Association of Sleep Quality and Nutritional Status in Middle-Aged and Older Adults: Findings From the WCHAT Study

Abstract Poor sleep quality and malnutrition are two common symptoms which are closely related to the health of middle-aged and older people, but few studies focus on the association between them. In this study, we aimed to identify associations between sleep quality and nutritional status in middle-aged and older adults. A total of 6792 community-dwelling adults aged 50 and older from the baseline of the West China Health and Aging Trend (WCHAT) study were analyzed in the present study. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Scores <=5, 6-10,11-15 and >=16 were categorized as good/mild impaired/moderate impaired/severe impaired sleep quality, respectively. Mini Nutritional Assessment Short Form (MNA-SF) was used to assess the nutritional status and a score<12 was identified as at risk of malnutrition. Logistic regression models were conducted to explore the associations. Of 6792 participants (mean age 62.41 ± 8.26 years, 62.49% women), 1831 (26.96%) had risk of malnutrition. The prevalence of participants with good/mild impaired/moderate impaired/severe impaired sleep quality were 53.72%, 35.54%, 9.61%, and 1.12%, respectively. In the logistic regression model, there were significant association between mild/moderate/severe impaired sleep quality and the presence of risk of malnutrition (OR=1.49, 95% CI=1.32, 1.68; OR=2.15, 95% CI=1.79, 2.59; OR=2.52, 95% CI=1.56, 4.06; all p<0.05) after adjusting for potential confounders. Sleep quality was significantly associated with malnutrition risk with a dosage effect among middle-aged and older adults. Our results highlight the importance of maintaining good sleep quality and nutritional status in middle-aged and older adults.

Download Full-text

Associations of sleep quality, quantity and nutrition in oldest-old men The Helsinki Businessmen Study (HBS)

European Geriatric Medicine ◽

10.1007/s41999-020-00421-z ◽

2020 ◽

Author(s):

Satu K. Jyväkorpi ◽

Annele Urtamo ◽

Mika Kivimäki ◽

Timo E. Strandberg

Keyword(s):

Nutritional Status ◽

Sleep Quality ◽

Nutritional Assessment ◽

Vegetable Intake ◽

Short Form ◽

Oldest Old ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Cross Sectional ◽

Old Men

Abstract Introduction Sleep quality and quantity often decline as people age, which may negatively impact health. We examined how nutrition is associated with self-reported sleep quality and quantity in oldest-old community-dwelling men. Methods In this cross-sectional analysis of the Helsinki Businessmen Study (HBS), a random sample of 130 surviving participants underwent a clinical examination in 2017–2018. Food and nutrient intakes were retrieved from 3-day food diaries in 126 men, and sleep quality and quantity were determined with a questionnaire. Nutritional status was assessed using Mini Nutritional Assessment Short Form (MNA-SF), General Health and Vitality were measured with RAND-36/SF-36 health-related quality of life instrument, and albumin and creatinine levels were analyzed from fasting serum samples. Results Mean age of the survivors was 87 years (range 83–99). Self-reported sleep quality and quantity were highly correlated (p < 0.001, η2 = 0.693). Nutritional status (MNA-SF) (p = 0.006, η2 = 0.076), vegetable intake (p = 0.030. η2 = 0.041) and vitality (p = 0.008, η2 = 0.101) were associated with better sleep quality and fish (p = 0.028, η2 = 0.051) intake was associated with longer sleep duration. This association remained after adjusting for age, sleep quality, carbohydrate energy %, and albumin levels. Conclusion Healthy nutrition may be an important contributor to sleep hygiene in oldest-old men.

Download Full-text

NUTRITIONAL INTAKE AND STATUS AND PHYSICAL FUNCTION OF OLDER ETHNIC MINORITIES: A LONGITUDINAL STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.3119 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S847-S848

Author(s):

