scholarly journals Assessment of Neck Grasp as a Screening Tool for Identifying Obstructive Sleep Apnea in Community-Dwelling Older Adults

2020 ◽  
Vol 11 ◽  
pp. 215013272098442
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Bettsy Y. Recalde ◽  
Pablo R. Castillo
Keyword(s):  
Older Adults ◽  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Sleep Apnea ◽  
Predictive Value ◽  
Regression Models ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Obstructive Sleep ◽  
Community Dwelling Older Adults

Background Inability to encircle the neck by hands (neck grasp) has been proposed as an indicator of obstructive sleep apnea (OSA) that would be useful for recognition of candidates for polysomnography (PSG). We assessed the value of neck grasp for predicting OSA in community-dwelling older adults of Amerindian ancestry. Methods Neck grasp was evaluated in individuals aged ≥60 years undergoing PSG. The association between neck grasp and OSA was assessed by logistic regression models adjusted for relevant covariates. Mediation analysis was used to establish the proportion of the effect of the association between neck grasp and OSA, which is mediated by the neck circumference (a well-known OSA biomarker). Receiver operator characteristics curve analysis was used to estimate diagnostic accuracy of neck grasp for predicting OSA. Results Of 201 individuals undergoing PSG, 167 (83%) had the neck grasp test. The remaining 34 could not perform the test because of different factors. Neck grasp was positive in 127 (76%) cases, and 114 (68%) individuals had OSA (apnea-hypopnea index ≥5). Multivariate logistic regression models disclosed a significant association between neck grasp and OSA. The neck circumference was the single covariate remaining independently significant in these models. Neck grasp was not efficient at predicting OSA (sensitivity: 83.3%, specificity: 39.6%, positive predictive value: 0.75 and negative predictive value: 0.53). The area under the curve disclosed only a moderate predictive capability (61.5%) of neck grasp. Conclusion Results do not support the use of neck grasp as an independent predictor of OSA in the study population.

scholarly journals Longitudinal Relationships Between Favorite Activities and Homebound Status in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 496-496
Author(s):  
Xiaocao Sun ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Yuxiao Li ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Regression Models ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
New Information ◽  
Homebound Older Adults ◽  
Watching Tv ◽  
Community Dwelling Older Adults ◽  
Longitudinal Relationships

Abstract Favorite activities are usually meaningful to older adults and may influence their homebound status and vice versa. Using Round 1 (R1, in 2011) and Round 5 (R5, in 2015) data from the National Health and Aging Trends Study, we examined the patterns of favorite activity by homebound status and investigated their relationship among community-dwelling older adults (N=3,332). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and needing help of outdoor mobility. Favorite activities were named by participants verbatim and then were classified into two categories (active and non-active) based on the estimated energy needed to perform the activity. Logistic regression models were used to determine whether homebound status at R1 predicted the types of favorite activity in R5, and ordinal logistic regression models for predictions from the types of favorite activity at R1 to homebound status at R5, adjusting for demographics and health conditions. The sample was, on average, 76±7.23 years old, non-Hispanic White (72.9%), and female (59.7%). Regardless of the homebound status, reading and walking are the top two favorite activities. Homebound older adults enjoyed “non-active” activities (e.g., watching TV), while non-homebound counterparts preferred “active” outdoor maintenance. Being homebound at R1 predicted non-active favorite activity in R5 (OR=.257, p<0.001), and R1 non-active favorite activity also predicted homebound status in R5 (OR=1.219, p =0.039). These findings provide new information on the activity preferences of older adults with different homebound status and how their preferences may influence their future homebound status.

scholarly journals Obstructive sleep apnea is an independent risk factor for severe COVID-19: a population-based study

SLEEP ◽  
2021 ◽  
Author(s):  
Kristján Godsk Rögnvaldsson ◽  
Elías Sæbjörn Eyþórsson ◽  
Össur Ingi Emilsson ◽  
Björg Eysteinsdóttir ◽  
Runólfur Pálsson ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Risk Factor ◽  
Sleep Apnea ◽  
Population Based ◽  
Community Dwelling ◽  
University Hospital ◽  
Logistic Regression Models ◽  
Icelandic Population ◽  
Obstructive Sleep ◽  
National University

