Bidirectional relationship between insomnia and frailty in older adults: A 2-year longitudinal study

Nemoto, Yuta; Sato, Shoei; Kitabatake, Yoshinori; Nakamura, Mutsumi; Takeda, Noriko; Maruo, Kazushi; Arao, Takashi

doi:10.1016/j.archger.2021.104519

Cited by 30 publications

(21 citation statements)

References 38 publications

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“…The associations between insomnia and frailty were consistent in both prospective and cross-sectional studies [25,28,29]. A prospective study of 14,208 older adults used sleep medication as a proxy for insomnia disorder and reported an increased risk of frailty (hazard ratio [HR] = 1.35,95% CI:1.13-1.61) [30].…”

Section: Discussionmentioning

confidence: 62%

“…A prospective study of 14,208 older adults used sleep medication as a proxy for insomnia disorder and reported an increased risk of frailty (hazard ratio [HR] = 1.35,95% CI:1.13-1.61) [30]. Besides, another prospective study of 3844 older adults showed a bidirectional relationship between insomnia and frailty, which indicated that insomnia might be an early index of frailty [28].…”

Section: Discussionmentioning

confidence: 99%

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Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Zhu

Fan²,

Yang³

et al. 2022

BMC Med

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Background Little is known about the effects of maintaining healthy sleep patterns on frailty transitions. Methods Based on 23,847 Chinese adults aged 30–79 in a prospective cohort study, we examined the associations between sleep patterns and frailty transitions. Healthy sleep patterns included sleep duration at 7 or 8 h/d, without insomnia disorder, and no snoring. Participants who persisted with a healthy sleep pattern in both surveys were defined as maintaining a healthy sleep pattern and scored one point. We used 27 phenotypes to construct a frailty index and defined three statuses: robust, prefrail, and frail. Frailty transitions were defined as the change of frailty status between the 2 surveys: improved, worsened, and remained. Log-binomial regression was used to calculate the prevalence ratio (PR) to assess the effect of sleep patterns on frailty transitions. Results During a median follow-up of 8.0 years among 23,847 adults, 45.5% of robust participants, and 10.8% of prefrail participants worsened their frailty status, while 18.6% of prefrail participants improved. Among robust participants at baseline, individuals who maintained sleep duration of 7 or 8 h/ds, without insomnia disorder, and no-snoring were less likely to worsen their frailty status; the corresponding PRs (95% CIs) were 0.92 (0.89–0.96), 0.76 (0.74–0.77), and 0.85 (0.82–0.88), respectively. Similar results were observed among prefrail participants maintaining healthy sleep patterns. Maintaining healthy sleep duration and without snoring, also raised the probability of improving the frailty status; the corresponding PRs were 1.09 (1.00–1.18) and 1.42 (1.31–1.54), respectively. Besides, a dose-response relationship was observed between constantly healthy sleep scores and the risk of frailty transitions (P for trend < 0.001). Conclusions Maintaining a comprehensive healthy sleep pattern was positively associated with a lower risk of worsening frailty status and a higher probability of improving frailty status among Chinese adults.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Zhu

Fan²,

Yang³

et al. 2022

BMC Med

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“…A 2-year longitudinal study of 3,844 rural older adults in Japan found a bidirectional relationship between insomnia and frailty: insomnia predicted the onset and aggravation of frailty and, conversely, frailty predicted the severity of insomnia [26]. In men, the effect that frailty had on insomnia was greater than the effect that insomnia had on frailty.…”

Section: Previous Epidemiological Studies Of Frailty and Insomniamentioning

confidence: 99%

Frailty and Insomnia in Older Adults

2022

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Frailty is a geriatric syndrome with increased risk for poor health outcomes, including falls, cognitive impairment, hospitalization, and mortality. In previous studies, associations between frailty and sleep-related factors or sleep disorders have been investigated. We examined the relationship between frailty and insomnia, which are both common condition in older adults. Hormonal changes with aging and/or lifestyle changes all affect sleep physiology, which are vulnerable to the risk of insomnia. As the severity of frailty decreases the quality of sleep, and the long/short sleep duration is related to the risk of frailty, it can be assumed that frailty and sleep are reciprocally related. The association between frailty and insomnia has been variously proven in epidemiological studies conducted around the world. A close evaluation of insomnia and frailty in older adults provides a basis for improving the health of people in the aged society. There are few related studies in Korea, and in the future, not only basic epidemiological studies but also studies explaining the psychoneuroendocrinological mechanism of the relationship between insomnia and frailty should be performed together.

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“…The use of antidepressant medications was considered separately because of the potential in uence of these medications on modifying BDNF concentrations. (7) Anxiety symptoms were assessed with the Short Anxiety Screening Test (SAST), a scale developed to standardize the detection of anxiety in the elderly, including somatic symptoms, consisting of 10 items, scored from one to four points, with a highest possible score of 40 (highest anxiety level) 15 Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D), a validated 20-item scale consisting of four factors: depressive effect, somatic complaints, positive impact, and interpersonal relations. Scores on the CES-D range from 0 to 60, where scores of 0 to 15 indicate the absence of depression and those of 16 to 60 re ect depressive symptomatology 16 .…”

Section: Cognitionmentioning

confidence: 99%

“…Insomnia is characterized by di culty with sleep quality, initiation or maintaining sleep, substantial distress and impairments of daytime functioning 6 and is mainly seen in older age groups. Furthermore, insomnia is a common risk factor for poor physical and mental health and has been associated with de cits in objective cognitive performance, increased risk of dementia 7 , and onset and worsening of frailty 8 . Despite evidence suggesting a relationship between sleep deprivation and cognitive decline, both of which have been associated with BDNF decrements, little is known about insomnia and cognitive health during aging.…”

Section: Introductionmentioning

confidence: 99%

Association of co-existence of insomnia with cognitive decline on BDNF concentration in serum samples from older adults

Sánchez-García

Moreno-Tamayo

Ramírez‐Aldana

et al. 2022

Preprint

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Aging has been defined as a biological process characterized by the functional decline of organs and systems leading to vulnerability and a susceptible state for developing neuronal, musculoskeletal, behavioral, and cardiovascular diseases and disorders. Sleep disorders, including insomnia, are common during aging, and these conditions have been associated with memory and cognitive decline in older adults. However, the molecular bases of such phenomenon have not been thoroughly described. Moreover, during the aging process, neurotransmitters, neurohormones, and neurotrophins decrease significantly, leading to the impairment of cognitive functions. In this sense, BDNF, the most abundant neurotrophic factor in the human brain, has been suggested as a potential target for the prevention and improvement of cognitive decline during aging; however, the current evidence demonstrates the exogenous administration of BDNF does not improve cognitive function. Hence, in the present study, we quantified pro-BDNF (inactive) and BDNF (active) concentrations in serum samples derived from older individuals with insomnia and/or cognitive decline. We used linear regression to analyze whether clinical or sociodemographic variables impacted the levels of BNDF concentration. We observed that insomnia, rather than cognitive decline, is significantly associated with BDNF concentration, and these effects are independent of other variables. To our knowledge, this is the first study that points to the impact of insomnia on improving the levels of BDNF during aging and suggests that opportune treatment of insomnia may be more beneficial to prevent cognitive decline during aging.

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Bidirectional relationship between insomnia and frailty in older adults: A 2-year longitudinal study

Cited by 30 publications

References 38 publications

Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Maintaining healthy sleep patterns and frailty transitions: a prospective Chinese study

Frailty and Insomnia in Older Adults

Association of co-existence of insomnia with cognitive decline on BDNF concentration in serum samples from older adults

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