Sex Differences in the Association Between Risk of Obstructive Sleep Apnea, Insomnia, and Frailty in Older Adults

Moreno-Tamayo, Karla; Manrique‐Espinoza, Betty; Guerrero-Zúñiga, Selene; Ramírez-García, Eliseo; Sánchez-García, Sergio

doi:10.2147/nss.s320192

Cited by 15 publications

(13 citation statements)

References 45 publications

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“…Overall, 12 cross‐sectional studies (Cavusoglu et al., 2021 ; Devkota et al., 2017 ; Ensrud et al., 2009 ; Fan et al., 2022 ; Liu et al., 2021 ; Moreno‐Tamayo et al., 2021 ; Moreno‐Tamayo et al., 2017 ; Pacholek et al., 2020 ; Tang et al., 2021 ; Vaz Fragoso et al., 2009 ; Xie et al., 2021 ; Zhao et al., 2019 ) including 16,895 old people contributed to the meta‐analysis. The characteristics of the included studies are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the included studies are summarized in Table 1 . The studies were published between 2009 and 2021 and were performed in the United States (Ensrud et al., 2009 ; Liu et al., 2021 ; Vaz Fragoso et al., 2009 ), Nepal (Devkota et al., 2017 ), Poland (Pacholek et al., 2020 ), China (Fan et al., 2022 ; Tang et al., 2021 ; Xie et al., 2021 ; Zhao et al., 2019 ), Mexico (Moreno‐Tamayo et al., 2021 ; Moreno‐Tamayo et al., 2017 ), and Turkey (Cavusoglu et al., 2021 ). All the studies included older people aged at least 60 years from the communities (Cavusoglu et al., 2021 ; Devkota et al., 2017 ; Ensrud et al., 2009 ; Fan et al., 2022 ; Liu et al., 2021 ; Moreno‐Tamayo et al., 2021 ; Moreno‐Tamayo et al., 2017 ; Pacholek et al., 2020 ; Tang et al., 2021 ; Vaz Fragoso et al., 2009 ; Xie et al., 2021 ) or nursing homes (Zhao et al., 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…The studies were published between 2009 and 2021 and were performed in the United States (Ensrud et al., 2009 ; Liu et al., 2021 ; Vaz Fragoso et al., 2009 ), Nepal (Devkota et al., 2017 ), Poland (Pacholek et al., 2020 ), China (Fan et al., 2022 ; Tang et al., 2021 ; Xie et al., 2021 ; Zhao et al., 2019 ), Mexico (Moreno‐Tamayo et al., 2021 ; Moreno‐Tamayo et al., 2017 ), and Turkey (Cavusoglu et al., 2021 ). All the studies included older people aged at least 60 years from the communities (Cavusoglu et al., 2021 ; Devkota et al., 2017 ; Ensrud et al., 2009 ; Fan et al., 2022 ; Liu et al., 2021 ; Moreno‐Tamayo et al., 2021 ; Moreno‐Tamayo et al., 2017 ; Pacholek et al., 2020 ; Tang et al., 2021 ; Vaz Fragoso et al., 2009 ; Xie et al., 2021 ) or nursing homes (Zhao et al., 2019 ). Diagnosis of insomnia was according to the Insomnia Severity Index (ISI) (Vaz Fragoso et al., 2009 ), Pittsburgh Sleep Quality Index (Cavusoglu et al., 2021 ; Ensrud et al., 2009 ; Tang et al., 2021 ), the Athens Insomnia Scale (AIS) (Fan et al., 2022 ; Moreno‐Tamayo et al., 2021 ; Pacholek et al., 2020 ; Zhao et al., 2019 ), or self‐reported symptoms of insomnia (Devkota et al., 2017 ; Liu et al., 2021 ; Moreno‐Tamayo et al., 2017 ; Xie et al., 2021 ), and the overall prevalence of insomnia was 6105/16895 (36.1%).…”

Section: Resultsmentioning

confidence: 99%

“…Accordingly, it has been proposed that insomnia may be an associated factor of frailty (Cochen et al, 2009). However, previous studies evaluating the possible association between insomnia and frailty showed inconsistent results (Cavusoglu et al, 2021;Devkota, Anderson, Soiza, & Myint, 2017;Ensrud et al, 2009;Fan et al, 2022;Liu et al, 2021;Moreno-Tamayo, Manrique-Espinoza, Guerrero-Zuniga, Ramirez-Garcia, & Sanchez-Garcia, 2021;Moreno-Tamayo, Manrique-Espinoza, Rosas-Carrasco, Perez-Moreno, & Salinas-Rodriguez, 2017;Pacholek et al, 2020;Tang et al, 2021;Vaz Fragoso, Gahbauer, Van Ness, & Gill, 2009;Xie, Ma, Chen, & Wang, 2021;Zhao, Gao, Li, & Wang, 2019), and it has also not determined if the difference in the symptoms of insomnia may affect the potential association. Accordingly, a systematic review and meta-analysis was performed to explore the association between insomnia and frailty in the older population.…”

