Cortical Thickness Mediates the Association Between Self-Reported Pain and Sleep Quality in Community-Dwelling Older Adults
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ABSTRACT:
SUBMITTER: Montesino-Goicolea S
PROVIDER: S-EPMC7522519 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:IMPORTANCE:Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest links between sleep and Alzheimer disease biomarkers. Studies are needed that evaluate whether sleep variables are associated with neuroimaging evidence of ?-amyloid (A?) deposition. OBJECTIVE To determine the association between self-reported sleep variables and A? deposition in community-dwelling older adults. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional study of 70 adults (mean age, 76 [range, 53-91] years) from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging, a normative aging study. EXPOSURE Self-reported sleep variables. MAIN OUTCOMES AND MEASURES ?-Amyloid burden, measured by carbon 11-labeled Pittsburgh compound B positron emission tomography distribution volume ratios (DVRs). RESULTS:After adjustment for potential confounders, reports of shorter sleep duration were associated with greater A? burden, measured by mean cortical DVR (B = 0.08 [95% CI, 0.03-0.14]; P = .005) and precuneus DVR (B = 0.11 [0.03-0.18]; P = .007). Reports of lower sleep quality were associated with greater A? burden measured by precuneus DVR (B = 0.08 [0.01-0.15]; P = .03). CONCLUSIONS AND RELEVANCE:Among community-dwelling older adults, reports of shorter sleep duration and poorer sleep quality are associated with greater A? burden. Additional studies with objective sleep measures are needed to determine whether sleep disturbance causes or accelerates Alzheimer disease.
| S-EPMC3918480 | biostudies-literature
Project description:The present study aims to examine and compare the predictors of changes in self-reported sleep duration in older adults. A total of 2,294 participants over the age of 65 in the Shih-Pai Sleep Study were followed-up for an average of 3 years. According to the self-reported sleep duration at baseline and the results of a follow-up survey conducted 3 years later, participants were classified into three categories: mid-range sleepers (6-7?hours), short sleepers (?5?hours), and long sleepers (?8?hours). The main outcome variable was the sleep duration at the follow-up survey. A comparison of the results of the baseline and follow-up surveys revealed that only 45.9% of participants remained in the same spectrum of sleep duration in both surveys, with baseline long sleepers having the lowest consistency rate (27.6%). Only incident diseases, with the exception of prevalent diabetes and physical disability, predicted shortening of sleep duration. In contrast, prevalent morbidities or baseline characteristics correlated with the lengthening of sleep duration. The findings suggested that the self-estimated sleep duration fluctuated in a significant proportion of study participants over time. Predictors of lengthening of sleep duration were essentially different from predictors of shortening of sleep duration.
| S-EPMC5498583 | biostudies-literature
Project description:Both sleep disturbances and decline in white matter microstructure are commonly observed in ageing populations, as well as in age-related psychiatric and neurological illnesses. A relationship between sleep and white matter microstructure may underlie such relationships, but few imaging studies have directly examined this hypothesis. In a study of 448 community-dwelling members of the Whitehall II Imaging Sub-Study aged between 60 and 82 years (90 female, mean age 69.2 ± 5.1 years), we used the magnetic resonance imaging technique diffusion tensor imaging to examine the relationship between self-reported sleep quality and white matter microstructure. Poor sleep quality at the time of the diffusion tensor imaging scan was associated with reduced global fractional anisotropy and increased global axial diffusivity and radial diffusivity values, with small effect sizes. Voxel-wise analysis showed that widespread frontal-subcortical tracts, encompassing regions previously reported as altered in insomnia, were affected. Radial diffusivity findings remained significant after additional correction for demographics, general cognition, health, and lifestyle measures. No significant differences in general cognitive function, executive function, memory, or processing speed were detected between good and poor sleep quality groups. The number of times participants reported poor sleep quality over five time-points spanning a 16-year period was not associated with white matter measures. In conclusion, these data demonstrate that current sleep quality is linked to white matter microstructure. Small effect sizes may limit the extent to which poor sleep is a promising modifiable factor that may maintain, or even improve, white matter microstructure in ageing. Hum Brain Mapp 38:5465-5473, 2017. © 2017 Wiley Periodicals, Inc.
