Quality In Older Adults Research Articles

Comparative efficacy of non-pharmacological interventions on sleep quality in old adults: A systematic review and network meta-analysis.

To compare the effectiveness of non-pharmacological interventions in enhancing sleep quality in older people. Sleep problems in older adults have become increasingly prominent. Sleep problems not only affect the health and quality of life of older people, but also the range of chronic diseases caused by sleep problems also impose a huge burden on social services and health care. Non-pharmacological interventions are an effective alternative to pharmacological therapies, but it is unclear which non-pharmacological therapies are most effective in enhancing sleep quality in older adults. A systematic review and network meta-analysis based on PRISMA-NMA. A total of seven databases were searched from the establishment of the database to March 2023. After literature screening and data extraction, the Cochrane Bias assessment tool 2.0 version of randomised controlled trials (RCTs) was used to evaluate literature quality. A network meta-analysis was performed to evaluate the relative efficacy of the non-pharmacological interventions on sleep quality. A total of 71 RCTs involving nine non-pharmacological interventions were included. The results of the network meta-analysis showed that the joint intervention may be the most effective non-pharmacological intervention to enhance sleep quality in older adults. This study confirms that non-pharmacological interventions can improve sleep quality in older adults. The use of non-pharmacological interventions can be promoted by healthcare professionals in the future to improve the quality of sleep and thus the physical and mental health of older people. This evidence suggests that joint interventions may be most effective. Therefore, in the future, a combination of non-pharmacological interventions could be used to maximise their effectiveness in improving sleep quality in older people and promoting healthy aging. No patient or public contribution is not applicable to this study.

Residential greenspace exposure, particularly green window-views, is associated with improved sleep quality among older adults: Evidence from a high-density city

Preliminary evidence suggests a potential link between greenspace exposure and better sleep quality. Here we aimed to investigate the specific associations between residential greenspace exposure, green-window views, and sleep quality among older adults and determine whether these associations were mediated through mitigation (i.e., perceived noise annoyance, air pollution, and artificial light pollution) and restoration (i.e., psychological stress) pathways. A total of 1007 older adults with an average age >70 years were recruited from 40 residential communities in the Old City District of Nanjing, China. We developed a set of fine-grained greenspace exposure indices based on 3D point cloud data derived from unmanned aerial vehicle photogrammetry, incorporating vegetation coverage and green volume ratio at the community level and green window ratio at the individual level. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. We examined the complex interrelationships between residential greenspace exposure, environmental stressors (air pollution, artificial light pollution, and noise), perceived mental stress, and sleep quality using multilevel linear regression models. The results suggested the following: (1) Vegetation coverage, green volume ratio, and green window ratio were significantly associated with sleep quality in older adults. (2) The green window ratio was more strongly associated with improved sleep quality than other greenspace exposure metrics. (3) These associations may be partially explained by noise mitigation and mental stress reduction. In conclusion, it seems advantageous to consider immediate residential greenspace, particularly through green-window views, as part of the interventions aimed at supporting sleep quality improvement among older adults.

The Effect of Web-Based Culinary Medicine to Enhance Protein Intake on Muscle Quality in Older Adults: Randomized Controlled Trial.

