

To explore whether poor sleep is associated with post-stroke anxiety (PSA) in Chinese patients with acute ischemic stroke (AIS) and to verify whether poor sleep is a predictor of PSA.

METHODS

A total of 327 patients with AIS were enrolled and followed up for 1 month. Sleep quality within 1 month before stroke was evaluated using the Pittsburgh Sleep Quality Index (PSQI) at admission. The patients were divided into the poor sleep group (PSQI > 7, n = 76) and good sleep group (PSQI ≤ 7, n = 251). One month after stroke, patients with obvious anxiety symptoms and a Hamilton Anxiety Scale score >7 were diagnosed with PSA.

RESULTS

Eighty-seven patients (26.6%) were diagnosed with PSA. Compared to the good sleep quality group, the incidence of PSA in patients with poor sleep quality was higher (42.1% vs. 21.9%, p = .001). Poor sleep quality is more common in patients with PSA (35.6% vs. 18.8%, p = .001). A logistic regression analysis indicated that poor sleep quality was significantly associated with PSA (OR: 2.265, 95% CI: 1.262-4.067, p = .003). After adjusting for conventional and identified risk factors, poor sleep quality was found to be independently associated with PSA (OR: 2.676, 95% CI: 1.451-4.936, p = .001).

CONCLUSIONS

Poor sleep quality before stroke was associated with PSA and may be an independent risk factor of PSA 1 month after AIS onset.