scholarly journals Sleep in Normal Aging, Homeostatic and Circadian Regulation and Vulnerability to Sleep Deprivation

2021 ◽  
Vol 11 (8) ◽  
pp. 1003
Author(s):  
Jacques Taillard ◽  
Claude Gronfier ◽  
Stéphanie Bioulac ◽  
Pierre Philip ◽  
Patricia Sagaspe
Keyword(s):  
Older Adults ◽  
Sleep Deprivation ◽  
Health Management ◽  
Nrem Sleep ◽  
Early Morning ◽  
Subcortical Structures ◽  
Wake Time ◽  
Adverse Health Outcomes ◽  
Neurobehavioral Function ◽  
Age Related

In the context of geriatric research, a growing body of evidence links normal age-related changes in sleep with many adverse health outcomes, especially a decline in cognition in older adults. The most important sleep alterations that continue to worsen after 60 years involve sleep timing, (especially early wake time, phase advance), sleep maintenance (continuity of sleep interrupted by numerous awakenings) and reduced amount of sigma activity (during non-rapid eye movement (NREM) sleep) associated with modifications of sleep spindle characteristics (density, amplitude, frequency) and spindle–Slow Wave coupling. After 60 years, there is a very clear gender-dependent deterioration in sleep. Even if there are degradations of sleep after 60 years, daytime wake level and especially daytime sleepiness is not modified with age. On the other hand, under sleep deprivation condition, older adults show smaller cognitive impairments than younger adults, suggesting an age-related lower vulnerability to extended wakefulness. These sleep and cognitive age-related modifications would be due to a reduced homeostatic drive and consequently a reduced sleep need, an attenuation of circadian drive (reduction of sleep forbidden zone in late afternoon and wake forbidden zone in early morning), a modification of the interaction of the circadian and homeostatic processes and/or an alteration of subcortical structures involved in generation of circadian and homeostatic drive, or connections to the cerebral cortex with age. The modifications and interactions of these two processes with age are still uncertain, and still require further investigation. The understanding of the respective contribution of circadian and homeostatic processes in the regulation of neurobehavioral function with aging present a challenge for improving health, management of cognitive decline and potential early chronobiological or sleep-wake interventions.

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

2021 ◽  
pp. 073346482110065
Author(s):  
Ming-Hsiu Chiang ◽  
Yi-Jie Kuo ◽  
Yu-Pin Chen
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hip Fracture ◽  
Postoperative Mortality ◽  
Clinical Event ◽  
High Morbidity ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Study Selection ◽  
And Function

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

scholarly journals A-03 The Brain–Body Connection in Aging Neurological Populations: Examining the Impact of Exercise and Sedentary Behavior on Brain Structure and Cognitive Functioning in Older Adults with Multiple Sclerosis

2020 ◽  
Vol 35 (6) ◽  
pp. 776-776
Author(s):  
C Roman ◽  
P Arnett
Keyword(s):  
Multiple Sclerosis ◽  
Older Adults ◽  
Graph Theory ◽  
Sedentary Behavior ◽  
Healthy Aging ◽  
Moderate Activity ◽  
Subcortical Structures ◽  
Negative Effects ◽  
Age Related ◽  
The Impact

Abstract Objective Advancements in treatments for multiple sclerosis (MS) have led to an increase in the number of older adults living with the disease. Exercise has been shown to be remarkably beneficial for “healthy aging,” while sedentary behavior has proved to have more deleterious effects. Despite evidence for the impact of these factors, their influence on older adults with MS is largely unknown. The current study utilizes volumetric measures and graph theory to investigate the relationship between physical activity/sedentary behavior, structural brain indices, and cognition in older adults with MS. Method Twenty-seven older adults (55+) with MS were scanned during a structural MRI protocol and cognitively evaluated using the Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test. Graph theory metrics were calculated to examine white matter network properties. FreeSurfer was used to calculate volumes for subcortical structures. Exercise was quantified as the ‘days per week engaged in moderate activity,’ while sedentary behavior was measured as ‘hours per day sitting.’ Results Multiple regression interaction analyses were conducted. Results showed an exercise by age interaction, such that exercise protected against the negative effects of age on thalamic volume and assortivity. Hours sitting per day was shown to add to the negative effects of aging on structural networks even after controlling for exercise. Lastly, exercise was observed to be protective against age-related cognitive decline in this sample. Conclusions This is one of the first studies to examine exercise/sedentariness and brain indices in older adults with MS, pointing to possible brain altering and protective interventions for this group.

