The Effect of Sleep Medication Use and Poor Sleep Quality on Risk of Falls in Community-Dwelling Older Adults in the US: A Prospective Cohort Study

Background: Early detection of cognitive impairment and poor sleep quality are necessary to prevent dementia and the improve the quality of life further. This study aimed to investigate the cognitive impairment and poor sleep quality in the community-dwelling older adults and its association with socio-demographic and health characteristics. Methods: A cross-sectional study of 1,180 people in Northern Thailand aged 60 years and above was conducted in 2017. Mental State Examination-Thai version (MSET10) was used to measure cognitive function while the Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality. Multiple logistic regression was used to analyze associations. Results: The prevalence of CI in older adults was 52.45% (95% CI: 49.64 - 55.42) which increased with age. The prevalence of poor sleep quality was 44.15% (95% CI: 1.29-47.03). Age, illiteracy, hypertension, comorbidities of hypertension and diabetes, alcohol consumption, lack of exercise, and depression were significantly associated with increased risk of CI, while being single, comorbidities of hypertension and diabetes, and depression were significantly associated with poor sleep quality. Conclusion: The rate of CI and poor sleep quality in older adults was relatively high in Thailand. Early detection of CI and poor sleep quality and screening for all risk factors are important to improve in access to service, optimization of medical management, reduction in risk factors, and increased quality of life in older adults.

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Associations between self-reported sleep quality and white matter in community-dwelling older adults: A prospective cohort study

Human Brain Mapping ◽

10.1002/hbm.23739 ◽

2017 ◽

Vol 38 (11) ◽

pp. 5465-5473 ◽

Cited By ~ 35

Author(s):

Claire E. Sexton ◽

Enikő Zsoldos ◽

Nicola Filippini ◽

Ludovica Griffanti ◽

Anderson Winkler ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

White Matter ◽

Sleep Quality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Poor Sleep and Risk of Falls in Community-Dwelling Older Adults: A Systematic Review

Journal of Applied Gerontology ◽

10.1177/0733464816681149 ◽

2016 ◽

Vol 37 (9) ◽

pp. 1059-1084 ◽

Cited By ~ 7

Author(s):

Yaena Min ◽

Patricia W. Slattum

Keyword(s):

Older Adults ◽

Sleep Problems ◽

Community Dwelling ◽

Poor Sleep ◽

Short Sleep Duration ◽

Exclusion Criteria ◽

Future Studies ◽

Risk Of Falls ◽

Falls In Older Adults ◽

Community Dwelling Older Adults

Concerns about sleep problems and falls in older adults are significant. This article reviews the association between sleep problems and falls in community-dwelling adults aged 65 years or older. Multiple databases were searched from inception until 2015 using sleep, sleep disorders, and falls as keywords, limiting to studies published in English in peer-reviewed journals. After screening and assessing for eligibility, 18 articles were selected based on the inclusion and exclusion criteria. Findings of an association between sleep problems and risk of falls are conflicting, but some specific sleep problems such as extremely short sleep duration, daytime sleepiness and naps appear to be significantly related to falls in older adults. Methodological limitations including variability in covariates included in the analyses and measurement of the exposure and outcome variables were identified. The results of this review identified the need to have comparable definitions, validated tools, and rigorous design of future studies.

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Potentially inappropriate medications in older adults: a population-based cohort study

Family Practice ◽

10.1093/fampra/cmz060 ◽

2019 ◽

Cited By ~ 8

Author(s):

Barbara Roux ◽

Caroline Sirois ◽

Marc Simard ◽

Marie-Eve Gagnon ◽

Marie-Laure Laroche

Keyword(s):