The most common age-related musculoskeletal disorder is sarcopenia. Sarcopenia is the progressive and generalized loss of muscle mass, strength, and function. The causes of sarcopenia can include insufficient nutritional status, which may be due to protein-energy malnutrition, anorexia, limited food access and eating ability, or malabsorption. In the United States, 15.51% of older adults have been diagnosed with sarcopenia. Culinary medicine (CM) is a novel evidence-based medical field that combines the science of medicine with food and cooking to prevent and treat potential chronic diseases. CM helps individuals learn and practice culinary skills while tasting new recipes. Therefore, this program could successfully reduce barriers to protein intake, enabling older adults to enhance their diet and muscle quality. This study aimed to examine how a web-based CM intervention, emphasizing convenient ways to increase lean red meat intake, could improve protein intake with the promotion of physical activity to see how this intervention could affect older adults' muscle strength and mass. A 16-week, single-center, parallel-group, randomized controlled trial was conducted to compare a web-based CM intervention group (CMG) with a control group (CG) while monitoring each group's muscle strength, muscle mass, and physical activity for muscle quality. The CMG received weekly web-based cooking demonstrations and biweekly nutrition education videos about enhancing protein intake, whereas the CG just received the recipe handout. Anthropometrics, muscle mass, muscle strength, dietary habits, physical activity, and cooking effectiveness were established at baseline and measured after the intervention. The final number of participants for the data analysis was 24 in the CMG and 23 in the CG. No between-group difference in muscle mass (P=.88) and strength (dominant P=.92 and nondominant P=.72) change from the prestudy visit was detected. No statistically significant difference in protein intake was seen between the groups (P=.50). A nonsignificant time-by-intervention interaction was observed for daily protein intake (P=.08). However, a statistically significant time effect was observed (P≤.001). Post hoc testing showed that daily protein intake was significantly higher at weeks 1 to 16 versus week 0 (P<.05). At week 16, the intake was 16.9 (95% CI 5.77-27.97) g higher than that at the prestudy visit. This study did not affect protein intake and muscle quality. Insufficient consistent protein intake, low physical activity, intervention adherence, and questionnaire accuracy could explain the results. These studies could include an interdisciplinary staff, different recruitment strategies, and different muscle mass measurements. Future research is needed to determine if this intervention is sustainable in the long term and should incorporate a follow-up to determine program efficacy on several long-term behavioral and health outcomes, including if the participants can sustain their heightened protein intake and how their cooking skills have changed. ClinicalTrials.gov NCT05593978; https://clinicaltrials.gov/ct2/show/NCT05593978.

Factors associated with the sleep quality in older adults and the risk of functional loss and frailty

Factors associated with the sleep quality in older adults and the risk of functional loss and frailty

One-leg standing time is a simple measure for loss of skeletal muscle mass and fat deposition in muscle: the J-SHIPP study

BackgroundsOne-leg standing time (OLST) has been frequently used physical performance measure; however, what muscular characteristics OLST represents remains uncertain.AimThis cross-sectional study aimed to investigate the association between OLST and muscle characteristics to clarify the possibility of using OLST as a physical performance measure.MethodsStudy participants comprised 1144 older adults aged 65 years or older. Computed tomography images provided mid-thigh skeletal muscle cross-sectional area and mean attenuation value. OLST was measured for a maximum of 60 s. Static postural instability was assessed using a posturography.ResultsA frequency of OLST < 20 s was increased by quartiles of muscle cross-sectional area (Q1: 33.6, Q2: 12.8, Q3: 13.6, Q4: 11.9%, P < 0.001) and mean attenuation value (Q1: 32.3, Q2: 21.7, Q3: 14.3, Q4: 7.7%, P < 0.001). Results of the multinomial regression analysis indicated that muscle cross-sectional area and mean attenuation value were independently associated with an OLST of less than 20 s. The crude odds ratio of OLST less than 20 s for the lowest quartiles of both cross-sectional area and mean attenuation value was 4.19 (95% CI: 3.01 − 5.84). The cross-sectional area of muscles with greater fat deposition was inversely associated with OLST, while that with smaller fat deposition showed a positive association with OLST, indicating why mean attenuation value and cross-sectional area were independently associated with OLST. No clear relationship was observed with static postural instability.ConclusionOLST was a simply measurable quantifiable physical measure representing the loss of muscle mass and quality in older adults.

The impact of 5-hydroxytryptophan supplementation on sleep quality and gut microbiota composition in older adults: A randomized controlled trial

