Associations of Sleep Quality with Gait Speed and Falls in Older Adults: The Mediating Effect of Muscle Strength and the Gender Difference

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Li Zhang ◽  
Shuqin Liu ◽  
Yujie Li ◽  
Suyun Li ◽  
Yili Wu
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Sleep Quality ◽  
Grip Strength ◽  
Gait Speed ◽  
Mediating Effect ◽  
Self Report ◽  
Mediating Effects ◽  
Walking Test ◽  
Falls In Older Adults

<b><i>Introduction:</i></b> Although previous studies have reported the significant associations of sleep quality with gait speed and falls, the mechanisms underlying these associations are unclear. We aimed to examine the gender-specific associations of sleep quality with gait speed and falls among older adults and to explore the possible mediating effect of muscle strength on these relationships. <b><i>Methods:</i></b> Data were taken from wave 6 (2012–2013) of the English Longitudinal Study of Aging (ELSA), including 7,664 participants aged 60 years and older. Sleep quality and falls were assessed by self-report. Gait speed was measured by the “timed walking test” and then adjusted by height. As an indicator of overall muscle strength, grip strength was measured by using the Smedley dynamometer. Baron and Kenny’s causal steps and the Karlson/Holm/Breen method were used to examine the mediating effect. <b><i>Results:</i></b> Higher sleep quality was associated with the higher level of gait speed (β = 0.008, <i>p</i> = 0.031 in men; β = 0.008, <i>p</i> = 0.017 in women) and with lower prevalence of falls (OR = 0.878, 95% CI: 0.773, 0.998 in men; OR = 0.874, 95% CI: 0.792, 0.965 in women). Grip strength mediated these associations in men but not in women, and the mediating effects of grip strength can explain 23.74 and 11.01% of the total effect of sleep quality on gait speed and falls, respectively. <b><i>Conclusion:</i></b> Our findings help explain the mechanism underlying the associations of sleep quality with gait speed and falls. Effort to maintain the mobility of the older men should focus on improving both sleep quality and muscle strength.

scholarly journals The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment

2021 ◽  
Vol 18 (7) ◽  
pp. 3712
Author(s):  
Claire E. Adam ◽  
Annette L. Fitzpatrick ◽  
Cindy S. Leary ◽  
Anjum Hajat ◽  
Elizabeth A. Phelan ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Gait Speed ◽  
Community Dwelling ◽  
Self Report ◽  
P Value ◽  
Risk Of Falling ◽  
Falls In Older Adults ◽  
Status Interaction

(1) Background: Falls are common in older adults and result in injuries, loss of independence, and death. Slow gait is associated with falls in older adults, but few studies have assessed the association between gait speed and falls among those with mild cognitive impairment (MCI). (2) Methods: The association between gait speed and falls was assessed in 2705 older adults with and without MCI participating in the Ginkgo Evaluation of Memory Study. Gait speed was measured via a 15-foot walk test and fall history through self-report. We used data collected at the 12-month (2001–2003) and 18-month visits (2002–2004). (3) Results: Participant average age was 78.5 years (sd = 3.2); 45% were female, and 14% had MCI at baseline. The average gait speed was 0.93 m/s (sd = 0.20). Sixteen percent (n = 433) and 18% (n = 498) reported at least one fall at the 12-month and 18-month visits, respectively. Faster gait speed was associated with decreased risk of falling (RR: 0.95, 95% CI: 0.91, 0.99) for every 10 cm/s increase in gait speed adjusted for age, gender, study arm, site, and MCI status. (4) Conclusions: The relationship between gait speed and risk of falling did not vary by MCI status (interaction p-value = 0.78).

scholarly journals A rapid point-of-care ultrasound marker for muscle mass and muscle strength in older adults

2020 ◽  
Author(s):  
Kenneth M Madden ◽  
Boris Feldman ◽  
Shane Arishenkoff ◽  
Graydon S Meneilly
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Grip Strength ◽  
Muscle Mass ◽  
Gait Speed ◽  
Point Of Care ◽  
Geriatric Medicine ◽  
Muscle Thickness ◽  
Muscle Quality ◽  
Point Of Care Ultrasound