| S-EPMC5655937 | biostudies-literature
Project description:In the current study, we aimed to examine the association between knee pain and diet quality in women aged ≥ 50 years using data from the Korea National Health and Nutrition Examination Survey. This was a population-based, cross-sectional study. Diet quality was assessed using the Diet Quality Index-International (DQI-I), and knee pain and osteoarthritis were self-reported. A multivariate logistic regression model was used to adjust for age, body mass index, household income, marital status, education, occupation, smoking status, hazardous alcohol use, regular physical activity, menopause, and chronic diseases, including hypertension, diabetes, dyslipidemia, osteoarthritis, and depression. A total of 3,881 women were included in this study, and the prevalence of knee pain was 25.4%. The intakes of total energy, protein, and fat were lower in women with knee pain than in those without (all P < 0.01), while the carbohydrate intake was higher (P = 0.01). No significant differences were noted in the scores for variety, overall balance, and moderation components, except for the item of total fat intake, between the DQI-I scores for women with and without knee pain, after adjusting for age. Women without knee pain showed higher scores in several items of the adequacy component (P < 0.05) than did women with knee pain. The total DQI-I scores were lower in women with knee pain than in women without knee pain, after adjusting for covariates, including osteoarthritis (OR = 0.985, 95% CI = 0.973-0.997, P = 0.01). Knee pain independent of osteoarthritis was associated with poor diet quality in community-dwelling women aged ≥ 50 years.
| S-EPMC7886155 | biostudies-literature
Project description:PurposeProactive care for community-dwelling older persons targeting self-reported hindering health complaints might prevent a decline in function. We investigated the spectrum of self-reported hindering complaints of community-dwelling older persons, the association with functional outcomes, and help-seeking behavior for these complaints.MethodsWithin the ISCOPE trial, participants (aged ≥75 years) received the ISCOPE screening questionnaire, including the open-ended question "At the moment, which health complaints limit you the most in your day-to-day life?". After coding the answers with the ICPC-1-NL, we examined the prevalence and the association between the number and type of complaints and functional outcomes (Groningen Activities Restriction Scale, quality of life measured on Cantril's Ladder, Mini-Mental State Examination, Geriatric Depression Scale-15, and De Jong Gierveld Loneliness Scale). Electronic patient registers were searched for the most reported complaints.Results7285 participants (median age: 81.0 years [IQR 77.8-85.3], 38.6% males) reported 13,524 hindering complaints (median 1, range 0-18); 32.7% reported no complaints. Participants mostly reported problems with walking/standing (22.1%), pain (20.8%) or weakness/tiredness (8.5%). These complaints were mentioned in the electronic patient registers in 28.3%, 91.3% and 55.5%, respectively. Higher numbers of hindering complaints were related to poorer scores on the number of domains with problems, Cantril's Ladder for quality of life, Groningen Activities Restriction Scale, Geriatric Depression Scale, and De Jong Gierveld Loneliness Scale. Self-reported weakness, problems with walking/standing, visual limitations, cognitive problems, dyspnea and back complaints were associated with poorer scores on the number of domains with problems, Groningen Activities Restriction Scale, MMSE or Geriatric Depression Scale.ConclusionOne third of the participants reported no hindering complaints. Problems with walking/standing, pain, and weakness/tiredness were most reported, but not always found in electronic patient registers. A higher number of, and specific self-reported hindering complaints, were associated with poorer scores on functional outcomes. It may be helpful for general practitioners to ask about these complaints and their influence on daily life.