scholarly journals Age-related changes in slow wave activity rise time and NREM sleep EEG with and without zolpidem in healthy young and older adults

2014 ◽  
Vol 15 (9) ◽  
pp. 1037-1045 ◽  
Author(s):  
Evan D. Chinoy ◽  
Danielle J. Frey ◽  
Daniel N. Kaslovsky ◽  
Francois G. Meyer ◽  
Kenneth P. Wright
Keyword(s):  
Older Adults ◽  
Slow Wave ◽  
Rise Time ◽  
Nrem Sleep ◽  
Wave Activity ◽  
Slow Wave Activity ◽  
Sleep Eeg ◽  
Age Related ◽  
Age Related Changes

Sarcopenia—definitions and epidemiology

2017 ◽  
pp. 409-414
Author(s):  
José A. Morais
Keyword(s):  
Older Adults ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Protein Intake ◽  
Skeletal Muscle Mass ◽  
Handgrip Strength ◽  
Resistance Exercise Training ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Underlying Mechanisms

Sarcopenia is a progressive and inevitable loss of skeletal muscle mass and strength associated with ageing that places older adults at high risk for adverse health outcomes. Up to of 15% of older adults suffer negative healthcare consequences because of sarcopenia. Furthermore, it is responsible for two to four times greater risk of disability. Expert groups have proposed clinical oriented criteria based on gait speed <0.8 m/s and low handgrip strength before performing muscle mass assessment. Multiple aetiologies are implicated in the development of sarcopenia including age-related, lifestyle, neurodegeneration, hormonal, and inflammation factors. Resistance exercise training and higher than recommended protein intake are two accessible means to counteract sarcopenia. Hormonal interventions, despite amelioration in muscle and fat masses, have not led to significant gains in function. Sarcopenia shares many features with frailty and can be considered as one of its underlying mechanisms.

scholarly journals P089 Loneliness and sleep duration among healthy older adults in Southeast Queensland, Australia

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A50-A50
Author(s):  
J Lam ◽  
D Mann ◽  
C Pattinson ◽  
A Allan ◽  
S Smith ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Onset Time ◽  
Older Individuals ◽  
Healthy Older Adults ◽  
Wake Time ◽  
Sleep Timing ◽  
Adverse Health Outcomes ◽  
Timing Variability

Abstract Introduction The relationship between sleep duration and loneliness among healthy older adults is not fully understood. Shorter sleep duration and increased variability of sleep timing (sleep onset and wake time) have recently been shown to have adverse health outcomes in younger adults. While physiological stressors associated with loneliness are likely distinct, we hypothesise that older adults who identify as lonely have reduced sleep duration and increased variability of sleep timing. Methods Older individuals (N=60) without significant co-morbidities were recruited via convenience sampling. Participants completed the de Jong Giervield Loneliness Scale and wore an actigraph for up to 2 weeks. Sleep metrics from actigraphy (sleep onset and wake times, and SD) were determined by algorithm assisted human scoring. Results Valid data was retrieved from N=37 participants (age 83±6.8 years [mean±SD]). There were no significant differences in demographics between those in the lonely (N=19) and not lonely (N=18) groupings. There was substantial heterogeneity in individual participant’s sleep metrics, both within and between groupings. The average sleep onset time was similar between groups, however lonely participants typically woke earlier resulting in slightly shorter sleep duration. Variability in sleep onset and wake times was reduced in lonely participants. Discussion While shorter sleep duration was expected, we did not anticipate the reduction in sleep timing variability amongst those defined as lonely; more regular sleep periods have previously been associated with better outcomes. We did not see statistically significant differences between our groups, possibly due to sample size limitations, however, the unexpected trend warrants further investigation.

scholarly journals Age-related losses in cardiac autonomic activity during a daytime nap

2020 ◽  
Author(s):  
Pin-Chun Chen ◽  
Negin Sattari ◽  
Lauren N. Whitehurst ◽  
Sara C. Mednick
Keyword(s):  
Older Adults ◽  
Nrem Sleep ◽  
Parasympathetic Activity ◽  
Total Power ◽  
Autonomic Activity ◽  
Daytime Sleep ◽  
Age Related ◽  
Daytime Nap ◽  
The Impact ◽  
Cardiac Autonomic Activity