Evans A Asamane ◽

Carolyn A Greig ◽

Janice L Thompson

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Physical Function ◽

Short Form ◽

Mini Nutritional Assessment ◽

Ethnically Diverse ◽

Community Dwelling ◽

Nutritional Intake ◽

Nutrient Intakes ◽

Over Time

Abstract There are limited longitudinal data regarding nutritional intake and status, and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n=100) and after 8-months (n=81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Multiple pass 24-hour dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. The Short Physical Performance Battery(SPPB) and handgrip strength measured physical function. Linear and multinomial regression analyses were used to predict the relationship between nutritional intake, status and physical function. Mean(SD) age was 70(8.1) years (60% male), with 62% of the sample being obese. Significant decreases in intakes of vitamin B6(0.88-0.77mg/day, p=0.014); vitamin B1(0.73-0.63mg/day, p=0.029); iron(6.16-5.85mg/d, p=0.045); folate(113.23-106.66µg/d, p=0.043); and magnesium(154.54-144.59mg/d, p=0.031) occurred over time. At both timepoints, across sexes, daily intakes of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes. There were significant declines in SPPB scores(Z=-4.01, p<0.001) and nutritional status(Z=-2.37,p=0.018) over time. At baseline, younger age, better nutritional status, and higher vitamin D and fibre intakes were associated with higher SPPB scores. At follow-up, higher baseline SPPB scores (OR=0.54 95% CI:0.35, 0.81) were associated with reduced decline in nutritional status. The observed declines in nutritional status and physical function, and the inadequate nutrient intakes in the absence of weight loss within eight months pose serious challenges to healthy ageing. There is an urgent need to re-evaluate and tailor appropriate dietary advice for this population to support them to age healthily.

Download Full-text

Denture Wearing and Malnutrition Risk Among Community-Dwelling Older Adults

Nutrients ◽

10.3390/nu12010151 ◽

2020 ◽

Vol 12 (1) ◽

pp. 151 ◽

Cited By ~ 2

Author(s):

Ya Su ◽

Michiko Yuki ◽

Kengo Hirayama ◽

Miho Sato ◽

Tianfang Han

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

The Elderly ◽

Community Dwelling ◽

Partial Denture

Most studies have associated denture wearing with a higher risk of malnutrition and lower nutritional intake in the elderly. As the effect of wearing dentures remains debatable, the aim of this study was to determine if older adults wearing dentures have a higher risk of malnutrition. We recruited 294 Japanese community-dwelling adults aged ≥65 years from two elderly welfare centers in Sapporo. The Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess their nutritional status. Their demographic characteristics, eating habits, and health status were assessed using a questionnaire. Moreover, salt-impregnated taste paper and bioelectrical impedance analysis were used to obtain salt taste sensitivity and body composition (body mass index and protein mass). The mean age of older adults was 75.8 ± 5.8 years and 71.1% were women. We found that 74.1% of the older adults wore dentures. The proportion of the whole population with a risk of malnutrition was 23.5%. Multivariate analysis revealed that partial denture wearing could be protective against the risk of malnutrition. In this study, we found more partial denture wearers with normal nutritional conditions and cooking by themselves than non-denture-wearing older adults. Furthermore, complete denture wearers were eating significantly less meats or fish every day. This study suggests that using partial dentures to replace the lost teeth to meet the dietary needs of the elderly is critical to maintaining a healthy nutritional status. Moreover, it also indicates the importance of providing education to older adults who wear complete dentures.

Download Full-text

A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010213 ◽

2020 ◽

Vol 18 (1) ◽

pp. 213

Author(s):

Masanori Iwasaki ◽

Keiko Motokawa ◽

Yutaka Watanabe ◽

Maki Shirobe ◽

Hiroki Inagaki ◽

...

Keyword(s):

Older Adults ◽

Oral Health ◽

Nutritional Status ◽

Short Form ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Tongue Pressure ◽

Increased Risk ◽

Community Dwelling Older Adults ◽

Oral Frailty

Background: Limited longitudinal studies exist to evaluate whether poor oral health and functions affect the incidence of deteriorating nutritional status. We investigated if there were longitudinal associations between oral frailty, defined as accumulated deficits in oral health, and deteriorating nutritional status among community-dwelling older adults. Methods: The study population consisted of 191 men and 275 women (mean age, 76.4 years) from the Takashimadaira Study. Multifaced oral health assessment was performed at baseline, and oral frailty was defined as having ≥3 of the following six components: fewer teeth, low masticatory performance, low articulatory oral motor skill, low tongue pressure, and difficulties in chewing and swallowing. Nutritional status assessment was performed at baseline and two-year follow-up using the Mini Nutritional Assessment®-Short Form (MNA®-SF). Deteriorating nutritional status was defined as a decline in the nutritional status categories based on the MNA®-SF score during the study period. The association between oral frailty and deteriorating nutritional status was assessed using logistic regression analyses. Results: Oral frailty was observed in 67 (14.4%) participants at baseline. During the study, 58 (12.4%) participants exhibited deteriorating nutritional status. After adjusting for potential confounders, oral frailty was significantly associated with deteriorating nutritional status (adjusted odds ratio, 2.24; 95% confidence interval, 1.08–4.63). Conclusion: Community-dwelling older adults with oral frailty had an increased risk of deteriorating nutritional status.