Background and AimsSleep quality is a pivotal part of health and there is growing evidence on the association between gut microbiota composition and sleep quality. 5-Hydroxytryptophan (5-HTP) is known as a precursor of the sleep regulating neurotransmitter and hormone however, efficacy of 5-HTP supplementation for improving sleep quality in older adults is unclear. Hence, the aim of this study is to assess the impact of 5-HTP supplementation on sleep quality and gut microbiota composition in older adults. MethodsThis is a single-blinded, 12-week parallel randomized controlled. Thirty older adults (66 ± 3 years) in Singapore were randomly assigned to either consume or not consume 100 mg 5-HTP daily. Every 4 weeks, sleep quality was assessed via both subjective (Pittsburg Sleep Quality Index) and objective (actigraphy watch) measures. A global sleep score (GSS) was obtained from the PSQI, where a GSS>5 defines as poor sleeper while a GSS≤5 defines as good sleeper. Blood serotonin level, urine melatonin concentration, gut microbiota composition and stool short chain fatty acids (SCFA) content was assessed at week 0 and 12. This study was registered in clinicaltrials.gov as NCT04078724 (https://clinicaltrials.gov/ct2/show/NCT04078724) Results5-HTP supplementation showed an overall favorable effect on certain sleep quality components and an increase in serum serotonin concentration. In particular, at week 12, not good sleepers but poor sleepers with 5-HTP supplementation were able to significantly improve subjective GSS (ΔSL5-HTP: -2.80 ± 1.10 mins, p-value=0.005). In addition, they showed an increase in microbiota diversity (Simpson5-HTP vs. SimpsonControl: 0.037 ± 0.032 a.u. vs. -0.007 ± 0.022 a.u.; pinteraction: 0.013) and relative abundance of SCFA producing bacteria in the gut. Conclusions5-HTP supplementation can improve certain sleep quality components in older adults and this benefit was more prominently observed in poor sleepers. 5-HTP was also able to improve the gut microbiota composition in poor sleepers.

Effect of matcha green tea on cognitive functions and sleep quality in older adults with cognitive decline: A randomized controlled study over 12 months.

Lifestyle habits after middle age significantly impact the maintenance of cognitive function in older adults. Nutritional intake is closely related to lifestyle habits; therefore, nutrition is a pivotal factor in the prevention of dementia in the preclinical stages. Matcha green tea powder (matcha), which contains epigallocatechin gallate, theanine, and caffeine, has beneficial effects on cognitive function and mood. We conducted a randomized, double-blind, placebo-controlled clinical study over 12 months to examine the effect of matcha on cognitive function and sleep quality. Ninety-nine participants, including 64 with subjective cognitive decline and 35 with mild cognitive impairment were randomized, with 49 receiving 2 g of matcha and 50 receiving a placebo daily. Participants were stratified based on two factors: age at baseline and APOE genotype. Changes in cognitive function and sleep quality were analyzed using a mixed-effects model. Matcha consumption led to significant improvements in social acuity score (difference; -1.39, 95% confidence interval; -2.78, 0.002) (P = 0.028) as evaluated by the perception of facial emotions in cognitive function. The primary outcomes, that is, Montreal Cognitive Assessment and Alzheimer's Disease Cooperative Study Activity of Daily Living scores, showed no significant changes with matcha intervention. Meanwhile, Pittsburgh Sleep Quality Index scores indicated a trend toward improvement with a difference of 0.86 (95% confidence interval; -0.002, 1.71) (P = 0.088) between the groups in changes from baseline to 12 months. The present study suggests regular consumption of matcha could improve emotional perception and sleep quality in older adults with mild cognitive decline. Given the widespread availability and cultural acceptance of matcha green tea, incorporating it into the daily routine may offer a simple yet effective strategy for cognitive enhancement and dementia prevention.

Association of dysphagia and loneliness and their interaction with sleep quality among older adults in nursing homes: A cross-sectional study.

Poor sleep quality is a risk factor for many adverse health outcomes and has become a widespread and serious public health problem, especially among older adults. This study aimed to explore the association between dysphagia, loneliness, and their interaction with sleep quality among older Chinese adults living in nursing homes. This cross-sectional study used multistage cluster random sampling to select 56 nursing homes in Hunan Province, China. Data on sociodemographic characteristics, health-related status, lifestyle, and behavioral and social psychological factors were collected. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. The 30 mL Water Swallowing Test and Eating Assessment Tool-10 items were used to screen for dysphagia, and the 14th item of the Center for Epidemiologic Studies Depression Scale was used to measure loneliness. Binary logistic regression models were used to analyze the relationship between poor sleep quality, dysphagia, and loneliness. The interaction between these variables was evaluated using multiplicative and additive interaction models. This study included 3,356 older adults aged 60 and above. The mean Pittsburgh Sleep Quality Index score was 6.31 ± 3.11, and the incidence of poor sleep quality was 30.8%. A total of 642 (19.1%) older adults had dysphagia, and 1,358 (40.5%) experienced loneliness. After adjusting for all covariates, dysphagia and loneliness were associated with an increased risk of poor sleep quality. The interaction analysis demonstrated that the risk of poor sleep quality among older adults with dysphagia and loneliness was 3.476 times higher than that in those without dysphagia and loneliness. Dysphagia and loneliness had an additive interaction effect on poor sleep quality in older adults living in nursing homes. Poor sleep quality can be effectively prevented by focusing on older adults in nursing homes experiencing dysphagia, loneliness, or both and implementing targeted health interventions.

