Abstract
Objectives
To test whether sleep disturbances are associated with frailty in older men and women.
Design
Cross-sectional analysis of cohort study data. The participants were 1168 community-dwelling older adults aged 70 to 84 years who took part in the Korean Frailty and Aging Cohort Study and completed both self-reported sleep parameters and assessment of frailty. Univariate and multivariate survey logistic regression models were used to calculate odds ratios (OR) with 95% confidence intervals (CI) for frailty. Frailty was defined using the Fried’s criteria.
Results
Frailty was associated with sleep latency in men. The odds ratio for this association was 3.39 (95% CI 1.31-8.76) after adjusting for age, body mass index (BMI), physical activity, and select comorbidities, and 2.16 (95% CI 0.75-6.23) after further adjusting for depression. Frailty was associated with long sleep duration of more than 8 hours a night in women. The odds ratio for this association was 3.95 (95% CI, 1.27-12.33) after adjusting for age, BMI, physical activity, select comorbidities, and the number of medications.
Conclusion
Prolonged sleep latency (≥60 minutes) in men and long sleep duration (>8hr per night) in women were each independently associated with higher odds of frailty. Long sleep latency in elderly men and long sleep duration in elderly women may suggest they have a high chance of frailty.
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References
Ancoli–Israel S, Roth T. Characteristics of insomnia in th. United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999 May 1;22 Suppl 2:S347–53.
Foley D, Ancoli–Israel S, Britz P, Walsh J. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res. 2004;56(5):497–502.
Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18(6):425–32.
Newman AB, Enright PL, Manolio TA, Haponik EF, Wahl PW, Cardiovascular Health Study Research Group. Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study. J Am Geriatr Soc. 1997;45(1):1–7.
Neikrug AB, Ancoli–Israel S. Sleep disorders in the older adult–a mini–review. Gerontology. 2010;56(2):181–9.
Vaz Fragoso CA, Gahbauer EA, Van Ness PH, Gill TM. Sleep–wake disturbances and frailty in community–living older persons. J Am Geriatr Soc. 2009;57(11):2094–100.
Ensrud KE, Blackwell TL, Redline S, Ancoli–Israel S, Paudel ML, Cawthon PM, et al. Sleep disturbances and frailty status in older community–dwelling men. J Am Geriatr Soc. 2009;57(11):2085–93.
Del Brutto OH, Mera RM, Sedler MJ, Zambrano M, Nieves JL, Cagino K, et al. The effect of age in the association between frailty and poor sleep quality: a populationbased study in community–dwellers (The Atahualpa Project). Journal of the American Medical Directors Association. 2016;17(3):269–71.
Moreno–Tamayo K, Manrique–Espinoza B, Rosas–Carrasco O, Pérez–Moreno A, Salinas–Rodríguez A. Sleep complaints are associated with frailty in Mexican older adults in a rural setting. Geriatrics & gerontology international. 2017;17(12):2573–8.
Goldman SE, Stone KL, Ancoli–Israel S, Blackwell T, Ewing SK, Boudreau R, et al. Poor sleep is associated with poorer physical performance and greater functional limitations in older women. Sleep. 2007;30(10):1317–24.
Lan T, Lan T, Wen C, Lin Y, Chuang Y. Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. Sleep. 2007;30(9):1105–10.
Smyth C. The Pittsburgh Sleep Quality Index (PSQI). J Gerontol Nurs. 1999;25(12):10–.
Lee W, Peng L, Liang C, Chiou S, Chen L. Long sleep duration, independent of frailty and chronic Inflammation, was associated with higher mortality: A national population–based study. Geriatrics & gerontology international. 2017;17(10):1481–7.
Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004;57(3):297–305.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001;56(3):M146–57.
Chen L, Liu L, Woo J, Assantachai P, Auyeung T, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. Journal of the American Medical Directors Association. 2014;15(2):95–101.
Orme JG, Reis J, Herz EJ. Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES–D) scale. J Clin Psychol. 1986;42(1):28–33.
Son J, Kim S, Won C, Choi H, Kim B, Park M. Physical frailty predicts medical expenses in community–dwelling, elderly patients: three–year prospective findings from living profiles of older people surveys in Korea. European Geriatric Medicine. 2015;6(5):412–6.