Abstract Study Objectives Obstructive sleep apnea (OSA) has been proposed as a risk factor for severe COVID-19. Confounding is an important consideration as OSA is associated with several known risk factors for severe COVID-19. Our aim was to assess the association of OSA with hospitalization due to COVID-19 using a population-based cohort with detailed information on OSA and comorbidities. Methods Included were all community-dwelling Icelandic citizens 18 years of age and older diagnosed with SARS-CoV-2 infection in 2020. Data on demographics, comorbidities, and outcomes of COVID-19 was obtained from centralized national registries. Diagnosis of OSA was retrieved from the centralized Sleep Department Registry at Landspitali–The National University Hospital. Severe COVID-19 was defined as the composite outcome of hospitalization and death. The associations between OSA and the outcome were expressed as odds ratios (OR) with 95% confidence intervals (95% CI), calculated using logistic regression models and inverse probability weighting. Results A total of 4,756 individuals diagnosed with SARS-CoV-2 infection in Iceland were included in the study (1.3% of the Icelandic population), of whom 185 had a diagnosis of OSA. In total, 238 were hospitalized or died, 38 of whom had OSA. Adjusted for age, sex, and BMI, OSA was associated with poor outcome (OR 2.2, 95% CI 1.4 -3.5). This association was slightly attenuated (OR 2.0, 95% CI 2.0, 1.2-3.2) when adjusted for demographic characteristics and various comorbidities. Conclusions OSA was associated with twofold increase in risk of severe COVID-19, and the association was not explained by obesity or other comorbidities.

scholarly journals Dietary and cardio-metabolic risk factors in patients with Obstructive Sleep Apnea: cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3259 ◽  
Author(s):  
Marta Stelmach-Mardas ◽  
Marcin Mardas ◽  
Khalid Iqbal ◽  
Magdalena Kostrzewska ◽  
Tomasz Piorunek
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Dietary Intake ◽  
Regression Models ◽  
Alcohol Intake ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Disturbed Sleep ◽  
Obstructive Sleep

BackgroundLittle is known about the role of dietary intake in obstructive sleep apnea (OSA), which could prove important in improving clinical outcomes for people with obesity and/or cardiovascular disease within these populations. Reduction in energy intake typically results in weight loss, markedly improving metabolic parameters and ameliorating OSA severity. The aim of this study was to evaluate the association of dietary and cardio-metabolic risk factors with OSA severity.MethodsThis was a cross-sectional study. A total of 75 volunteers at risk of OSA were recruited from 153 patients suffering from sleep disturbance at the Department of Pulmonology, Allergology and Respiratory Oncology at the Poznan University of Medical Sciences. Polysomnography was used for OSA diagnosis. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. Blood pressure, parameters of glucose (fasting glucose, glucose tolerance test) and lipid metabolism (TC, LDL-C, HDL-C, TG) were assessed using routine enzymatic methods. Dietary intake was evaluated by 24-hr dietary recalls and Food Frequency Questionnaire. Ordinal logistic regression models were used for association of background characteristics and dietary intake with OSA severity. All analyses were adjusted for age, sex, BMI, smoking and alcohol intake.ResultsA higher percentage of smokers were observed in patients with mild OSA, while alcohol intake was the highest in severe OSA patients. Approximately 60% of the studied patients were self-reported poor sleepers. Results from ordinal logistic regression models showed that higher intakes of alcohol intake were associated with increased odds of severe OSA; whereas higher HDL-C levels were associated with lower odds (OR 0.01; 95% CI [0.0003–0.55]). Significantly higher odds of high OSA severity were observed in patients with disturbed sleep stages and obstructive sleep apnea. Moreover, the investigation of nutrient intake in relation to OSA severity showed that a higher intake of dietary fiber was associated with decreased OSA severity (OR 0.84; 95% CI [0.71–0.98]).ConclusionsThe severity of OSA is related to higher alcohol consumption and disturbed sleep. The significantly lower dietary fiber intake in patients with severe OSA is of particular importance for dietary consulting in clinical practice, which may positively influence cardiometabolic outcomes.