The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study

BackgroundSleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults.MethodsIn this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016–2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis.ResultsThe mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66).ConclusionsThe results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.

How Do Older Patients with End-Stage Osteoarthritis of the Hip Eat Prior to Hip Replacement? A Preliminary Snapshot That Highlights a Poor Diet

Diet quantity and quality in older adults is critical for the proper functioning of the musculoskeletal system. In view of hip surgery, old patients should consume 1.2–1.5 g of proteins and 27–30 kcal per kilo of body weight daily, and adhere to healthy eating habits. In this analytical study, we studied diet quantity and quality in relation to the clinical chemistry and functional status of 57 older adults undergoing elective hip replacement. Nine in ten patients did not meet suggested protein and energy intakes and only one in ten patients exhibited high adherence to the Mediterranean diet. Legume consumption adjusted for sex, age, body mass index, and health status successfully forecasted haemoglobin levels (p &lt; 0.05), and patients regularly consuming olive oil reported minor hip disability compared to those using it less frequently (p &lt; 0.05). Patients who reported daily ingestion of &lt;1 serving of meat versus those consuming &gt;1.5 servings had greater cumulative comorbidity (p &lt; 0.05), with meat consumption independently predicting walking ability, mobility, and balance in the fully adjusted model (p &lt; 0.01). In conclusion, our patients seem to eat poorly. There is room for improvement in pre-operative pathways to make older adults eat better, but there is a need to plan an interventional study to fully understand the cause–effect of a dietary pattern or specific food in enhancing recovery after surgery.

The quality of older adults’ involvement in clinical communication with general practitioners: evidence from rural towns in Australia

ObjectiveA study was conducted about the putative links of older rural Australians’ health knowledge and preparation with their quality of involvement in patient-general practitioner (GP) communication during health intake visits. MethodsIt was a cross-sectional study between January 2021 and April 2022. The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software. This online survey was administered by sending an email request to the Renmark Rotary Club, which actively promoted this study across five rural towns in South Australia. 121 participants completed the surveys. Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes, specifically initiation of information, active participation, and emotional expression. We employed different methods including t-tests, ANOVA, and leaner regressions to analyse data. ResultsThe demographic profile of participants characterised by a female predominance (58.7%, 71/121), a majority falling within the 65‒< 70 age bracket (47.1%, 57/121), and a high level of educational attainment (58.7% had completed high school or higher, 71/121). Additionally, 35% of the participants predominantly spoke a language other than English at home. Regarding the initiation of information with GPs, the mean sum-score was (20.5 ± 3.7), indicating a marginally above-average level of engagement. Contrarily, the active participation was suboptimal, as suggested by a mean sum score of (35.9 ± 6.3). Furthermore, the emotional expression was relatively low, with a mean score of (13.9 ± 1.8). Substantial variations were discerned in the quality of patient-GP communication, contingent upon factors such as educational background, language spoken at home, health literacy, and preparatory measures for clinical visits. Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs (P < 0.001). Higher educational attainment was positively correlated with increased active participation (P < 0.001). Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation (P < 0.001). ConclusionMeaningful engagement through recognition, empowerment, and support (health literacy programs) for older rural adults is suggested for improving their quality of involvement in communication with GPs.

Effects of Temperature, Duration, and Heating Height of Foot Thermal Therapy on Sleep Quality of Older Adults: A Systematic Review and Meta-Analysis.

