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1.
J Adolesc ; 76: 48-54, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31442814

RESUMO

INTRODUCTION: E-cigarette use is highly prevalent among adolescents. However, little research has examined the relationship between e-cigarette use and sleep-related complaints in this population. The objective of this study was to assess whether exclusive e-cigarette, exclusive combusted cigarette, and dual-product use are associated with sleep-related complaints among adolescents. METHODS: Participants were 9,588 U.S. adolescents from the Population Assessment of Tobacco and Health Study, a nationally representative cohort, followed from 2013 through 2015. Using logistic regression, we examined the cross-sectional association between past-year e-cigarette, combusted cigarette, or dual-product use and past-year sleep-related complaints (bad dreams, sleeping restlessly, or falling asleep during the day), both measured at Wave 2. We controlled for Wave 1 demographic characteristics, emotional and behavioral health, and prior history of e-cigarette use, combusted cigarette use, and sleep-related complaints. RESULTS: In unadjusted analyses, e-cigarette, combusted cigarette, and dual-product use were significantly associated with greater odds of sleep-related complaints, compared to use of neither product (e-cigarettes: OR = 1.61, 95% CI 1.34-1.94; combusted cigarettes: OR = 1.62, 95% CI 1.26-2.09; dual-product use: OR = 2.00, 95% CI 1.63-2.46). Associations between e-cigarette and dual-product use and sleep-related complaints remained significant in fully adjusted analyses (e-cigarettes: aOR = 1.29, 95% CI 1.05-1.59; dual-product use: aOR = 1.57, 95% CI 1.24-1.99), whereas associations with combusted cigarette use were significant in all models except the fully adjusted model (aOR = 1.30, 95% CI 0.98-1.71). CONCLUSIONS: E-cigarette and dual-product use are significantly associated with greater odds of reporting sleep-related complaints among adolescents. Future research should evaluate whether this association may be causal.

2.
Am J Geriatr Psychiatry ; 27(12): 1386-1396, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31353188

RESUMO

OBJECTIVE: Excessive and insufficient sleep have been associated with cognitive dysfunction in older adults in U.S. and non-U.S. STUDIES: However, the U.S. studies were not in nationally representative samples. The authors investigated the association between sleep duration and cognitive performance in a nationally representative sample of U.S. older adults. PARTICIPANTS: The authors studied 1,496 survey participants aged 60 years or older from the National Health and Nutrition Examination Survey 2013-2014 dataset. MEASUREMENTS: Our primary predictor was weekday (or workday) nighttime sleep duration, categorized as 2-4, 5, 6, 7 (reference), 8, 9, and 10 hours or more. The authors studied five cognitive outcomes: Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL) immediate recall, CERAD-WL delayed recall, Animal Fluency Test (AFT), Digital Symbol Substitution Test (DSST), and subjective cognitive problems (SCP). RESULTS: After adjusting for age, sex, race, education, depressive symptoms, and sedative-hypnotic use, sleep duration of 10 hours or more was significantly associated with lower scores on CERAD-WL immediate recall, CERAD-WL delayed recall, AFT, and DSST, and greater odds of SCP; sleep duration of 8 hours or more was associated with lower CERAD-WL delayed recall scores: 8, 9, and 10 hours or more. After adjustment, there were no significant associations of shorter sleep duration with cognition. CONCLUSION: In U.S. adults aged 60 years or older, long nighttime weekday or workday sleep duration is associated with poorer verbal memory, semantic fluency, working memory, and processing speed in addition to greater odds of self-reported cognitive problems. Long sleep duration may be a marker of fragmented sleep or neurodegeneration in U.S. older adults.