Van Cauter E, Leproult R, Plat L. Age–related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. JAMA. 2000;284(7):861–8.
Bauer ME, Jeckel CMM, Luz C. The role of stress factors during aging of the immune system. Ann N Y Acad Sci. 2009;1153(1):139–52.
Ensrud KE, Blackwell TL, Redline S, Ancoli–Israel S, Paudel ML, Cawthon PM, et al. Sleep disturbances and frailty status in older community–dwelling men. J Am Geriatr Soc. 2009;57(11):2085–93.
Song HJ, Choi J, Lee YJ, Youn NH, Oh JM, Lee YR. The Association of Objective Depression and Subjective Depression with Weight Change among Korean Adults Aged over 65 Years: Korean National Health and Nutrition Examination Survey, 2010–2012. Korean Journal of Family Practice. 2018;8(2):281–5.
Kwon Y, Jang S, Park E, Cho A, Shim J, Linton JA. Long sleep duration is associated with sarcopenia in Korean adults based on data from the 2008–2011 KNHANES. Journal of Clinical Sleep Medicine. 2017;13(09):1097–104.
Lee JS, Auyeung T, Leung J, Chan D, Kwok T, Woo J, et al. Long sleep duration is associated with higher mortality in older people independent of frailty: a 5–year cohort study. Journal of the American Medical Directors Association. 2014;15(9):649–54.
Self–reported sleep duration as a predictor of all–cause mortality: results from the JACC study. Japan. Sleep. 2004;27(1):51–4.
Hublin C, Partinen M, Koskenvuo M, Kaprio J. Sleep and mortality: a populationbased 22–year follow–up study. Sleep. 2007;30(10):1245–53.
Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Sleep duration and all–cause mortality: a systematic review and meta–analysis of prospective studies. Sleep. 2010;33(5):585–92.
Stone KL, Ewing SK, Ancoli–Israel S, Ensrud KE, Redline S, Bauer DC, et al. Selfreported sleep and nap habits and risk of mortality in a large cohort of older women. J Am Geriatr Soc. 2009;57(4):604–11.
Kurina LM, McClintock MK, Chen J, Waite LJ, Thisted RA, Lauderdale DS. Sleep duration and all–cause mortality: a critical review of measurement and associations. Ann Epidemiol. 2013;23(6):361–70.
Mesas AE, López–García E, León–Muñoz LM, Guallar–Castillón P, Rodríguez–Artalejo F. Sleep duration and mortality according to health status in older adults. J Am Geriatr Soc. 2010;58(10):1870–7.
Li Y, Sato Y, Yamaguchi N. Potential biochemical pathways for the relationship between sleep duration and mortality. Sleep Med. 2013;14(1):98–104.
Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration, and inflammation: a systematic review and meta–analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016;80(1):40–52.
Gale CR, Baylis D, Cooper C, Sayer AA. Inflammatory markers and incident frailty in men and women: the English Longitudinal Study of Ageing. Age. 2013;35(6):2493–501.
Khor Y, Tolson J, Churchward T, Rochford P, Worsnop C. Patients’ estimates of their sleep times: reliability and impact on diagnosis of obstructive sleep apnoea. Intern Med J. 2015;45(8):850–3.
Lee M, Choh A, Demerath E, Knutson K, Duren D, Sherwood R, et al. Sleep disturbance in relation to health–related quality of life in adults: the Fels Longitudinal Study. JNHA–The Journal of Nutrition, Health and Aging. 2009;13(6):576–83.
Cochen V, Arbus C, Soto M, Villars H, Tiberge M, Montemayor T, et al. Sleep disorders and their impacts on healthy, dependent, and frail older adults. JNHA–The Journal of Nutrition, Health and Aging. 2009;13(4):322–9.
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Kang, I., Kim, S., Kim, B.S. et al. Sleep Latency in Men and Sleep Duration in Women Can Be Frailty Markers in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). J Nutr Health Aging 23, 63–67 (2019). https://doi.org/10.1007/s12603-018-1109-2
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DOI: https://doi.org/10.1007/s12603-018-1109-2