Background: Sleep disturbances, which are common problems in older adults, often lead to cognitive decline and depression and may even increase mortality risk. Foot thermal therapy is a simple and safe approach for improving sleep and is associated with relatively few side effects. However, the effect of different operations of foot thermal therapy on sleep quality in older adults is inconclusive. This study aimed to access the effects of temperature, duration, and heating height of foot thermal therapy (administered through a footbath) on the subjective and objective sleep quality of older adults. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, eight databases were searched for all relevant articles published up to July 2023, and a rigorous systematic review and meta-analysis was conducted. This study was registered in the PROSPERO database (CRD42022383460). Inclusion criteria were: (1) participants with a mean age ≥60 years; (2) interventions that included foot thermal therapy; (3) a control group that received routine care but no thermal therapy; (4) outcome measurements that assessed sleep quality; and (5) the studies that utilized randomized controlled trials or quasi-experimental studies. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. The meta-analysis was performed using RevMan version 5.4. Results: A total of 11 studies were included. Foot thermal therapy before bedtime improved subjective sleep quality in older adults, with optimal parameters of 40°C temperature (standardized mean difference [SMD] = 0.66, 95% confidence interval [CI]: 0.33 to 0.99), ≤20-min duration (SMD = 0.66, 95% CI: 0.39 to 0.93), and 10 cm heating height (SMD = 0.78, 95% CI: 0.45 to 1.11). Subgroup analyses revealed that a temperature of 41°C-42°C can improve objective sleep latency (SMD = 0.54, 95% CI: 0.09 to 0.99). Conclusions: It is recommended to administer foot thermal therapy (40°C; ≤20 min; 10 cm above the ankle) to older adults 1 h before their bedtime. If they have trouble falling asleep, the temperature can be increased to 41°C-42°C.

Unraveling the Nexus: Exploring the Relationship between Exercise Habits and Sleep Quality in Older Adults.

The objective of this study is to investigate the impact of exercise habits on enhancing the sleep quality of older adults. The Pittsburgh Sleep Quality Scale and other questionnaires were utilized to assess the sleep quality of older adults aged 60 years and above in the H district. The sampling method employed was stratified random sampling. To analyze the influencing factors of sleep quality, the average treatment effect was estimated, the robustness of the results was assessed and statistical methods such as Logit regression and propensity score matching were employed. The study revealed that exercise habits strongly correlated with improved sleep quality in the older adult (p < 0.05), with the average total sleep quality score being 6.22 (±3.53). It was observed that older adults who engaged in exercise habits experienced a significant 12.66% increase in the likelihood of achieving good sleep. This investigation highlights the positive association between exercise habits and enhanced sleep quality among older adults. Additionally, age, physical pain and self-rated health statuses were identified as significant factors influencing sleep quality in this population. To enhance the sleep quality of older adults, this article recommends promoting relevant exercise habits, thus contributing to their overall well-being and quality of life.

Sleep Quality and Associated Factors Among Older Adults in Tabriz, Iran: Tabriz Older People Health Survey (TOPS-2019)

Objectives: The study aimed to investigate the sleep quality of aged people in Tabriz and identify its associated factors. Design: Cross-sectional study. Setting(s): Tabriz, the capital of the East Azerbaijan province in northwest Iran. Participants: A total of 1362 participants were selected from a representative sample of community-dwelling older people aged≥60 years who were living in Tabriz, using the probability proportional to size (PPS) sampling method. Outcome measures: Blood pressure (BP), sleep quality, depression, anxiety, loneliness, physical activity, daily activities, living independently, and social support were assessed using a standard mercury sphygmomanometer, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), the 6-item De Jong Gierveld Loneliness Scale, Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), respectively. Results: The mean score of total PSQI was 5.39±2.91. The multivariable logistic regression model showed that being female (Odds ratio [OR]=1.68, 95% confidence interval [CI]=1.29 to 2.18), hypertensive (OR=2.12, 95% CI=1.52 to 2.95), diabetes mellitus (DM) (OR=1.29, 95% CI=0.96 to 1.72), abnormal anxiety level (OR=2.38, 95% CI=1.67 to 3.38), and low PASE score (OR=0.99, 95% CI=0.99 to 1) were significantly associated with a higher risk of poor sleep quality. Conclusions: Low physical activity is a modifiable risk factor for low sleep quality in older adults. Hence, the development of physical activity programs can be effective in improving sleep quality. Furthermore, women are the priority in designing interventions.

Sex Difference in the Association Between Sedentary Behavior and Sleep Quality: A Longitudinal Study Among Older Adults in Rural China.