4.
Int J Geriatr Psychiatry ; 34(7): 1008-1017, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30901482

RESUMO

INTRODUCTION: The reasons why women are at higher risk than men for developing dementia are unclear. Although studies implicate sex differences in the effect of stress on cognitive functioning, whether stressful life events are associated with subsequent cognitive decline has received scant research attention. METHODS: In Wave 3 (1993-1996) of the Baltimore Epidemiologic Catchment Area study, 337 men and 572 women (mean age = 47 years) reported recent (within the last year) and remote (from 1981 until 1 year ago) traumatic events (eg, combat) and stressful life events (eg, divorce/separation). At Waves 3 and 4 (2004-2005), they completed the Mini Mental State Examination (MMSE) and a word-list memory test. Multivariable models were used to examine the association between traumatic and stressful life events at Wave 3 and cognitive change by Wave 4. RESULTS: A greater number of recent stressful life events at Wave 3, but not of more remote stressful events, was associated with greater verbal memory decline by Wave 4 in women but not in men. Stressful events were not associated with change in MMSE, and there were no associations between traumatic events occurring at any time and subsequent memory or MMSE decline in either sex. CONCLUSIONS: Unlike men, middle-aged women with a greater number of recent stressful life events demonstrate memory decline over a decade later. Sex differences in cognitive vulnerability to stressful life events may underlie women's increased risk of memory impairment in late life, suggesting that stress reduction interventions may help prevent cognitive decline in women.

5.
J Gerontol A Biol Sci Med Sci ; 74(4): 560-567, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30357322

RESUMO

BACKGROUND: With aging, daily physical activity (PA) becomes less frequent and more fragmented. Accumulation patterns of daily PA-including transitions from active-to-sedentary behaviors-may provide important insights into functional status in older, less active populations. METHODS: Participants of the Baltimore Longitudinal Study of Aging (n = 680, 50% male, aged 27-94 years) completed a clinical assessment and wore an Actiheart accelerometer. Transitions between active and sedentary states were modeled as a probability (Active-to-Sedentary Transition Probability [ASTP]) defined as the reciprocal of the average PA bout duration. Cross-sectional associations between ASTP and gait speed (m/s), fatigability (rating-of-perceived-exertion [RPE]), 400 m time (seconds), and expanded short physical performance battery score were modeled using linear and logistic regression, adjusted for chronic conditions. Further analyses explored the utility of ASTP over-and-above total daily PA. RESULTS: In continuous models, each 0.10-unit higher ASTP was associated slower gait (ß = -0.06 m/s, SE = 0.01), higher fatigability (ß = 0.60 RPE, SE = 0.12), slower 400 m time (ß = 16.31 s, SE = 2.70), and lower functioning (ß = -0.13 expanded short physical performance battery score, SE = 0.03; p < .001). In categorical analyses, those in the highest tertile of ASTP were >2 times more likely to have high fatigability (rating of perceived exertion ≥10), slow 400 m time (>300 seconds) and reduced functional performance (expanded short physical performance battery score < 3.07) than those in the lowest tertile (p < .01). Further analyses demonstrated ASTP provided additional insight into functional outcomes beyond total daily PA. CONCLUSION: Fragmented daily PA-as measured by ASTP-is strongly linked with measures of health and functional status and may identify those at risk of high fatigability and reduced functional performance over and above traditional PA metrics.