Abstract Background/Objectives Sarcopenia is defined as the gradual age-associated loss of both muscle quantity and strength in older adults, and is associated with increased mortality, falls, fractures and hospitalisations. Current sarcopenia criteria use dual-energy X-ray absorptiometry (DXA) measures of muscle mass, a test that cannot be performed at the bedside, unlike point-of-care ultrasound (PoCUS). We examined the association between ultrasonic measures of muscle thickness (MT, vastus medialis muscle thickness) and measures of muscle quantity and strength in older adults. Methods A total of 150 older adults (age ≥ 65; mean age 80.0 ± 0.5 years, 66 women, 84 men) were recruited sequentially from geriatric medicine clinics. Each subject had lean body mass (LBM, by bioimpedance assay), grip strength, mid-arm biceps circumference (MABC), gait speed and MT measured. All initial models were adjusted for biological sex. Results In our final parsimonious models, MT showed a strong significant correlation with all measures of muscle mass, including LBM (Standardised β = 0.204 ± 0.058, R2 = 0.577, P &lt; 0.001) and MABC (Standardised β = 0.141 ± 0.067, R2 = 0.417, P = 0.038). With respect to measures of muscle quality, there was a strong significant correlation with grip strength (Standardised β = 0.118 ± 0.115, R2 = 0.511, P &lt; 0.001) but not with subject performance (gait speed). Conclusions MT showed strong correlations with both measures of muscle mass (LBM and MABC) and with muscle strength (grip strength). Although more work needs to be done, PoCUS shows potential as a screening tool for sarcopenia in older adults.

scholarly journals Does Poor Sleep Quality Predict Functional Limitations?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 427-427
Author(s):  
Elliot Friedman ◽  
Elizabeth Teas
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Physical Function ◽  
Functional Capacity ◽  
Gait Speed ◽  
The United States ◽  
Self Report ◽  
Poor Sleep ◽  
Linear Regression Models ◽  
Mobility Limitations

Abstract Previous work from our group (Friedman, 2016) linked sleep complaints to declines in mobility and risk of incident limitations over a 9-10 year follow-up among middle-aged and older adults. While these results suggest that poor sleep might undermine functional capacity, the self-report nature of the data leaves the robustness of this association unclear. The current study addressed this uncertainty by examining links between sleep and mobility limitations using subjective and objective assessments of both. Data were from the Midlife in the United States (MIDUS) study: the biomarker sub-sample (N = 664) from the original cohort (collected 2004-2006) and the Refresher cohort (collected 2011-2013). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI; subjective) and 7 consecutive days of actigraphy (objective). Functional capacity was assessed by self-report of limitations and measured gait speed, grip strength, and chair stands. In linear regression models adjusting for demographic and health factors, lower PSQI scores (better sleep quality) predicted fewer reported limitations, stronger grip, quicker gait, and faster chair stands (all p&lt;.01). Of the objective sleep metrics, time to fall asleep and time spent awake during the night predicted more self-report limitations, weaker grip (latency only), and slower gait speed and chair stands. These results extend our prior work by showing a) subjective sleep is linked to measured as well as self-reported physical function, and b) objective assessments of sleep predict reduced physical function, albeit to a lesser extent. They also brighten the spotlight on sleep as a key health determinant in older adults.

Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽  
2019 ◽  
Vol 32 (1) ◽  
pp. 41-52
Author(s):  
Matthew C. Costello ◽  
Shane J. Sizemore ◽  
Kimberly E. O’Brien ◽  
Lydia K. Manning
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Gait Speed ◽  
Well Being ◽  
Self Report ◽  
Subjective Report ◽  
Healthy Older Adults ◽  
Relative Value ◽  
Cognitive Speed ◽  
Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

scholarly journals Multidimensional Sleep Health and Physical Functioning in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 428-428
Author(s):  
Caitlan Tighe ◽  
Ryan Brindle ◽  
Sarah Stahl ◽  
Meredith Wallace ◽  
Adam Bramoweth ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
The United States ◽  
Depression Symptoms ◽  
Sleep Health ◽  
Lower Extremity Strength ◽  
Sleep Parameters

Abstract Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.