Sleep quality plays a vital role in maintaining health in older adults. Sedentary behavior may be a risk factor for poor sleep quality in older adults. This study aimed to explore the relationship between sedentary behavior and sleep quality among older adults in rural China and determine whether there is a sex difference in this association. A longitudinal design. The data used in this study were obtained from the Shandong Rural Elderly Health Cohort (wave 1: 2019, wave 2: 2020). Data were from 2731 individuals aged ≥60years from rural areas in China. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sedentary behavior and control variables were measured using self-reported questions. Multivariable logistic regression and generalized estimating equations were used to assess the associations. After full adjustment, the association between sedentary behavior and poor sleep quality was statistically significant [odds ratio (OR) 1.49, 95% CI 1.20-1.85]. Specifically, a longer sedentary time was associated with worse subjective sleep quality, less sleep latency, and lower habitual sleep efficiency (OR 1.39-1.58). A significant association was observed in women but not men. Older adults who spend more time engaging in sedentary activities have poorer sleep quality and more sleep problems. Prolonged sedentary time is more detrimentally associated with poor sleep quality in women than men. There is a need for tailored exercise prescriptions and guidelines to stimulate older adults of different sexes to change their sedentary behavior, which may improve sleep quality in older adults.

Uneven surface and cognitive dual-task independently affect gait quality in older adults

BackgroundReal-world mobility involves walking in challenging conditions. Assessing gait during simultaneous physical and cognitive challenges provides insights on cognitive health. Research questionHow does uneven surface, cognitive task, and their combination affect gait quality and does this gait performance relate to cognitive functioning? MethodsCommunity-dwelling older adults (N = 104, age=75 ± 6 years, 60 % females) performed dual-task walking paradigms (even and uneven surface; with and without alphabeting cognitive task (ABC)) to mimic real-world demands. Gait quality measures [speed(m/s), rhythmicity(steps/minute), stride time variability (%), adaptability (m/s2), similarity, smoothness, power (Hz) and regularity] were calculated from an accelerometer worn on the lower back. Linear-mixed modelling and Tukey analysis were used to analyze independent effects of surface and cognitive task and their interaction on gait quality. Partial Spearman correlations compared gait quality with global cognition and executive function. ResultsNo interaction effects between surface and cognitive task were found. Uneven surface reduced gait speed(m/s) (β = –0.07). Adjusted for speed, uneven surface reduced gait smoothness (β = –0.27) and increased regularity (β = 0.09), Tukey p < .05, for even vs uneven and even-ABC vs uneven-ABC. Cognitive task reduced gait speed(m/s) (β = –0.12). Adjusted for speed, cognitive task increased variability (β = 7.60), reduced rhythmicity (β = –6.68) and increased regularity (β = 0.05), Tukey p < .05, for even vs even-ABC and uneven vs uneven-ABC. With demographics as covariates, gait speed was not associated with cognition. Gait quality [lower variability during even-ABC (ρp =–.31) and uneven-ABC (ρp =–.28); greater rhythmicity (ρp between.22 and.29) and greater signal-adaptability AP (ρp between.22 and.26) during all walking tasks] was associated with better global cognition. Gait adaptability during even (ρp =–0.21, p = 0.03) and uneven(ρp =–0.19, p = 0.04) walking was associated with executive function. SignificanceSurface and cognitive walking tasks independently affected gait quality. Our study with high-functioning older adults suggests that task-related changes in gait quality are related to subtle changes in cognitive functioning.

Association of spermidine blood levels with microstructure of sleep—implications from a population-based study

Deteriorations in slow wave sleep (SWS) have been linked to brain aging and Alzheimer’s disease (AD), possibly due to its key role in clearance of amyloid-beta and tau (Aß/tau), two pathogenic hallmarks of AD. Spermidine administration has been shown to improve sleep quality in animal models. So far, the association between spermidine levels in humans and parameters of SWS physiology are unknown but may be valuable for therapeutic strategies. Data from 216 participants (age range 50–81 years) of the population-based Study of Health in Pomerania TREND were included in our analysis. We investigated associations between spermidine plasma levels, key parameters of sleep macroarchitecture and microarchitecture that were previously associated with AD pathology, and brain health measured via a marker of structural brain atrophy (AD score). Higher spermidine levels were significantly associated with lower coupling between slow oscillations and spindle activity. No association was evident for SWS, slow oscillatory, and spindle activity throughout non-rapid eye movement sleep. Furthermore, elevated spermidine blood levels were significantly associated with a higher AD score, while sleep markers revealed no association with AD score. The association between higher spermidine levels and brain health was not mediated by coupling between slow oscillations and spindle activity. We report that higher spermidine blood levels are associated not only with deteriorated brain health but also with less advantageous markers of sleep quality in older adults. Future studies need to evaluate whether sleep, spermidine, and Aß/tau deposition are interrelated and whether sleep may play a mediating role.