| S-EPMC4646486 | biostudies-literature
Project description:BackgroundVitamin D is critical to brain health and a promising candidate to prevent cognitive decline and onset of Alzheimer disease (AD), although the underlying brain mechanisms are unclear.ObjectivesThis study aimed to determine the association between vitamin D intake and brain cortical thickness in older adults.MethodsThis was a cross-sectional investigation of 263 cognitively unimpaired participants, aged 65 y and older, participating in the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) trial (an ongoing study testing the effects of a 3-y diet intervention on cognitive decline). Vitamin D intake, from diet and supplements, was ascertained from an FFQ. Linear regression analysis, adjusted for age, sex, race, education, income, cognitive and physical activities, and cardiovascular disease risk factors, was used to determine the association between vitamin D intake and cortical thickness of the whole brain, lobes, and AD signature.ResultsTotal vitamin D intake was associated with cortical thickness of the temporal lobe and AD signature. Compared with individuals in the lowest quartile of total vitamin D intake [median: 140 international units (IU)/d], those in the highest quartile (median: 1439 IU/d) had a 0.038-mm (95% CI: 0.006, 0.069 mm) thicker temporal lobe and 0.041-mm (95% CI: 0.012, 0.070 mm) thicker AD signature. Most vitamin D intake was from supplements, and supplemental intake was also associated with cortical thickness. Compared with those who used no supplement, individuals taking 800-1000 IU/d and >1000 IU/d of supplemental vitamin D had a 0.039-mm (95% CI: 0.013, 0.066 mm) and 0.047-mm (95% CI: 0.013, 0.081 mm) thicker temporal lobe and a 0.037-mm (95% CI: 0.013, 0.061 mm) and 0.046-mm (95% CI: 0.015, 0.077 mm) thicker AD signature, respectively. Dietary vitamin D was not related to brain cortical thickness in our sample.ConclusionsIn cognitively unimpaired older adults, total and supplemental vitamin D intakes were associated with cortical thickness in regions vulnerable to AD.This trial was registered at clinicaltrials.gov as NCT02817074.
| S-EPMC8417916 | biostudies-literature
Project description:Older adults experience slips, trips, stumbles, and other losses of balance (LOBs). LOBs are more common than falls and are closely linked to falls and fall-injuries. Data about real-world LOBs is limited, particularly information quantifying the prevalence, frequency, and intrinsic and extrinsic circumstances in which they occur. This paper describes a new method to identify and analyze LOBs through long-term recording of community-dwelling older adults. The approach uses wearable inertial measurement units (IMUs) on the feet, trunk and one wrist, together with a voice recorder for immediate, time-stamped self-reporting of the type, context and description of LOBs. Following identification of an LOB in the voice recording, concurrent IMU data is used to estimate foot paths and body motions, and to create body animations to analyze the event. In this pilot study, three older adults performed a long-term monitoring study, with four weeks recording LOBs by voice and two concurrent weeks wearing IMUs. This report presents a series of LOB cases to illustrate the proposed method, and how it can contribute to interpretation of the causes and contexts of the LOBs. The context and timing information from the voice records was critical to the process of finding and analyzing LOB events within the voluminous sensor data record, and included much greater detail, specificity, and nuance than past diary or smartphone reporting.
| S-EPMC6398340 | biostudies-literature
Project description:To compare the effects of different types of physical and mental activity on self-reported sleep quality over 12 weeks in older adults with cognitive and sleep complaints.Randomized controlled trial.General community.Seventy-two inactive community-dwelling older adults with self-reported sleep and cognitive problems (mean age 73.3 ± 6.1; 60% women).Random allocation to four arms using a two-by-two factorial design: aerobic+cognitive training, aerobic+educational DVD, stretching+cognitive training, and stretching+educational DVD arms (60 min/d, 3 d/wk for physical and mental activity for 12 weeks).Change in sleep quality using seven questions from the Sleep Disorders Questionnaire on the 2005 to 2006 National Health and Nutrition Examination Survey (range 0-28, with higher scores reflecting worse sleep quality). Analyses used intention-to-treat methods.Sleep quality scores did not differ at baseline, but there was a significant difference between the study arms in change in sleep quality over time (P < .005). Mean sleep quality scores improved significantly more in the stretching+educational DVD arm (5.1 points) than in the stretching+cognitive training (1.2 points), aerobic+educational DVD (1.1 points), or aerobic+cognitive training (0.25 points) arms (all P < .05, corrected for multiple comparisons). Differences between arms were strongest for waking at night (P = .02) and taking sleep medications (P = .004).Self-reported sleep quality improved significantly more with low-intensity physical and mental activities than with moderate- or high-intensity activities in older adults with self-reported cognitive and sleep difficulties. Future longer-term studies with objective sleep measures are needed to corroborate these results.
