Sleep Quality Mediates the Association Between Cerebral Small Vessel Disease Burden and Frailty: A Community-Based Study

Abstract

Background: Physical frailty is a common problem among older adults which usually leads to adverse health outcomes. The imaging markers of cerebral small vessel disease (CSVD) are associated with frailty, but the underlying mechanisms remain unclear. The present study aimed to investigate the mediating role of sleep quality in the relationship between CSVD burden and frailty.Methods: We performed a cross-sectional study and enrolled community residents. Frailty and sleep quality were measured using the Fried frailty phenotype and the Pittsburgh Sleep Quality Index (PSQI), respectively. A multivariate linear regression analysis and a Bootstrap analysis were performed to examine the association among the key variables and the mediating role of sleep quality.Results: Of the 726 participants (mean age: 65.5 ± 6.5 years, 59.8% female), the numbers (percentages) of the frail, prefrail, and robust residents were 49 (6.7%), 310 (42.7%), and 367 (50.6%), respectively. After adjusting for covariates, the CSVD burden and PSQI score were significantly associated with the frailty score. In addition, sleep quality played a partial mediating role in the association between CSVD burden and physical frailty. The mediating effect was 21.9%.Conclusion: The present study suggests that sleep quality is a mediator of this association between CSVD and frailty in community-dwelling older adults. Improving sleep quality might be helpful to mitigate the risk of frailty in CSVD patients.

Sleep quality, frailty and overall health among community‐dwelling older people: A longitudinal study

“…The mean value of sleep quality was 6.1 ( SD 3.4) and more than half of the participants had poor sleep quality (values >5), similar to previous studies (Alqahtani, 2021; Zhao et al, 2021). Our results showed that subjective sleep quality, sleep latency (difficulty in falling asleep) and sleep disturbance had the highest scores for sleep problems in older people, similar to those of earlier studies.…”

“…The mean value of sleep quality was 6.1 (SD 3.4) and more than half of the participants had poor sleep quality (values >5), similar to previous studies (Alqahtani, 2021;Zhao et al, 2021). was significantly associated with the overall health after 1 year, supported by previous studies (Matsui et al, 2021;Sella et al, 2021).…”

Neuropsychiatric symptoms and altered sleep quality in cerebral small vessel disease

“…Poor sleep quality is considered to be one of the non-traditional risk factors for cardiovascular and cerebrovascular diseases ( 6 , 7 ), and it is not only associated with cognitive decline ( 8 ) but also with development or exacerbation of other psychiatric symptoms ( 9 , 10 ). Prosperous sleep quality plays a vital role in consolidating memory, regulating immunity, and balancing homeostasis ( 11 ).…”

Relationship between physical activity, sleep quality, and frailty in middle-aged and older adults: a cross-sectional study Running title: The correlation between physical activity, sleep quality, and frailty

“…In this study, sleep quality was assessed using The PSQI (38), which is used to evaluate better the sleep quality status of the study participants in the last month, and it is the most widely used subjective sleep assessment scale (39). The Chinese version of the scale currently in use has been shown to have good reliability and validity (40) and has been used in several studies (39,41), with a Cronbach's alpha of 0.736 in this study. The scale consists of 18 self-assessment items divided into seven dimensions, namely subjective sleep quality, sleep duration, time to fall asleep, sleep disorders, sleep e ciency, use of hypnotic medication, and daytime dysfunction, with scores ranging from 0 to 3 for each dimension, and a total score ranging from 0 to 21, with higher scores being associated with poorer sleep quality.…”