Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study

Zhao, Yunli; Lu, Ying; Zhao, Wenchuan; Wang, Yanyan; Ge, Meiling; Zhou, Lixing; Yue, Jirong; Dong, Birong; Qin, Hao

doi:10.1186/s12877-021-02455-9

Cited by 22 publications

(18 citation statements)

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“…Poor sleep quality significantly mediates the association between frailty severity and cognitive outcomes ( 41 ). In addition, an important study investigated the association between nighttime sleep duration and cognitive frailty, and the results showed that long sleep duration (≥9 h) was significantly associated with high prevalence of cognitive frailty among community-dwelling Chinese aged 50 and older ( 25 ). It is impossible to effectively assess the sleep quality of individuals because nighttime sleep duration is only one dimension.…”

Section: Discussionmentioning

confidence: 99%

“…Referring to previous study groups ( 25 , 32 ), our study divided the included participants into five groups according to physical frailty and cognitive function status: (1) robust group: neither had physical frailty, physical pre-frailty, nor cognitive impairment; (2) physical pre-frailty group: older adults with only physical pre-frailty and without cognitive impairment; (3) physical frailty group: older adults with only physical frailty and no cognitive impairment; (4) cognitive impairment group: older adults who only had cognitive impairment but neither had physical pre-frailty nor physical frailty; (5) cognitive frailty group: older adults with both cognitive impairment and physical pre-frailty or physical frailty.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, many studies have shown that both physical frailty and cognitive impairment are associated with sleep status, including sleep quality ( 21 , 22 ) and nap duration ( 23 , 24 ). There are still insufficient studies related to the association between sleep status and cognitive frailty, except for a study on the association of nighttime sleep duration with cognitive frailty among community-dwelling older adults in 2021 ( 25 ). Few studies have systematically investigated the association between sleep quality and nap duration, and cognitive frailty among older adults in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

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Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

Liu

Zhao

Guo

et al. 2022

Front. Public Health

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BackgroundSleep status, including sleep quality and nap duration, may be associated with frailty and cognitive impairment in older adults. Older adults living in nursing homes may be more prone to physical and cognitive frailties. This study aimed to investigate the association between sleep quality and nap duration, and cognitive frailty among older adults living in nursing homes.MethodsThis study included 1,206 older adults aged ≥ 60 years from nursing homes in Hunan province, China. A simple frailty questionnaire (FRAIL scale) was used and Mini-Mental State Examination was conducted to assess physical frailty and cognitive impairment, respectively, to confirm cognitive frailty. The Pittsburgh Sleep Quality Index was used to assess the sleep quality. Nap duration was classified as follows: no, short (≤30 min), and long (>30 min) napping. Multinomial logistic regression was conducted to estimate the odds ratio (OR) and 95% confidence interval (CI).ResultsThe prevalence of cognitive frailty among the older adults in nursing homes was 17.5%. Approximately 60.9% of the older adults had a poor sleep quality. Among the 1,206 participants, 43.9% did not take naps, 29.1% had short naps, and 26.9% had long naps. After adjusting for all covariates, poor sleep quality (OR 2.53; 95% CI 1.78–3.59; P < 0.001) and long nap duration (OR 1.77; 95% CI 1.19–2.64; P = 0.003) were associated with higher odds of cognitive frailty, but short nap duration (OR 0.60; 95% CI 0.40–0.89; P = 0.012) was associated with low prevalence of cognitive frailty.ConclusionPoor sleep quality and long nap duration are significantly associated with high risk of cognitive frailty among the older adults in nursing homes. Short nap duration was associated with low prevalence of cognitive frailty. However, these associations require further validation in older adults.Clinical trial registrationhttps://osf.io/57hv8.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

Liu

Zhao

Guo

et al. 2022

Front. Public Health

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“…In that case, a key consideration in addressing CF is to find the potential predictors. Some studies have reported several factors associated with CF [13][14][15]. However, these findings mainly came from cross-sectional studies, which cannot establish the cause-and-effect relationships.…”

Section: Introductionmentioning

confidence: 99%

The transitions and predictors of cognitive frailty with multi-state Markov model: a cohort study

Yuan

Fang

2022

BMC Geriatr

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Background Cognitive frailty (CF) is characterized by the simultaneous presence of physical frailty and cognitive impairment. Previous studies have investigated its prevalence and impact on different adverse health-related outcomes. Few studies have focused on the progression and reversibility of CF and their potential predictors. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). A total of 4051 older adults with complete data on three waves of the survey (2011, 2013, and 2015) were included and categorized into four groups: normal state (NS), cognitive impairment (CI) only, physical frailty (PF) only and CF (with both PF and CI). A multi-state Markov model was constructed to explore the transitions and predicting factors of CF. Results The incidence and improvement rates of CF were 1.70 and 11.90 per 100 person-years, respectively. The 1-year transition probability of progression to CF in those with CI was higher than that in the PF population (0.340 vs. 0.054), and those with CF were more likely to move to PF (0.208). Being female [hazard ratio (HR) = 1.46, 95%CI = 1.06, 2.02)], dissatisfied with life (HR = 4.94, 95%CI = 1.04, 23.61), had a history of falls (HR = 2.36, 95%CI = 1.02, 5.51), rural household registration (HR = 2.98, 95%CI = 1.61, 5.48), multimorbidity (HR = 2.17, 95%CI = 1.03, 4.59), and depression (HR = 1.75, 95%CI = 1.26, 2.45) increased the risk of progression to CF, whereas literacy (HR = 0.46, 95%CI = 0.33, 0.64) decreased such risk. Depression (HR = 0.43, 95%CI = 0.22, 0.84) reduced the likelihood of CF improvement, whereas literacy (HR = 2.23, 95%CI = 1.63, 3.07) increased such likelihood. Conclusions Cognitive frailty is a dynamically changing condition in older adults. Possible interventions aimed at preventing the onset and facilitating the recovery of cognitive frailty should focus on improving cognitive function in older adults.

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“…Previous prospective studies explored the associations between sleep behaviors at baseline and the subsequent frailty status. However, the effects of unhealthy sleep duration were still inconclusive [5][6][7]. A prospective study with a small sample reported the association between sleep difficulties and worsening frailty [8].…”

Section: Introductionmentioning

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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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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Long sleep duration is associated with cognitive frailty among older community-dwelling adults: results from West China Health and Aging Trend study

Cited by 22 publications

References 56 publications

Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

Association of sleep quality and nap duration with cognitive frailty among older adults living in nursing homes

The transitions and predictors of cognitive frailty with multi-state Markov model: a cohort study

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

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