Older Adults ◽

Cohort Study ◽

Chronic Diseases ◽

Medication Use ◽

Population Based ◽

Community Dwelling ◽

The Public ◽

Factors Associated ◽

Community Dwelling Older Adults ◽

Public Drug

Abstract Background Non-optimal medication use among older adults is a public health concern. A concrete picture of potentially inappropriate medication (PIM) use is imperative to ensure optimal medication use. Objective To assess the prevalence of PIMs in community-dwelling older adults and identify associated factors. Methods A retrospective population-based cohort study was conducted using the Quebec Integrated Chronic Disease Surveillance System (QICDSS). The QICDSS includes data on drug claims for community-dwelling older adults with chronic diseases or at risk of developing chronic diseases aged ≥65 years who are insured by the public drug insurance plan. Individuals aged ≥66 years who were continuously insured with the public drug plan between 1 April 2014 and 31 March 2016 were included. PIMs were defined using the 2015 Beers criteria. We conducted multivariate robust Poisson regression analyses to explore factors associated with PIM use. Results A total of 1 105 295 individuals were included. Of these, 48.3% were prescribed at least one PIM. The most prevalent PIMs were benzodiazepines (25.7%), proton-pump inhibitors (21.3%), antipsychotics (5.6%), antidepressants (5.0%) and long-duration sulfonylureas (3.3%). Factors associated with PIM exposure included being a woman [rate ratio (RR): 1.20; 95% confidence interval (CI): 1.20–1.21], increased number of medications and having a high number of chronic diseases, especially mental disorders (RR: 1.50; 95% CI: 1.49–1.51). Conclusion Almost one out of two community-dwelling older adults use a PIM. It is imperative to reduce the use of PIMs, by limiting their prescription and by promoting their deprescribing, which necessitates not only the active involvement of prescribers but also patients.

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0837 Well-Being Predicts Sleep Disturbance in a Prospective Cohort of Older Adults

SLEEP ◽

10.1093/sleep/zsaa056.833 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A319-A319

Author(s):

S D Hershner ◽

L M Swanson ◽

A Meng ◽

E C Jansen ◽

J F Burke ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Duration ◽

Well Being ◽

Community Dwelling ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Logistic Regression Models ◽

The Mean ◽

Insomnia Symptoms

Abstract Introduction Lower well-being negatively impacts health among older adults. Optimal sleep - a determinant of health - has been associated with higher well-being. Several domains of well-being, e.g., mindfulness and purpose in life have been shown to improve sleep. But, whether well-being impacts sleep remains unclear. This study examined associations between well-being and sleep duration, sleep quality, and incident insomnia symptoms among a nationally representative sample of older US adults. Methods This study analyzed data from the 2011-2013 National Health and Aging Trends Study (NHATS), a longitudinal, annual survey of community-dwelling Medicare beneficiaries. The exposure, a validated scale of well-being used questions on purpose, emotion, and self-satisfaction and divided responses into quartiles. Sleep outcomes included sleep duration, sleep quality, and insomnia symptoms. Unadjusted and adjusted linear and logistic regression models examined relationships between the health characteristics and well-being score in 2012 and sleep outcomes in 2013. Covariates included demographics and health characteristics. Results Half of study participants (n=2,000) were women. The mean sleep duration was 7.2 and 7.3 (standard error(SE) ±0.1) for men and women. Poor sleep quality was reported by 30% of subjects and more frequently among Hispanic subjects, older adults, and those with less education. The mean well-being score was 17.2 (SE ±0.07). Higher well-being scores correlated with male gender, younger age, higher education, marriage, and increased physical activity. Well-being scores in the 2nd - 4th quartile had lower odds of poor sleep quality (4th quartile adjusted odd ratio 0.24 (95% CI 0.15, 0.38). The highest well-being quartile had a 4-fold lower incidence of insomnia symptoms. Well-being scores were not associated with sleep duration Conclusion Higher well-being may protect older adults against the development of insomnia and poor sleep quality. Strategies to improve well-being could offer an innovative way to improve the health of older Americans though better sleep. Support none

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Potentially serious alcohol–medication interactions and falls in community-dwelling older adults: a prospective cohort study

Age and Ageing ◽

10.1093/ageing/afz112 ◽

2019 ◽

Vol 48 (6) ◽

pp. 824-831 ◽

Cited By ~ 1

Author(s):

Alice Holton ◽

Fiona Boland ◽

Paul Gallagher ◽

Tom Fahey ◽

Frank Moriarty ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Community Dwelling ◽

Adjusted Relative Risk ◽

Injurious Falls ◽

Risk Of Falls ◽

Community Dwelling Older Adults

Abstract Objective To investigate the association between potentially serious alcohol–medication interactions (POSAMINO criteria), hypothesised to increase the risk of falls in older adults, and falls in community-dwelling older adults at two and 4 years follow-up. Design A prospective cohort study. Setting The Irish Longitudinal Study on Ageing. Subjects A total of 1,457 community-dwelling older adults aged ≥65 years, with a complete alcohol and regular medication data to allow for the application of the POSAMINO criteria. Outcomes Self-reported falls at 2 and 4 years follow-up, any falls (yes/no), injurious falls (yes/no) and number of falls (count variable). Results The number of participants who reported falling since their baseline interview at 2 and 4 years were 357 (24%) and 608 (41.8%), respectively; 145 (10%) reported an injurious fall at 2 years and 268 (18%) at 4 years. Median (IQR) number of falls was 1 (1–2) at 2 years and 2 (1–3) at 4 years. Exposure to CNS POSAMINO criteria, hypothesised to increase the risk of falls due primarily to increased sedation, was associated with a significantly increased risk for falling (adjusted relative risk (RR) 1.50, 95% confidence interval (CI) 1.21–1.88) and for injurious falls (adjusted RR 1.62, 95% CI: 1.03–2.55) at 4 years. These equate to an absolute risk of 19% for falling (95% CI: 5–33%) and 8% for injurious falls (95% CI, 4–20%) at 4 years. Conclusions Assessment and management strategies to prevent falls in community-dwelling older adults should consider patients’ alcohol consumption alongside their assessment of patient medications, particularly among those receiving CNS agents.