6.
Int J Geriatr Psychiatry ; 34(1): 87-96, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30311961

RESUMO

OBJECTIVES: To determine the association of napping intention, frequency, and duration with cognition in a nationally-representative sample of US older adults. METHODS: We performed a cross-sectional analysis of community-dwelling Medicare beneficiaries aged ≥65 years from Rounds 3 or 4 (2013-2014) of the National Health and Aging Trends Study (N = 2549). Participants reported past-month napping intention (intentional/unintentional), napping frequency (rarely/never [non-nappers], some days [infrequent nappers], most days/every day [frequent nappers]), and average nap duration (we categorized as ≤30 minutes [short]; 31-60 minutes [moderate]; and > 60 minutes [long]). Cognitive outcomes were performance on immediate and delayed word recall tests (IWR and DWR, respectively), the Clock Drawing Test (CDT), and self-rated memory (score: 1[excellent]-5[very poor]). RESULTS: After adjustment for potential confounders, unintentional nappers had poorer immediate word recall test performance than non-nappers (B = -0.23, P < 0.01) and intentional nappers (B = -0.26, P < 0.01). After further adjustment for daytime sleepiness, frequent nappers reported poorer self-rated memory than non-nappers (B = 0.14, P < 0.05). Compared with short nappers, long nappers had poorer IWR (B = -0.26, P < 0.05) and CDT scores (B = -0.17, P < 0.05). Except for the association of nap duration with IWR and CDT, these associations remained after excluding participants with dementia and/or proxy respondents. Among participants undiagnosed with dementia or proxies, moderate-duration naps were associated with better DWR than short naps (B = 0.24, P < 0.05). Neither napping intentionality nor frequency was associated with CDT performance. CONCLUSIONS: Among older adults, distinct aspects of napping are associated with cognitive performance. Prospective research, with objective measures of napping, is needed to elucidate the link between napping and cognitive trajectories.


Assuntos
Cognição/fisiologia , Sono/fisiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Rememoração Mental/fisiologia , Testes Neuropsicológicos , Estudos Prospectivos , Fatores de Tempo
7.
Occup Environ Med ; 75(12): 856-862, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30323011

RESUMO

OBJECTIVES: To investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study. METHODS: The sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993-1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004-2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition. RESULTS: Participants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: -0.24, 95% CI -0.36 to -0.11; verbal memory scores: -0.26, 95% CI -0.44 to -0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors. CONCLUSIONS: Findings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.


Assuntos
Transtornos Cognitivos/etiologia , Emprego/psicologia , Estresse Psicológico/etiologia , Adulto , Baltimore , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
9.
Sleep ; 41(10)2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30192978

RESUMO

Study Objectives: To determine the association of excessive daytime sleepiness (EDS) and napping with subsequent brain ß-amyloid (Aß) deposition in cognitively normal persons. Methods: We studied 124 community-dwelling participants in the Baltimore Longitudinal Study of Aging Neuroimaging Substudy who completed self-report measures of EDS and napping at our study baseline and underwent [11C] Pittsburgh compound B positron emission tomography (PiB PET) scans of the brain, an average ±standard deviation of 15.7 ± 3.4 years later (range 6.9 to 24.6). Scans with a cortical distribution volume ratio of >1.06 were considered Aß-positive. Results: Participants were aged 60.1 ± 9.8 years (range 36.2 to 82.7) at study baseline; 24.4% had EDS and 28.5% napped. In unadjusted analyses, compared with participants without EDS, those with EDS had more than 3 times the odds of being Aß+ at follow-up (odds ratio [OR] = 3.37, 95% confidence interval [CI]: 1.44, 7.90, p = 0.005), and 2.75 times the odds after adjustment for age, age2, sex, education, and body mass index (OR = 2.75, 95% CI: 1.09, 6.95, p = 0.033). There was a trend-level unadjusted association between napping and Aß status (OR = 2.01, 95% CI: 0.90, 4.50, p = 0.091) that became nonsignificant after adjustment (OR = 1.86, 95% CI: 0.73, 4.75, p = 0.194). Conclusions: EDS is associated with more than 2.5 times the odds of Aß deposition an average of 15.7 years later. If common EDS causes (e.g., sleep-disordered breathing, insufficient sleep) are associated with temporally distal AD biomarkers, this could have important implications for AD prevention.


