Malnutrition, Depression, Poor Sleep Quality, and Difficulty Falling Asleep at Night Are Associated with a Higher Risk of Cognitive Frailty in Older Adults during the COVID-19 Restrictions

Abstract

The COVID-19 restrictions, such as social isolation and disruption of daily routines, can have detrimental effects, including increased stress, anxiety, sleep disturbance, and physical and cognitive decline among older adults. This study aimed to examine the association between nutritional status, depression, sleep quality, falling asleep at night, and cognitive frailty (CF) among older Thai adults during the COVID-19 pandemic. This cross-sectional study included 408 older adults with an average age of 70.54 (5.49) years. CF was determined using Fried’s frailty phenotype and the Montreal Cognitive Assessment Basic. The Mini Nutritional Assessment-Short Form, Pittsburgh Sleep Quality Index, and geriatric depression assessment were used for assessment. Multiple logistic regression analysis demonstrated that participants who were malnourished (OR 3.786; 95%CI 1.719–8.335), depressed (OR 5.003; 95%CI 2.399–10.434), had poor sleep quality (OR 1.613; 95%CI 1.041–2.500), and engaged in difficulty falling asleep (OR 1.809; 95%CI 1.022–3.203) had a higher risk of CF compared to those who did not exhibit these factors. Therefore, malnutrition, depression, poor sleep quality, and difficulty falling asleep were identified as risk factors for CF among older adults in Thailand linked to the impact of the COVID-19 pandemic. It is crucial to develop interventions to prevent CF resulting from the mentioned variables.

Predicting COVID-19 Re-Positive Cases in Malnourished Older Adults: A Clinical Model Development and Validation

“…Since January 8, 2023, China has implemented “Class B management” for COVID-19 infection, and the focus of prevention and control has shifted to “maintaining health and preventing severe cases.” The incubation period of COVID-19 variants has shortened, and the pathogenicity has shown a significant downward trend, but related studies have shown that the risk of developing severe or fatal cases is still high for older adults, 29 another study found that malnourished older adults are more likely to develop severe cases, 30 , 31 leading to an increase in severe and mortality rates. 32 , 33 In view of the prominent role of nutritional support in preventing and slowing down the development of infection, it is of great guiding significance for how to carry out the next step of nutritional support and predict the disease progression and prognosis of malnourished older adults to foresee the risk factors of COVID-19 “re-positive” in malnourished older adults as early as possible.…”

An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study

“…At present, in addition to Tai Chi exercises [ 68 ], other treatments for sleepiness and sleep disorders mainly include medication, health education, health lectures, psychotherapy, acupuncture therapy, maintenance of daily activities, relaxation training and low-intensity exercise. Although medication is the most effective means to significantly improve the problem of falling asleep and sleep disorders [ 69 ], medication produces strong side effects and dependence, and taking sleep medication for a long period of time will result in weakening of the medication's effect and aggravation of sleep disorders [ 70 ], which will increase the hazards to human health [ 71 ], especially for the elderly [ 72 ], and lead to a series of chronic diseases; health education, health lectures, and psychotherapy, Health education, health lectures, psychotherapy, acupuncture treatment, etc., even if they can solve the problems of sleep and sleep disorders, they cannot guarantee long-term improvement and require more time for the audience; daily activities, relaxation training, low-intensity exercise, etc., are not only difficult to choose the appropriate method and ensure the durability of the effect, but also more difficult for the elderly sleep disorder group. On the other hand, Tai Chi is a kind of aerobic exercise with more comfortable movements, focusing on the combination of rigidity and flexibility, sinking the shoulders and dropping the elbows, relaxing the body and mind, bringing the form with the intention, and unifying the form with the intention, which is a kind of safe and easy-to-learn method without the constraints of time and place.…”

Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial

“…13 Poor sleep, in turn, impairs cognitive functions such as memory, attention and executive functions. 14 Also, most studies focus on body weight and weight loss rather than maintaining a balanced body composition. Body composition is associated with an increased risk of chronic metabolic and cardiovascular disease, representing important potential outcomes of PA interventions.…”

“…Possible mechanisms for this include the effects of physical inactivity on poorer sleep quality 13. Poor sleep, in turn, impairs cognitive functions such as memory, attention and executive functions 14…”

“… 13 Poor sleep, in turn, impairs cognitive functions such as memory, attention and executive functions. 14 …”