A Greater Extent of Insomnia Symptoms and Physician-Recommended Sleep Medication Use Predict Fall Risk in Community-Dwelling Older Adults

Chen, Tuo Yu; Lee, Soomi; Buxton, Orfeu M.

doi:10.1093/sleep/zsx142

Cited by 51 publications

(37 citation statements)

References 35 publications

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“…Notably, taking sleeping pills and performing irregular or regular physical exercise were not independently correlated with falls in the three waves of surveys, and these findings contradict those of two large published studies [47,48] and the updated review of exercise as a single intervention for preventing falls [49]. It could be due to bias in data collection, since we did not collect information about fall-related medication dosage and detailed intensity, duration, and type of exercise.…”

Section: Discussioncontrasting

confidence: 70%

Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan

Tsai¹,

Yang²,

Yang

et al. 2020

Preprint

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Background: An aging society incurs great losses due to fall-related injuries and mortalities. The foreseeable increased burden of fall-related injury among older people requires a nationwide study on the fall epidemic in Taiwan. Methods: The fall epidemic was examined using data from three consecutive waves of the National Health Interview Survey (2005, 2009, and 2013). Common explanatory variables across these surveys included sociodemographic factors (age, sex, and difficulty in performing activities of daily living (ADL) or instrumental ADL), biological factors (vision, comorbidities, urinary incontinence, and depressive symptoms), and behavioral risk factors (sleeping pill use, and frequency of exercise). After the univariate and bivariate analyses, the prevalence of falls was investigated using multiple linear regression models adjusted for age group, sex, and year of survey. A multivariate logistic regression model for falls with adjustments for these common explanatory variables was established across three waves of surveys. Results: For each survey, there were consecutively 2,722; 2,900; and 3,200 respondents with a mean age of 75.1, 75.6, and 76.4 years, respectively. The multiple linear regression model yielded a negative association between the prevalence of falls and year of survey. Several sociodemographic and biological factors, including female sex, difficulty in performing one basic ADL, difficulty in performing two or more instrumental ADLs, unclear vision, comorbidities, urinary incontinence, and depressive symptoms, were significantly associated with falls.Conclusion: Although information regarding the change in fall prevalence over time supports existing fall intervention strategies in Taiwan, the identification of risk factors in older people may increase the effectiveness of future fall prevention programs.

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Section: Discussioncontrasting

confidence: 70%

Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan

Tsai¹,

Yang²,

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Physical activity (PA) can reduce insomnia symptoms and enhance sleep quality [ 17 , 18 ]; however, menopausal elderly women have muscle weakness, which may lead to reduced PA [ 19 , 20 ]. In addition, previous studies reported insomnia symptoms and sleep disturbances are associated with the falling risk in elderly adults [ 21 , 22 ]. Thus, elderly women with insomnia may impose a potential societal cost [ 12 , 23 ], which may decrease the quality of life.…”

Section: Introductionmentioning

confidence: 99%

Association between Gait Variability and Gait-Ability Decline in Elderly Women with Subthreshold Insomnia Stage

Lee

Youm

et al. 2020

IJERPH

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This study investigates the gait characteristics of elderly women, aged more than 65 years, with subthreshold insomnia stage at various walking speeds. A total of 392 participants (insomnia: 202 and controls: 190) wearing shoe-type inertial measurement units completed walking tests on a treadmill for a duration of 1 min at slower, preferred, and faster speeds. The insomnia group indicated lower pace parameters (range of Cohen’s d: 0.283–0.499) and the single support phase (Cohen’s d: 0.237), greater gait variability (range of Cohen’s d: 0.217–0.506), and bilateral coordination (range of Cohen’s d: 0.254–0.319), compared with their age-matched controls; the coefficient of variance (CV) of the stance phase at the faster speed condition was a crucial variable for distinguishing between insomnia and control groups. In addition, the insomnia group demonstrated insufficient gait adaptation at the slower and preferred speeds, as indicated by the CVs of the stride length, stride time, and step time. In particular, participants with worsened insomnia symptoms or sleep problems showed that these worse gait patterns may increase the potential risk of falling in elderly women. Thus, elderly women with subthreshold insomnia stage need to improve their sleep quality to enhance their physical functions.

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“…It is also noteworthy that taking sleeping pills and getting physical exercise either irregularly or regularly were not independently correlated with falls in the three waves of surveys, and these findings contradict those of two large published studies [33,34] and the updated review of exercise as a single intervention for preventing falls [35]. Further studies are needed to clarify this discrepancy.…”

Section: Discussionmentioning

confidence: 77%

Study on prevalence and risk factors of falls among community-dwelling elderly adults: results from three consecutive waves of the national health interview survey in Taiwan

Tsai¹,

Yang²,

Yang³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background An aging society incurs great losses due to fall-related injuries and mortalities. The foreseeable increased burden of injury due to falls among elderly people requires a nationwide study on the fall epidemic in Taiwan. Methods The fall epidemic was examined using data from three consecutive waves of the National Health Interview Survey (2005, 2009, and 2013). Common explanatory variables across these surveys included socio-demographic factors (age, sex, and difficulty in performing activities of daily living or instrumental activities of daily living), biological factors (vision, comorbidities, urinary incontinence, and depressive symptoms), and behavioral risk factors (sleeping pill use, and frequency of exercise). After univariate and bivariate analyses were conducted, the prevalence of falls was investigated using multiple linear regression models adjusted for age group, sex, and the year of survey. A multivariate logistic regression model for falls with adjustments for these common explanatory variables was established across three waves of surveys. Results For each survey, there were consecutively 2,722; 2,900; and 3,200 respondents, with a mean age of 75.1, 75.6, and 76.4 years, respectively. The multiple linear regression model yielded a negative association between the prevalence of falls and the year of survey. Several sociodemographic and biological factors, including female gender, difficulty in performing one basic ADL, difficulty in performing two or more instrumental ADLs, unclear vision, comorbidities, urinary incontinence, and depressive symptoms, were significantly associated with falls. Conclusion Although information regarding the change in fall prevalence over time supports existing fall intervention strategies in Taiwan, the identification of risk factors in the elderly may increase the effectiveness of future fall prevention programs.

show abstract

A Greater Extent of Insomnia Symptoms and Physician-Recommended Sleep Medication Use Predict Fall Risk in Community-Dwelling Older Adults

Cited by 51 publications

References 35 publications

Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan

Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan

Association between Gait Variability and Gait-Ability Decline in Elderly Women with Subthreshold Insomnia Stage

Study on prevalence and risk factors of falls among community-dwelling elderly adults: results from three consecutive waves of the national health interview survey in Taiwan

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