AbstractIn healthy, young individuals, a reduction in cardiovascular output and a shift from sympathetic to parasympathetic (vagal) dominance is observed from wake into stages of nocturnal and daytime sleep. This cardiac autonomic profile, measured by heart rate variability (HRV), has been associated with significant benefits for cardiovascular health. Aging is associated with decreased nighttime sleep quality and lower parasympathetic activity during both sleep and resting. However, it is not known whether age-related dampening of HRV extends to daytime sleep, diminishing the cardiovascular benefits of naps in the elderly. Here, we investigated this question by comparing the autonomic activity profile between young and older healthy adults during a daytime nap and a similar period of wakefulness (quiet wake; QW). For each condition, from the electrocardiogram (ECG), we obtained beat-to-beat HRV intervals (RR), root mean square of successive differences between adjacent heart-beat-intervals (RMSSD), high frequency (HF), low frequency (LF) power and total power (TP), HF normalized units (HFnu), and the LF/HF ratio. As previously reported, young subjects showed a parasympathetic dominance during NREM, compared with REM, pre-nap rest, and WASO. On the other hand, older, compared to younger, adults showed significantly lower vagally-mediated HRV (measured by RMSSD, HF, HFnu) during NREM. Interestingly, however, no age-related differences were detected during pre-nap rest or QW. Altogether, our findings suggest a sleep-specific reduction in parasympathetic modulation that is unique to NREM sleep in older adults.Impact StatementSleep is naturally modulated by the autonomic nervous system (ANS), with greater dominance of parasympathetic over sympathetic activity during non-rapid-eye-movement (NREM) sleep. As such, sleep has been termed a “cardiovascular holiday” and has been associated with positive health outcomes. Aging, however, is linked to decreases in cardiac autonomic activity and sympathovagal imbalance. While the impact of aging on ANS activity during nocturnal sleep has received some attention, the cardiac profiles during a daytime nap, to our knowledge, have not yet been studied under the context of aging. Herein, young adults demonstrated increased parasympathetic activity during deep sleep. Older adults, however, showed less parasympathetic modulation during NREM sleep, suggesting loss of the cardiovascular holiday. Importantly, no age-related declines in parasympathetic activity were detected during wake, suggesting a sleep-specific reduction in parasympathetic modulation that is unique to NREM sleep in older adults.

Frailty in older adults

2017 ◽  
pp. 429-436
Author(s):  
Jeremy Walston
Keyword(s):  
Older Adults ◽  
Environmental Drivers ◽  
Geriatric Syndrome ◽  
Geriatric Syndromes ◽  
Multiple Measurement ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Measurement Tools ◽  
Novel Approaches

Frailty is most often conceptualized as an age-related medical syndrome with a biological basis that results in substantial vulnerability stressors and adverse health outcomes. It is increasingly thought of as the geriatric syndrome that underlies all other geriatric syndromes. Multiple measurement tools have been developed that have helped to differentiate frail from more robust or resilient older adults; and these tools enabling the characterization of and consequences of frailty, as well as its underlying biology. The recognition of frailty as a condition of advanced vulnerability has led to the development of interventions and novel approaches to integrate frailty into clinical practice. The following chapter describes the conceptualization of frailty, surveys the vast array of tools used to identify frailty, provides demographic information and epidemiological characterizations of causes and consequences of frailty, identifies important biological and environmental drivers of frailty, and describes the clinical efforts underway to better utilize frailty tools.

scholarly journals Autonomic dysregulation and sleep homeostasis in insomnia

SLEEP ◽  
2020 ◽  
Author(s):  
Daniela Grimaldi ◽  
Kathryn J Reid ◽  
Nelly A Papalambros ◽  
Rosemary I Braun ◽  
Roneil G Malkani ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Underlying Mechanism ◽  
Sleep Cycle ◽  
Activity Levels ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Adverse Health Outcomes ◽  
Mechanistic Pathway ◽  
Age Related