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confidence: 99%

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Association between insomnia and frailty in older population: A meta‐analytic evaluation of the observational studies

et al. 2022

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Introduction:Poor sleep quality has been suggested as a risk factor of frailty. However, previous studies that evaluated the association between insomnia and frailty in older population showed inconsistent results. We performed a meta-analysis to comprehensively evaluate the association.Methods: Observational studies related to the aim of the meta-analysis were identified by search of PubMed, Embase, and Web of Science databases. A random-effect model incorporating the potential between-study heterogeneity was used to pool the results.Results: Twelve studies including 16,895 old people contributed to the meta-analysis.Pooled results suggested a significant association between insomnia and frailty in the older population (odds ratio [OR]: 1.95, 95% confidence interval [CI]: 1.52-2.41, p < .001; I 2 = 80%). Subgroup analyses showed consistent association between different symptoms of insomnia and frailty, including difficulty in falling asleep (OR: 1.45), difficulty in maintaining sleep (OR: 1.23), early morning awakening (OR: 1.21), and non-restorative sleep (OR: 1.84, p for subgroup difference = .15). Results were also consistent for subgroup analyses according to the study country, sample size, cutoffs of age for defining the older population, proportions of men, diagnostic criteria for frailty, adjustment of depression, and scores of study quality (p for subgroup difference all > .05). However, a stronger association was observed for insomnia detected with the Athens Insomnia Scale (OR: 2.92) than that with Pittsburgh Sleep Quality Index (OR: 1.30) or self-reporting (OR: 1.60, p for subgroup difference = .002). Conclusion:Insomnia is independently associated with frailty in the older population.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Association between insomnia and frailty in older population: A meta‐analytic evaluation of the observational studies

et al. 2022

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“…Frailty is characterized by diminished physiologic reserve and an increased risk of adverse health events [ 23 ]. Frailty affects approximately 17% and 10% of older adults in middle-income and high-income economies, respectively [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Higher Hospital Frailty Risk Score Is an Independent Predictor of In-Hospital Mortality in Hospitalized Older Adults with Obstructive Sleep Apnea

Ajibawo

Okunowo

2022

Geriatrics

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Background: Frailty predisposes individuals to stressors, increasing morbidity and mortality risk. Therefore, this study examined the impact of frailty defined by the Hospital Frailty Risk Score (HFRS) and other characteristics in older hospitalized patients with Obstructive Sleep Apnea (OSA). Methods: We conducted a retrospective study using the National Inpatient Sample 2016 in patients ≥65 years old with OSA. Logistic regression was used to evaluate the impact of frailty on inpatient mortality. A Kaplan-Meier curve with a log-rank test was used to estimate survival time between frailty groups. Results: 182,174 discharge records of elderly OSA were included in the study. 54% of the cohort were determined to be a medium/high frailty risk, according to HFRS. In multivariable analysis, frailty was associated with a fourfold (medium frailty, adjusted odd ratio (aOR): 4.12, 95% Confidence Interval (CI): 3.76–4.53, p-value < 0.001) and sixfold (high frailty, OR: 6.38, 95% CI: 5.60–7.27, p-value < 0.001) increased odds of mortality. Hospital survival time was significantly different between the three frailty groups (Log-rank test, p < 0.0001). Comorbidity burden defined by Charlson comorbidity Index (CCI) was associated with increased mortality (p < 0.001). Conclusion: More than half of the whole cohort was determined to be at medium and high frailty risk. Frailty was a significant predictor of in-hospital deaths in hospitalized OSA patients. Frailty assessment may be applicable for risk stratification of older hospitalized OSA patients.

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The relationship between insomnia and multidimensional frailty in community-dwelling older adults: A systematic review

Qi,

Kong,

et al. 2025

Archives of Gerontology and Geriatrics

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Sex Differences in the Association Between Risk of Obstructive Sleep Apnea, Insomnia, and Frailty in Older Adults

Cited by 15 publications

References 45 publications

Association between insomnia and frailty in older population: A meta‐analytic evaluation of the observational studies

Association between insomnia and frailty in older population: A meta‐analytic evaluation of the observational studies

Higher Hospital Frailty Risk Score Is an Independent Predictor of In-Hospital Mortality in Hospitalized Older Adults with Obstructive Sleep Apnea

The relationship between insomnia and multidimensional frailty in community-dwelling older adults: A systematic review

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