Download Full-text

Impact of Rehabilitation Dose on Nutritional Status at Discharge from a Convalescent Rehabilitation Ward in Malnourished Patients with Hip Fracture

Healthcare ◽

10.3390/healthcare9060722 ◽

2021 ◽

Vol 9 (6) ◽

pp. 722

Author(s):

Yusuke Ito ◽

Hidetaka Wakabayashi ◽

Shinta Nishioka ◽

Shin Nomura ◽

Ryo Momosaki

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Hip Fracture ◽

Nutritional Status ◽

Logistic Regression Analysis ◽

Short Form ◽

Mini Nutritional Assessment ◽

Functional Independence ◽

Rehabilitation Ward ◽

The Impact

The object of this study is to determine the impact of the rehabilitation dose on the nutritional status at discharge from a convalescent rehabilitation ward in malnourished patients with hip fracture. This retrospective case-control study involved malnourished patients with hip fracture aged 65 years or older who had been admitted to a convalescent rehabilitation ward and whose data were registered in the Japan Rehabilitation Nutrition Database. The primary outcome was nutritional status at discharge. Patients were classified according to whether nutritional status was improved or not at discharge, according to the Mini Nutritional Assessment-Short Form® (MNA-SF) score. The association between improved nutritional status and rehabilitation dose was assessed by a logistic regression analysis. Data were available for 145 patients (27 men, 118 women; mean age 85.1 ± 7.9 years). Daily rehabilitation dose was 109.5 (median 94.6–116.2) min and the MNA-SF score at admission was 5 (median 4–6). Nutritional status was improved in 97 patients and not improved in 48. Logistic regression analysis showed the following factors to be independently associated with nutritional status at discharge: Functional Independence Measure score (OR 1.042, 95% CI 1.016–1.068), energy intake (OR 1.002 CI 1.000–1.004), daily rehabilitation dose (OR 1.023, 95% CI 1.002–1.045), and length of hospital stay (OR 1.026, 95% CI 1.003–1.049). The daily rehabilitation dose in malnourished patients with hip fracture may positively impact nutritional status at discharge.

Download Full-text

Malnutrition among older adults living in Portuguese nursing homes: the PEN-3S study

Public Health Nutrition ◽

10.1017/s1368980018002318 ◽

2018 ◽

Vol 22 (3) ◽

pp. 486-497 ◽

Cited By ~ 3

Author(s):

Teresa Madeira ◽

Catarina Peixoto-Plácido ◽

Nuno Sousa-Santos ◽

Osvaldo Santos ◽

Violeta Alarcão ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Logistic Regression ◽

Nursing Homes ◽

Nutritional Status ◽

Functional Status ◽

Mini Nutritional Assessment ◽

Computer Assisted ◽

Depression Symptoms ◽

Symptoms Of Depression

AbstractObjectiveTo characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes.DesignCross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, loneliness feelings and functional status were collected by trained nutritionists through a computer-assisted face-to-face structured interview followed by standardised anthropometric measurements. Logistic regression was used to identify factors associated with being at risk of malnutrition/malnourished.SettingPortuguese nursing homes.SubjectsNationally representative sample of the Portuguese population aged 65 years or over living in nursing homes.ResultsA total of 1186 individuals (mean age 83·4 years; 72·8 % women) accepted to participate. According to the Mini Nutritional Assessment, 4·8 (95 % CI 3·2, 7·3) % were identified as malnourished and 38·7 (95 % CI 33·5, 44·2) % were at risk of malnutrition. These percentages increased with age and were significantly higher for women. Logistic regression showed (OR; 95 % CI) that older adults reporting no or little appetite (6·5; 2·7, 15·3), those revealing symptoms of depression (2·6; 1·6, 4·2) and those who were more dependent in their daily living activities (4·7; 2·0, 11·1) were also at higher odds of being malnourished or at risk of malnutrition.ConclusionsMalnutrition and risk of malnutrition are prevalent among nursing home residents in Portugal. It is crucial to routinely screen for nutritional disorders, as well as risk factors such as symptoms of depression and lower functional status, to prevent and treat malnutrition.