Assuntos
Peptídeos beta-Amiloides/análise , Química Encefálica , Cognição , Tomografia por Emissão de Pósitrons/métodos , Sonolência , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Baltimore , Biomarcadores/análise , Índice de Massa Corporal , Encéfalo/metabolismo , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Razão de Chances , Sono/fisiologia , Síndromes da Apneia do Sono
10.
J Reprod Immunol ; 128: 9-15, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29803192

RESUMO

Pregnant women experience more sleep disturbances and greater systemic inflammation than non-pregnant women. However, the few studies that have examined the links between sleep and inflammation in pregnant women have been in clinical samples. We examined whether sleep duration is associated with C-reactive protein (CRP) levels, a marker of inflammation, in pregnant and non-pregnant women in a population-based sample of US women. Participants were 2865 women of reproductive age (aged 20-44 years) in the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of Americans. Sleeping <5 h on weeknights or workdays was significantly associated with increased CRP levels among both pregnant and non-pregnant women in unadjusted analyses; however, after adjustment for demographic, and health-related variables (depressive symptoms, self-rated health status, body mass index (BMI), diabetes), sleeping <5 h was no longer significantly related to CRP levels. Pregnant women had significantly higher CRP levels, after adjusting for sleep duration, demographic, and health-related variables. Our findings suggest that pregnancy is associated with increased peripheral CRP, after adjustment for sleep duration, demographic, and health factors. Further, in both pregnant and non-pregnant U.S. women of reproductive age, short sleep duration is associated with higher CRP levels, but this link is explained by self-rated health, BMI, and diabetes. Further studies are needed to investigate links of other sleep parameters (e.g., sleep fragmentation) with CRP in these populations.


Assuntos
Proteína C-Reativa/análise , Transtornos do Sono-Vigília/sangue , Sono/fisiologia , Adulto , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Inflamação/fisiopatologia , Inquéritos Nutricionais , Gravidez , Autorrelato , Transtornos do Sono-Vigília/fisiopatologia , Estados Unidos , Adulto Jovem
11.
Metabolism ; 84: 85-93, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29409842

RESUMO

Type 2 diabetes (T2D) and sleep disturbance (e.g., insomnia, sleep-disordered breathing) are prevalent conditions among older adults that are associated with cognitive decline and dementia, including Alzheimer's disease (AD). Importantly, disturbed sleep is associated with alterations in insulin sensitivity and glucose metabolism, and may increase the risk of T2D, and T2D-related complications (e.g., pain, nocturia) can negatively affect sleep. Despite these associations, little is known about how interactions between T2D and sleep disturbance might alter cognitive trajectories or the pathological changes that underlie dementia. Here, we review links among T2D, sleep disturbance, cognitive decline and dementia-including preclinical and clinical AD-and identify gaps in the literature, that if addressed, could have significant implications for the prevention of poor cognitive outcomes.


Assuntos
Demência/etiologia , Diabetes Mellitus Tipo 2/complicações , Transtornos do Sono-Vigília/complicações , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/fisiopatologia , Demência/epidemiologia , Demência/fisiopatologia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/etiologia , Complicações do Diabetes/psicologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/psicologia , Humanos , Fatores de Risco , Sono/fisiologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia
12.
JAMA Psychiatry ; 75(3): 303, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29365028
14.
Chronobiol Int ; 35(3): 416-434, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29283283