Abstract Study objectives Insomnia is common in older adults, and is associated with poor health, including cognitive impairment and cardio-metabolic disease. Although the mechanisms linking insomnia with these comorbidities remain unclear, age-related changes in sleep and autonomic nervous system (ANS) regulation might represent a shared mechanistic pathway. In this study, we assessed the relationship between ANS activity with indices of objective and subjective sleep quality in older adults with insomnia. Methods Forty-three adults with chronic insomnia, and 16 age-matched healthy sleeper controls were studied. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), objective sleep quality by electroencephalogram spectral components derived from polysomnography, and ANS activity by measuring 24-h plasma cortisol and norepinephrine (NE). Results Sleep cycle analysis displayed lower slow oscillatory (SO: 0.5-1.25 Hz) activity in the first cycle in insomnia compared to controls. In insomnia, 24-h cortisol levels were higher and 24-h NE levels were lower than controls. In controls, but not in insomnia, there was a significant interaction between NE level during wake and SO activity levels across the sleep cycles, such that in controls but not in insomnia, NE level during wake was positively associated with the amount of SO activity in the first cycle. In insomnia, lower 24-h NE level and SO activity in the first sleep cycle were associated with poorer subjective sleep quality. Conclusion Dysregulation of autonomic activity may be an underlying mechanism that links objective and subjective measures of sleep quality in older adults with insomnia, and potentially contribute to adverse health outcomes.

Later endogenous circadian temperature nadir relative to an earlier wake time in older people

1998 ◽  
Vol 275 (5) ◽  
pp. R1478-R1487 ◽  
Author(s):  
Jeanne F. Duffy ◽  
Derk-Jan Dijk ◽  
Elizabeth B. Klerman ◽  
Charles A. Czeisler
Keyword(s):  
Older People ◽  
Light Exposure ◽  
Young Men ◽  
Early Morning ◽  
Wake Time ◽  
Circadian Phase ◽  
Age Related ◽  
High Prevalence ◽  
Circadian Timing System ◽  
Older Subjects

The contribution of the circadian timing system to the age-related advance of sleep-wake timing was investigated in two experiments. In a constant routine protocol, we found that the average wake time and endogenous circadian phase of 44 older subjects were earlier than that of 101 young men. However, the earlier circadian phase of the older subjects actually occurred later relative to their habitual wake time than it did in young men. These results indicate that an age-related advance of circadian phase cannot fully account for the high prevalence of early morning awakening in healthy older people. In a second study, 13 older subjects and 10 young men were scheduled to a 28-h day, such that they were scheduled to sleep at many circadian phases. Self-reported awakening from scheduled sleep episodes and cognitive throughput during the second half of the wake episode varied markedly as a function of circadian phase in both groups. The rising phase of both rhythms was advanced in the older subjects, suggesting an age-related change in the circadian regulation of sleep-wake propensity. We hypothesize that under entrained conditions, these age-related changes in the relationship between circadian phase and wake time are likely associated with self-selected light exposure at an earlier circadian phase. This earlier exposure to light could account for the earlier clock hour to which the endogenous circadian pacemaker is entrained in older people and thereby further increase their propensity to awaken at an even earlier time.

Age-Related Differences in Processing Dynamic Information to Identify Vowel Quality

1992 ◽  
Vol 35 (4) ◽  
pp. 892-902 ◽  
Author(s):  
Robert Allen Fox ◽  
Lida G. Wall ◽  
Jeanne Gokcen
Keyword(s):  
Older Adults ◽  
Vowel Quality ◽  
Perceptual Cues ◽  
Dynamic Information ◽  
Process Dynamic ◽  
Center Condition ◽  
Age Related ◽  
Control Version ◽  
Older Subjects ◽  
Whole Word

This study examined age-related differences in the use of dynamic acoustic information (in the form of formant transitions) to identify vowel quality in CVCs. Two versions of 61 naturally produced, commonly occurring, monosyllabic English words were created: a control version (the unmodified whole word) and a silent-center version (in which approximately 62% of the medial vowel was replaced by silence). A group of normal-hearing young adults (19–25 years old) and older adults (61–75 years old) identified these tokens. The older subjects were found to be significantly worse than the younger subjects at identifying the medial vowel and the initial and final consonants in the silent-center condition. These results support the hypothesis of an age-related decrement in the ability to process dynamic perceptual cues in the perception of vowel quality.

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