Download Full-text

342 The Association Between Benzodiazepine Use and Falls, and the Impact of Sleep Quality on this Association: Data from TILDA

Age and Ageing ◽

10.1093/ageing/afz103.224 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Louise Marron ◽

Ricardo Segurado ◽

Paul Claffey ◽

Rose Anne Kenny ◽

Triona McNicholas

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Effect Size ◽

Community Dwelling ◽

Public Health Issue ◽

P Value ◽

Poor Sleep ◽

Daytime Somnolence ◽

Falling Asleep ◽

The Impact

Abstract Background Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults. Previous research has shown an association between BZDs and falls and BZDs have been shown to impact sleep quality. The aim of this study is to assess the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50. Methods Data from the first wave of The Irish Longitudinal Study on Ageing were used. Participants were classed as BZD users or non-users and asked if they had fallen in the last year, and whether any of these falls were unexplained. Sleep quality was assessed via self-reported trouble falling asleep, daytime somnolence, and early-rising. Logistic regression assessed for an association between BZD use and falls, and the impact of sleep quality on this association was assessed by categorising based on BZD use and each sleep quality variable. Results Of 8,175 individuals, 302 (3.69%) reported taking BZDs. BZD use was associated with falls, controlling for con-founders (OR 1.40; 1.08, 1.82; p-value 0.012). There was no significant association between BZDs and unexplained falls, controlling for con-founders (OR 1.41; 95% CI 0.95, 2.10; p-value 0.09), however a similar effect size to all falls was evident. Participants who take BZDs and report daytime somnolence (OR 1.93; 95% CI 1.12, 3.31; p-value 0.017), early-rising (OR 1.93; 95% CI 1.20, 3.11; p-value 0.007) or trouble falling asleep (OR 1.83; 95% CI 1.12, 2.97; p-value 0.015), have an increased odds of unexplained falls. Conclusion BZD use is associated with falls, with larger effect size in BZD users reporting poor sleep quality in community dwelling older adults. Appropriate prescription of and regular review of medications such as BZDs is an important public health issue.

Download Full-text

Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033661 ◽

2020 ◽

Vol 10 (6) ◽

pp. e033661 ◽

Cited By ~ 2

Author(s):

Ana Rita Sousa-Santos ◽

Cláudia Afonso ◽

Nuno Borges ◽

Alejandro Santos ◽

Patrícia Padrão ◽

...

Keyword(s):

Older Adults ◽

Nutritional Assessment ◽

Multinomial Logistic Regression ◽

Short Form ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Secondary Outcome ◽

Physical Frailty ◽

Cross Sectional ◽

European Working

ObjectivesTo investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.DesignCross-sectional.SettingPortugal.Participants1454 older adults with 65 years or older, from Nutrition UP 65 study.Primary and secondary outcome measuresSarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.Results57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.ConclusionsAlmost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

Download Full-text

Association between kidney function, nutritional status and anthropometric measures in older people

BMC Geriatrics ◽

10.1186/s12877-020-01699-1 ◽

2020 ◽

Vol 20 (S1) ◽

Cited By ~ 1

Author(s):

Agnieszka Guligowska ◽

◽

Andrea Corsonello ◽

Małgorzata Pigłowska ◽

Regina Roller-Wirnsberger ◽

...

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Overweight And Obesity ◽

Community Dwelling ◽

Albumin Concentration ◽

Anthropometric Measures ◽

Baseline Phase

Abstract Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.

Download Full-text

Sleep and Olfaction among Older Adults

Neuroepidemiology ◽

10.1159/000479066 ◽

2017 ◽

Vol 48 (3-4) ◽

pp. 147-154 ◽

Cited By ~ 2

Author(s):

V. Eloesa McSorley ◽

Jayant Pinto ◽

L. Philip Schumm ◽

Kristen Wroblewski ◽

David Kern ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Structural Equation Models ◽

Sleep Problems ◽

Community Dwelling ◽

Odor Identification ◽

Self Report ◽

Poor Sleep ◽

Wrist Actigraphy ◽

Odor Sensitivity

Background: Sleep and olfaction are both critical physiological processes that tend to worsen with age. Decline in olfaction can be an early indicator of neurodegenerative diseases, whereas poor sleep quality is associated with reduced physical and mental health. Given associations with aging-related health declines, we explored whether variations in sleep were associated with olfactory function among older adults. Methods: We assessed the relationship between sleep characteristics and olfaction among 354 community-dwelling older adults. Olfaction was measured using a validated field and survey research tool. Sleep characteristics were measured using wrist actigraphy and with self-report of sleep problems. We fit structural equation models of latent constructs of olfaction based on olfactory task items and let this be a function of each sleep characteristic. Results: Actigraph sleep quality measures were associated with odor identification, but not with odor sensitivity. Longer duration sleepers had worse odor sensitivity compared to medium (58 h) sleepers, but sleep duration was not associated with odor identification. Reported sleep problems and reported usual duration were not associated with olfaction. Conclusions: Diminished sleep quality was associated with reduced capacity to identify odors. Determining whether this is a causal association will require further study and longitudinal data.

Download Full-text