RESUMO

BACKGROUND: We propose a method for estimating the timing of in-bed intervals using objective data in a large representative US sample, and quantify the association between these intervals and age, sex, and day of the week. METHODS: The study included 11,951 participants 6 years and older from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, who wore accelerometers to measure physical activity for seven consecutive days. Participants were instructed to remove the device just before the nighttime sleep period and put it back on immediately after. This nighttime period of non-wear was defined in this paper as the objective bedtime (OBT), an objectively estimated record of the in-bed interval. For each night of the week, we estimated two measures: the duration of the OBT (OBT-D) and, as a measure of the chronotype, the midpoint of the OBT (OBT-M). We estimated day-of-the-week-specific OBT-D and OBT-M using gender-specific population percentile curves. Differences in OBT-M (chronotype) and OBT-D (the amount of time spent in bed) by age and sex were estimated using regression models. RESULTS: The estimates of OBT-M and their differences among age groups were consistent with the estimates of chronotype obtained via self-report in European populations. The average OBT-M varied significantly by age, while OBT-D was less variable with age. In the reference group (females, aged 17-22 years), the average OBT-M across 7 days was 4:19 AM (SD = 30 min) and the average OBT-D was 9 h 19 min (SD = 12 min). In the same age group the average OBT-D was 18 minutes shorter for males than for females, while the average OBT-M was not significantly different between males and females. The most pronounced differences were observed between OBT-M of weekday and weekend nights. In the reference group, compared to the average OBT-M of 3:50 am on Monday through Thursday nights, there was a 57-minute delay in OBT-M on Friday nights (entering the weekend), a 69-minute delay on Saturday nights (staying in the weekend), and a 23-minute delay on Sunday night (leaving the weekend). For both OBT-M and OBT-D, in most age groups and for most days of the week, there were no statistically significant differences between males and females, except for OBT-D on Wednesdays and Thursdays, with males having 31 (p-value < 0.05) and 45 (p-value < 0.05) minutes shorter OBT-D, respectively. CONCLUSIONS: The proposed measures, OBT-D and OBT-M, provide useful information of time in bed and chronotype in NHANES 2003-2006. They identify within-week patterns of bedtime and can be used to study associations between the bedtime and the large number of health outcomes collected in NHANES 2003-2006.


Assuntos
Ritmo Circadiano/fisiologia , Inquéritos Nutricionais , Sono , Acelerometria , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Autorrelato , Fatores de Tempo , Estados Unidos , Adulto Jovem
15.
Psychiatr Serv ; 69(2): 235-238, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29089011

RESUMO

OBJECTIVE: Clinical guidelines suggest that benzodiazepines (BZDs) and non-BZD hypnotics (NBHs) be used on a short-term basis. The authors examined trends in long-term BZD and NBH use from 1999 to 2014. METHODS: Data included 82,091 respondents in the 1999-2014 waves of the National Health and Nutrition Examination Survey (NHANES). NHANES recorded medications used in the past 30 days on the basis of prescription bottles, and participants reported use duration. BZD and NBH use were categorized as short, medium, and long term, and time trends in use were assessed. RESULTS: BZD and NBH use increased from 1999 to 2014, driven by increases in medium- and long-term use, even after adjustment for age and race-ethnicity. In most years, only a fifth of current BZD or NBH users reported short-term use. CONCLUSIONS: Long-term BZD and NBH use has grown independent of U.S. demographic shifts. Monitoring of use is needed to prevent adverse outcomes.


Assuntos
Benzodiazepinas/administração & dosagem , Uso de Medicamentos/tendências , Hipnóticos e Sedativos/administração & dosagem , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Adolescente , Adulto , Idoso , Benzodiazepinas/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estados Unidos , Adulto Jovem
16.
J Gerontol A Biol Sci Med Sci ; 73(3): 380-385, 2018 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-28329301

RESUMO

Background: Anemia is associated with poorer sleep in children, and clinically, anemia is linked to insomnia. However, the association between anemia and insomnia in older adults is understudied. Methods: We examined the cross-sectional association between anemia and insomnia in 1,053 adults (71.4 ± 10.6 years) in the Baltimore Longitudinal Study of Aging. Participants were classified as nonanemic, non-iron-deficient anemic, or iron-deficient anemic based on hemoglobin, ferritin, transferrin saturation, and mean cell volume. Insomnia symptoms were evaluated by the Women's Health Initiative Insomnia Rating Scale (WHIIRS). A total score (range 0-20) was generated, and participants were also classified as having 0, 1, or 2+ symptoms. Results: Overall, 10.5% of participants had non-iron-deficient anemia, 0.9% had iron-deficient anemia, and 88.5% had no anemia. Due to its low prevalence, the iron-deficient anemic group was dropped from analyses. In models adjusted for demographics, number of medical conditions, and Center for Epidemiologic Studies Depression Scale score, non-iron-deficient anemic individuals had significantly higher WHIIRS total scores, indicating greater insomnia severity, compared to those without anemia (predicted adjusted mean WHIIRS of 7.24 [95% confidence interval (CI): 6.40-8.08] vs 5.92 [95% CI: 5.65-6.19]). They also had twice the risk of reporting ≥2 insomnia symptoms (vs 0 symptoms; relative risk ratio = 2.20, 95% CI: 1.25-3.89). Conclusions: Results suggest that individuals with non-iron-deficient anemia are more likely to experience insomnia symptoms than those who are nonanemic. These results may have implications for insomnia treatment or the identification of underlying frailty in individuals with sleep problems.


