Bidirectional relationship between insomnia and frailty in older adults: A 2-year longitudinal study
Bidirectional relationship between insomnia and frailty in older adults: A 2-year longitudinal study
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老年人失眠与虚弱之间的双向关系：一项为期2年的纵向研究
DOI：
10.1016/j.archger.2021.104519
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发表时间：
2021-09-24
影响因子：
4
通讯作者：
Arao, Takashi
中科院分区：
文献类型：
--
作者：
Nemoto, Yuta;Sato, Shinichiro;Arao, Takashi
背景：大多数以前的研究，探讨失眠与脆弱的关联使用横断面设计。因此，这些因素之间的时间关系在很大程度上是未知的。本研究旨在探讨失眠与性别之间的双向关系。方法：一项为期2年的纵向研究，涉及所有居住在日本农村地区的社区老年人（n = 3844）。失眠和虚弱的验证措施。使用雅典失眠量表评估失眠，使用Kihon检查表评估虚弱。我们进行了交叉滞后面板模型，调整了年龄，性别，受教育年限，就业状况，自测健康，并发症（高血压，糖尿病，中风或骨关节炎），BMI，体力活动，饮酒和吸烟状况，并评估了性别差异。结果如下：睡眠不佳可预测随访期间虚弱的发生和恶化（标准化系数[95%置信区间]：0.076 [0.045，0.107]）。虚弱也可预测严重失眠症状（0.074 [0.044，0.104]）。然而，这些条件之间的时间关联因性别而异。在老年男性中，虚弱对失眠的影响比失眠对虚弱的影响更大。然而，在女性中，失眠对虚弱的影响比虚弱对失眠的影响更大。结论：失眠和虚弱之间的联系的主要潜在原因可能因性别而异，男性虚弱，女性失眠。针对性别的干预措施，以改善睡眠质量和持续时间，并保持日常生活中的功能能力，可能有助于预防和管理老年人的虚弱和失眠。
Background: Most previous studies that examined the association of insomnia with frailty used cross-sectional designs. The temporal relationship between these factors is therefore largely unknown. This study aimed to examine the bidirectional relationship between insomnia and frailty by sex. Methods: A 2-year longitudinal study involving all community-dwelling older adults living in a rural area in Japan (n = 3844). Validated measures of insomnia and frailty were employed. Insomnia was assessed using the Athens insomnia scale, and frailty using the Kihon checklist. We performed a cross-lagged panel model, adjusted for age, sex, years of education, employment status, self-rated health, complications (hypertension, diabetes, stroke, or osteoarthritis), BMI, physical activity, alcohol consumption, and smoking status, and assessed differences by sex. Results: Poor sleep predicted the onset and worsening of frailty during follow up (standardized coefficient [95% confidence interval]: 0.076 [0.045, 0.107]). Frailty also predicted severe insomnia symptoms (0.074 [0.044, 0.104]). However, the temporal association between these conditions varied by sex. In older men, the effect of frailty on insomnia was stronger than that of insomnia on frailty. However, in women, the impact of insomnia on frailty was stronger than that of frailty on insomnia. Conclusions: The primary potential cause of the association between insomnia and frailty may vary by sex, being frailty in men and insomnia in women. Sex-specific interventions to improve sleep quality and duration, and maintain functional abilities in daily life may contribute to the prevention and management of both frailty and insomnia in older adults.