165 Sex differences in the relationship between self-reported sleep quality and frailty in South Florida older adult outpatients

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A67-A67
Author(s):  
Sonya Kaur ◽  
Katalina McInerney ◽  
Mitchell Slugh ◽  
Annelly Bure ◽  
Marina Sarno ◽  
...  
Keyword(s):  
Older Adults ◽  
Sex Differences ◽  
Sleep Quality ◽  
Grip Strength ◽  
Brain Research ◽  
Functional Independence ◽  
South Florida ◽  
Left Hand ◽  
Depression Status ◽  
The Relationship

Abstract Introduction Frailty, a multidimensional construct of decreased reserve is an important predictor of functional independence and quality of life in older adults. There is a growing body of evidence highlighting reduced sleep efficiency and sleep duration predicts frailty in older adults. However, the sex differences in these relationships have been understudied. Methods 253 participants (163) ranging in age from 50-92 years (mean= 67.59 years, S.D.= 9.22 years), underwent frailty assessment and completed the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Statistical moderation was assessed using nonparametric bootstrapping. All models statistically controlled for age, education and depression status. Results Higher scores on the PSQI predicted higher levels of fatigue (β=1.87, 95% CI= 0.48-3.27) and higher grip strength with the left hand (β= 0.81, 95% CI= 0.85-1.53). These relationships were significantly moderated by sex (β=-0.77, p=0.05 & β=-0.52, p=0.01). Specifically, high scores on the PSQI predicted more fatigue stronger grip strength in men (β=1.11, 95% CI=0.41-1.81) and weaker grip strength in women (β=-0.25, 95% CI=-0.51--0.02). There was no association between scores on the ESS and any of the frailty measures. Conclusion The relationships between PSQI scores and measures of fatigue and grip strength were statistically moderated by sex. These differences are not explained by sex differences in overall sleep quality or baseline frailty. This is consistent with the literature emphasizing sex differences in the effects of risk/lifestyle factors. It is possible that the relationship between sleep quality and frailty is altered by additional hormonal factors and warrant further investigation. Support (if any) This research was supported by the Evelyn F. McKnight Brain Research Foundation

scholarly journals Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

2021 ◽  
pp. 1-7
Author(s):  
J.J. Aziz ◽  
K.F. Reid ◽  
J.A. Batsis ◽  
R.A. Fielding
Keyword(s):  
United States ◽  
Older Adults ◽  
Grip Strength ◽  
Muscle Weakness ◽  
Rural Areas ◽  
Gait Speed ◽  
The United States ◽  
Cross Sectional ◽  
Comorbidity Burden ◽  
Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

Abstract 016: Muscular Strength Predicts All-Cause Mortality Independent of MVPA in Women Ages 63-99 Years

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michael J LaMonte ◽  
David M Buchner ◽  
Cora E Lewis ◽  
Eileen Rillamas-Sun ◽  
John Bellettiere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Standard Deviation ◽  
Muscle Strength ◽  
Grip Strength ◽  
Gait Speed ◽  
Muscular Strength ◽  
Sedentary Time ◽  
Lower Mortality ◽  
Race Ethnicity ◽  
Lower Mortality Risk

Background: While some studies report muscle strength is associated with mortality, independent of aerobic physical activity (PA), in older people, there are less data in women and lack of studies adjusting the association for objective measures of PA and physical performance. We prospectively examined this association in 5,061 multiethnic (White, 48.2%; Black, 34.0%; Hispanic, 17.9%) women ages 63-99 (mean 78.3) with complete information for analysis in the Objective Physical Activity and Cardiovascular Health Study. Methods: Quartile categories of dominant hand grip strength (<14, 14-18, 18.1-22.5, >22.5 kg) and EPESE categories of time to complete five consecutive unassisted chair stands (>16.6, 16.6-13.7, 13.6-11.2, <11.2 sec) were the muscle strength exposure measures. Primary covariables included age, race-ethnicity, current smoking, BMI, and number of comorbidities. Accelerometer measured moderate-to-vigorous PA (MVPA) and total sedentary time, and gait speed during a self-paced 8 meter walk test were further assessed as confounding factors. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: There were 306 (5.5%) all-cause deaths during a mean 3.3 year follow-up. Adjusting for primary covariables, significant inverse trends in mortality were observed across categories of grip strength, HR (95% CI) = 1.00 (ref), 0.70 (0.53, 0.93), 0.77 (0.56, 1.05), 0.59 (0.41, 0.87), trend p = .007, and chair stands, 1.00, 0.82 (0.62, 1.09), 0.76 (0.55, 1.04), 0.53 (0.36, 0.77), trend p <.001. Further adjustment for MVPA attenuated these associations which remained statistically significant, 1.00, 0.72, 0.81, 0.66, trend p = .032, and 1.00, 0.91, 0.88, 0.65, trend p = .033, respectively. Similarly, adding sedentary time or gait speed to the primary covariables did not eliminate significance of the inverse mortality trends with either muscle strength measure. Adjusting for primary covariables, each 1-standard deviation (6.2 sec) faster chair stand time was associated with 12% lower mortality risk (p = .004), which was attenuated to 8% risk reduction (p = .04) when further controlling for MVPA. Adjusting for primary covariables and MVPA, each 1-standard deviation (6.8 kg) increment in grip strength was associated with 13% lower mortality risk (p = .04), and this inverse association was generally consistent across subgroups defined by age (interaction p = .78), race-ethnicity (p = .19), and BMI (p = .88). Controlling for gait speed opposed to MVPA resulted in consistent findings. Conclusions: Higher muscular strength is associated with lower mortality in older women, independent of device-measured MVPA and sedentary time, and measured gait speed, an indicator of aerobic fitness. If results are confirmed, in addition to guideline recommendations regarding aerobic PA, promoting skeletal muscle strength is an important component of aging well.