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Association Between Sleep and Motoric Cognitive Risk Syndrome Among Community-Dwelling Older Adults: Results From the China Health and Retirement Longitudinal Study

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.774167 ◽

2021 ◽

Vol 13 ◽

Author(s):

Weihao Xu ◽

Anying Bai ◽

Xin Huang ◽

Yinghui Gao ◽

Lin Liu

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Sleep Quality ◽

Sleep Duration ◽

Multivariate Logistic Regression Analysis ◽

Community Dwelling ◽

Poor Sleep ◽

Night Sleep ◽

Poor Sleep Quality ◽

Cognitive Risk

Background: Sleep is increasingly recognized as an important lifestyle contributor to health; however, its relationship with Motoric cognitive risk syndrome (MCR) is still unclear. The present study aimed to examine the associations between sleep duration, sleep quality, and MCR among community-dwelling Chinese older adults.Methods: We recruited 5,387 participants aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). Sleep-related variables including night sleep duration and sleep quality were assessed via self-reported questionnaires. MCR syndrome was defined as cognitive complaints and slow gait speed without dementia or impaired mobility. Multivariate logistic regression analysis was performed to explore the associations between sleep-related variables and MCR after controlling for all potential confounders including demographic characteristics, lifestyle factors, and comorbidities.Results: We found that sleep duration was significantly associated with MCR, and the multivariate-adjusted odds ratios (OR) were highest for those with the shortest (<6 h OR = 1.55, 95% CI = 1.18–2.04) and longest (≥10 h OR = 1.73, 95% CI = 1.03–2.91) sleep durations. Moreover, an increasing frequency of self-perceived poor sleep quality was significantly associated with MCR in the adjusted model (3–4 days OR = 1.58, 95% CI = 1.16–2.17; 5–7 days OR = 1.81, 95% CI = 1.37–2.40).Conclusions: Our study indicated an inverted U-shaped association between night sleep duration and MCR. Poor sleep quality was also associated with higher odds of MCR in community-dwelling Chinese elders. Longitudinal studies with a larger population size are needed to establish causality in the future and further explore potential action mechanisms.

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SLEEP QUALITY AND DEPRESSIVE SYMPTOMS IN LATER-LIFE: CROSS-SECTIONAL EXAMINATION OF COGNITIVE MECHANISMS

Innovation in Aging ◽

10.1093/geroni/igz038.3198 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S872-S872

Author(s):

David Brush ◽

Daniel Paulson ◽

Manuel Herrera Legon ◽

Nicholas James ◽

Jennifer Scheurich ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Sleep Quality ◽

Inhibitory Control ◽

Depression Scale ◽

Later Life ◽

Community Dwelling ◽

Mediating Effect ◽

Poor Sleep ◽

Community Dwelling Older Adults

Abstract Sleep quality relates to depressive symptom endorsement. The mechanisms relating these variables are not clearly elucidated, though inhibitory control and rumination are believed to play key roles. The current study aims to elucidate the relationship between sleep quality and depressive symptoms by examining the moderated mediating effect of inhibitory control and rumination. The sample included 41 community-dwelling older adults (age 70 and older). Measures included the Pittsburg Sleep Quality Inventory, a Stroop task (inhibitory control), the Ruminative Responses Scale, and the Geriatric Depression Scale. A series of bootstrapped models were employed to test hypotheses using a stepped approach. Poorer sleep quality was associated with higher rumination and depressive symptoms; however, these associations were no longer significant among older adults with higher inhibitory control. The association between sleep quality and depression was fully attenuated by rumination, and inhibitory control significantly moderated the association between sleep quality and rumination in the final model. Among community-dwelling older adults, the association between sleep quality and depression is mediated by rumination, and this effect is mitigated by inhibitory control. As such, these findings suggest that inhibitory control may be a relevant target for intervention in older adults with poor sleep quality, rumination, and depressive symptoms.

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