Nighttime ambient temperature and sleep in community-dwelling older adults

This longitudinal study examines the association between bedroom nighttime temperature and sleep quality in a sample of community dwelling older adults. Using wearable sleep monitors and environmental sensors, we assessed sleep duration, efficiency, and restlessness over an extended period within participants' homes while controlling for potential confounders and covariates. Our findings demonstrated that sleep was most efficient and restful when nighttime ambient temperature ranged between 20 and 25 °C, with a clinically relevant 5–10 % drop in sleep efficiency when the temperature increased from 25 °C to 30 °C. The associations were primarily nonlinear, and substantial between-subject variations were observed. These results highlight the potential to enhance sleep quality in older adults by optimizing home thermal environments and emphasize the importance of personalized temperature adjustments based on individual needs and circumstances. Additionally, our study underscores the potential impact of climate change on sleep quality in older adults, particularly those with lower socioeconomic status, and supports increasing their adaptive capacity in the face of a changing climate.

The association between nutritional status and sleep quality of Chinese community-dwelling older adults.

Sleep disorders are a common syndrome and could affect the life quality of the older adults. This study aimed to investigate the association between nutritional status and sleep quality in the Chinese community-dwelling older adults. A total of 2,878 participants ≥ 65years old from the Yiwu Elderly Cohort were included in the study. Nutritional status was assessed using the Mini Nutritional Assessment Short Form (MNA-SF). Participants were categorized as subjects with malnutrition, at risk of malnutrition or well-nourished based on their MNA-SF score. Pittsburgh Sleep Quality Index (PSQI) was used to identify sleep disorders. PSQI score ≥ 6 was categorized as poor sleep quality. Among the 2,878 participants (mean age 72.71 ± 5.79years, 50.3% men), 31.5% (n = 906) were classified as having sleep disorders, and 25.5% were identified as malnutrition or at risk of malnutrition. We found a significantly relationship between nutritional status and sleep quality in older adults, and the results showed well-nourished decreased the risk of sleep disorders (OR = 0.32, 95% CI = 0.13, 0.75). And well-nourished status was significantly associated with less daytime dysfunction, adequate sleep duration, and good subjective sleep quality (all P < 0.05). There was a close association of nutritional status and sleep quality in older adults. We should pay more attention to the nutritional status of older people with sleep problems, as well as the sleep quality of older adults with malnutrition.

The Association Between Essential Metal Element Mixture and Sleep Quality in Chinese Community-Dwelling Older Adults.

Previous studies have related single essential metal elements (EMEs) to sleep quality among older adults, however, the association of the EME mixture with sleep quality remained poorly understood. This study aimed to investigate the relationships between single EMEs and the EME mixture and sleep quality in older adults living in Chinese communities. This study consisted of 3957 older adults aged 60years or over. Urinary concentrations of cobalt (Co), vanadium (V), selenium (Se), molybdenum (Mo), strontium (Sr), calcium (Ca), and magnesium (Mg) were detected using inductively coupled plasma mass spectrometry. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI). The associations of single EMEs and EME mixture with sleep quality were assessed using logistic regression and Bayesian kernel machine regression (BKMR) models, respectively. Adjusted single-element logistic regression models showed that Mo (OR = 0.927, 95%CI:0.867-0.990), Sr (OR = 0.927, 95%CI:0.864-0.994), and Mg (OR = 0.934, 95%CI:0.873-0.997) were negatively related to poor sleep quality. BKMR models exhibited similar results. Also, higher levels of the EME mixture in urine were inversely related to the odds of poor sleep quality after adjustment for covariates, and Mo had the largest conditional posterior inclusion probability (condPIP) value in the mixture. Mo, Sr, and Mg were negatively related to poor sleep quality, separately and as the mixture. The EME mixture in urine was associated with decreased odds of poor sleep quality in older adults, and Mo was the greatest contributor within the mixture. Additional cohort research is warranted to clarify the relationship of multiple EMEs with sleep quality.