| S-EPMC4356237 | biostudies-literature
Project description:BackgroundSleep characteristics associated with dementia are poorly defined and whether their associations vary by demographics and APOE genotype among older adults are unclear.MethodsThis population-based cross-sectional study included 4742 participants (age ≥ 65 years, 57.1% women) living in rural China. Sleep parameters were measured using the self-rated questionnaires of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and the National Institute on Aging-Alzheimer's Association criteria for Alzheimer's disease (AD). Data were analysed using multiple logistic and general linear regression models.ResultsDementia was diagnosed in 173 participants (115 with AD). Multivariable-adjusted odds ratio (OR) of dementia was 1.71 (95%CI, 1.07-2.72) for sleep duration ≤4 h/night (vs. > 6-8 h/night), 0.76 (0.49-1.18) for > 4-6 h/night, 1.63 (1.05-2.55) for > 8 h/night, 1.11 (1.03-1.20) for lower sleep efficiency (per 10% decrease), and 1.85 (1.19-2.89) for excessive daytime sleepiness. Very short sleep duration (≤4 h/night), lower sleep efficiency, and excessive daytime sleepiness were significantly associated with being diagnosed with AD (multivariable-adjusted OR range = 1.12-2.07; p < 0.05). The associations of sleep problems with dementia and AD were evident mainly among young-old adults (65-74 years) or APOE ε4 carriers. Among dementia-free participants, these sleep characteristics were significantly associated with a lower MMSE score.ConclusionsSelf-reported sleep problems in dementia are characterized by very short or long sleep duration, low sleep efficiency, and excessive daytime sleepiness, especially among young-old people and APOE ε4 carriers.Trial registrationChiCTR1800017758 (Aug 13, 2018).
| S-EPMC8722012 | biostudies-literature
Project description:BACKGROUND:Older adults have the highest drug utilization due to multimorbidity. Although the number of people over age 70 is expected to double within the next decades, population-based data on their medication patterns are scarce especially in combination with polypharmacy and potentially inappropriate medication (PIM). Our objective was to analyse the frequency of polypharmacy, pattern of prescription (PD) and over-the-counter (OTC) drug usage, and PIMs according to age and gender in a population-based cohort of very old adults in Germany. METHODS:Cross-sectional baseline data of the Berlin Initiative Study, a prospective cohort study of community-dwelling adults aged ≥70 years with a standardized interview including demographics, lifestyle variables, co-morbidities, and medication assessment were analysed. Medication data were coded using the Anatomical Therapeutic Chemical (ATC) classification. Age- and sex-standardized descriptive analysis of polypharmacy (≥5 drugs, PD and OTC vs. PD only and regular and on demand drugs vs regular only), medication frequency and distribution, including PIMs, was performed by age (</≥80) and gender. RESULTS:Of 2069 participants with an average age of 79.5 years, 97% (95%CI [96%;98%]) took at least one drug and on average 6.2 drugs (SD = 3.5) with about 40 to 66% fulfilling the criteria of polypharmacy depending on the definition. Regarding drug type more female participants took a combination of PD and OTC (male: 68%, 95%CI [65%;72%]); female: 78%, 95%CI [76%;80%]). Most frequently used were drugs for cardiovascular diseases (85%, 95%CI [83%;86%]). Medication frequency increased among participants aged ≥80 years, especially for cardiovascular drugs, antithrombotics, psychoanaleptics and dietary supplements. Among the top ten prescription drugs were mainly cardiovascular drugs including lipid-lowering agents (simvastatin), beta-blockers (metoprolol, bisoprolol) and ACE inhibitors (ramipril). The most common OTC drug was acetylsalicylic acid (35%; 95%CI [33%;37%])). Dose-independent PIM were identified for 15% of the participants. CONCLUSIONS:Polypharmacy was excessive in older adults, with not only PD but also OTC drugs contributing to the high point prevalence. The medication patterns reflected the treatment of chronic diseases in this age group. There was even an increase in medication frequency between below and above 80 years especially for drugs of cardiovascular diseases, antithrombotic medication, psychoanaleptics, and dietary supplements.
| S-EPMC6974973 | biostudies-literature