Pain as a Risk Factor for Loneliness Among Older Adults

2017 ◽  
Vol 30 (9) ◽  
pp. 1450-1461 ◽  
Author(s):  
Kerstin Emerson ◽  
Ian Boggero ◽  
Glenn Ostir ◽  
Jayani Jayawardhana
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Functional Decline ◽  
Premature Mortality ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Community Dwelling Older Adults ◽  
Retirement Study ◽  
Time Point

Objective: The objective of this is to examine whether pain is associated with the onset of loneliness in a sample of community-dwelling older adults. Methods: We used data from the 2008 and 2012 Health and Retirement Study. We limited the sample to community-dwelling persons aged 60 years and over who were not lonely in 2008 in order to predict the risk of onset of loneliness (incidence) in 2012. Our analytic sample included 1,563 observations. Results: Approximately 31.7% of participants reported loneliness at follow-up (2012). Logistic regression models showed that the odds of loneliness onset was 1.58 higher for those with pain at both time points, compared with those who had pain at neither time point, even after controlling for other covariates. Discussion: The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.

scholarly journals The risk assessment by clinical background and cephalometry for obstructive sleep apnea with CPAP indication in Japanese

2021 ◽  
Author(s):  
Shuhei Nozawa ◽  
Kazuhisa Urushihata ◽  
Ryosuke Machida ◽  
Masayuki Hanaoka
Keyword(s):  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Sleep Apnea ◽  
Positive Predictive Value ◽  
Pulse Oximetry ◽  
Predictive Value ◽  
Obstructive Sleep ◽  
Clinical Background ◽  
At Home

AbstractObstructive sleep apnea (OSA) is a disease characterized by a brief period of cessation or marked decline in ventilation. The standard treatment is continuous positive airway pressure (CPAP). To determine the indication, full-night polysomnography (PSG) is required; however, it is a stressful examination. We verified the usefulness of pulse-oximetry at home as a predictor for CPAP indication before PSG. Simultaneously, the clinical background and cephalometry were also verified. Among 376 subjects who received PSG at our hospital from February 2005 to April 2020, 138 subjects received pulse-oximetry at home before PSG were enrolled retrospectively and performed logistic regression analysis on those with CPAP indication. Concurrently, 262 of 376 subjects received cephalometry were enrolled, and logistic regression analysis were performed using clinical background and cephalometry. A 3% oxygen desaturation (3% ODI) on the pulse-oximeter was a predictor for CPAP indication. The positive predictive value of 3% ODI ≥ 28.5 events/h was 73.3% and the negative predictive value was 62.5%. Older age, higher body mass index (BMI), stronger lower jaw retraction (wider ∠ANB), and longer distance from the anterior superior tip of the hyoid bone to the mandibular plane (MP-H) on cephalometry were also independent predictors. The positive predictive value when both BMI ≥ 26.0 kg/m2 and MP-H ≥ 17.5 mm were present was 88.2% and the negative predictive value when both were absent was 71.3%. The combination of clinical background and cephalometry would be a useful screening tool as well as a pulse-oximetry at home for CPAP indication.

scholarly journals Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

2020 ◽  
Vol 76 (12) ◽  
pp. 1695-1707
Author(s):  
Thi Ngoc Mai Nguyen ◽  
Dana Clarissa Laetsch ◽  
Li-Ju Chen ◽  
Walter Emil Haefeli ◽  
Andreas D Meid ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Logistic Regression ◽  
High Intensity ◽  
Regression Models ◽  
Community Dwelling ◽  
Pain Severity ◽  
Older Population ◽  
Logistic Regression Models ◽  
Pain Duration

Abstract Purpose Chronic pain is common in the older population and a significant public health concern. However, comprehensive studies on analgesics use in this age group from Germany are scarce. This study aims to give a comprehensive overview on the use of the most common therapeutic groups of analgesics in community-dwelling older adults from Germany. Methods A cross-sectional study was carried out using data from a German cohort of 2038 community-dwelling adults aged 63–89 years. Descriptive statistics and logistic regression models were applied to assess the utilization of analgesics by age, sex, pain severity, pain duration, and locations. Results One out of four study participants was suffering from high-intensity or disabling pain. Approximately half of those taking analgesics still reported to suffer from high-intensity or disabling pain. Among analgesics users, occasional non-steroidal anti-inflammatory drugs (NSAIDs) use was the most frequent pain therapy (in 43.6% of users), followed by metamizole (dipyrone) use (16.1%), regular NSAIDs use (12.9%), strong opioids use (12.7%), and weak opioids use (12.0%). In multivariate logistic regression models, higher age, higher pain severity, longer pain duration, abdominal pain, and back pain were statistically significantly associated with opioids use. Metamizole use was also statistically significantly associated with higher pain severity but inversely associated with pain duration. Conclusions A significant number of older German adults are affected by high-intensity and disabling chronic pain despite receiving analgesics. Long-term studies are needed to compare the effectiveness and safety of different treatments for chronic pain in older adults.

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