scholarly journals Psychological Capital Mediates the Association between Job Stress and Burnout of among Korean Psychiatric Nurses

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 199
Author(s):  
Sooyeong Kim ◽  
YoungRan Kweon
Keyword(s):  
Job Stress ◽  
Psychological Capital ◽  
Statistical Significance ◽  
Psychiatric Hospitals ◽  
Mediating Effect ◽  
Self Report ◽  
Psychiatric Nurses ◽  
Mediating Effects ◽  
The Relationship ◽  
One Way Anova

This study examined the mediating effect of psychological capital in the relationship between job stress and burnout of psychiatric nurses. The participants were 108 psychiatric nurses working in three psychiatric hospitals located in South Korea. Data were collected from 10 August to 15 September 2018 using self-report questionnaires. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple linear regression by IBM SPSS 24.0 program. In addition, a bootstrapping test using the SPSS PROCESS macro was conducted to test the statistical significance of the mediating effect. There was significant correlation between job stress, psychological capital, and burnout. Psychological capital showed partial mediating effects in the relationship between job stress and burnout. Job stress explained 29.7% of the variance in burnout, and the model including job stress and psychological capital explained 49.6% of the variance in burnout. The bootstrapping showed that psychological capital was a significant sub-parameter and decreased job stress and burnout (LLCI = −0.1442, ULCI = −0.3548). These findings suggest that psychiatric nurses’ burnout can be reduced by implementing various health care programs designed to increase psychological capital.

Sleep disturbances in adults with frailty and sarcopenia

2020 ◽  
Vol 21 (2) ◽  
pp. 89-107
Author(s):  
Reona Chiba ◽  
Yuki Ohashi ◽  
Akiko Ozaki
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Short Sleep Duration ◽  
Night Time ◽  
Content Type ◽  
Age Related ◽  
Increased Risk ◽  
The Relationship

Purpose Several epidemiological studies have reported an age-related increase in the prevalence of sleep disturbances. This study aims to investigate the relationship between sleep and sarcopenia/frailty in older adults and clarify issues that remain to be addressed in future studies. Design/methodology/approach PubMed was searched for relevant studies with the following keywords in the title: “sleep” and “sarcopenia” or “sleep” and “frailty.” A total of 15 studies published in English between 1998 and 2018 were reviewed. Findings Among the four studies that examined the relationship between sarcopenia and sleep, two reported that long or short sleep duration increased the risk of sarcopenia and this association was more pronounced in women than men. Among the seven studies examining the relationship between frailty and sleep, four reported that higher Pittsburgh Sleep Quality Index (PSQI) scores were associated with an increased risk of frailty. Practical implications Most previous studies have focused on interventions targeting a single area such as muscle strength or exercise habits, in older adults at risk for frailty. The results suggest that interventions targeting improved sleep may positively impact the maintenance of muscle strength. Originality/value The literature review revealed that too much or too little sleep increases the risk of sarcopenia in older adults. Further, sleep deprivation, greater night-time wakefulness and reduced sleep quality increase the risk of frailty. Interestingly, the risk of mortality is increased in individuals with daytime functional disorders such as excessive drowsiness or napping habits.

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