Assuntos
Anemia/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Baltimore/epidemiologia , Estudos Transversais , Feminino , Humanos , Vida Independente , Estudos Longitudinais , Masculino , Prevalência
17.
J Gerontol B Psychol Sci Soc Sci ; 73(3): 413-420, 2018 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-28379498

RESUMO

Objectives: To better understand links between anxiety and sleep disturbances in older adults, we examined the association of different phenotypic presentations of anxiety (i.e., affective, cognitive, and somatic clusters) with global sleep quality and daytime sleepiness. Methods: 109 community-dwelling adults aged 66-92 years old (57% female) completed assessments of global sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness Scale), affective anxiety symptoms (Geriatric Anxiety Scale (GAS) affective subscale), cognitive anxiety symptoms (GAS cognitive subscale), and somatic anxiety symptoms (GAS somatic subscale). Results: In hierarchical regression models adjusted for depressive symptoms and health status, greater affective and somatic anxiety were associated with poorer global sleep quality (affective B = 0.30, p = .01; somatic B = 0.41, p = .01). Somatic and cognitive anxiety were associated with greater daytime sleepiness (somatic B = 0.74, p < .001; cognitive B = 0.30, p = .03), but these associations were attenuated by covariates added to the models. Discussion: These findings indicate that anxiety symptom clusters are differentially associated with specific sleep-related disturbances, underscoring the complex relationship of late-life anxiety to sleep. Results suggest that personalized treatments, such as targeted sleep interventions, may improve specific anxiety-symptom domains, or vice versa.


Assuntos
Ansiedade/complicações , Fadiga/etiologia , Sono , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e Questionários
18.
Gerontologist ; 58(5): e311-e324, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-28575230

RESUMO

Purpose of the Study: Interest in cognitive training for healthy older adults to reduce cognitive decline has grown considerably over the past few decades. Given the shift toward a more diverse society, the purpose of this review is to examine the extent of race/ethnic minority participation in cognitive training studies and characteristics of studies that included race/ethnic minority participants. Design and Methods: This review considered peer-reviewed studies reporting cognitive training studies for cognitively healthy, community-dwelling older adults (age 55+) in the United States published in English before December 31, 2015. A total of 31 articles published between 1986 and 2015 meeting inclusion criteria were identified and included in the review. Results: A total of 6,432 participants were recruited across all of the studies, and ranged in age from 55 to 99 years. Across all studies examined, 39% reported racial/ethnic background information. Only 3 of these studies included a substantial number of minorities (26.7% in the ACTIVE study; 28.4% in the SeniorWISE study; 22.7% in the TEAM study). Race/ethnic minority older adults were disproportionately underrepresented in cognitive training studies. Implications: Further research should aim to enroll participants representative of various race/ethnic minority populations. Strategies for recruitment and retention of ethnic minority participants in cognitive training research are discussed, which could lead to the development of more culturally appropriate and perhaps more effective cognitive interventions.


Assuntos
Cognição , Disfunção Cognitiva/prevenção & controle , Grupos Étnicos/psicologia , Grupos Minoritários/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
19.
J Gerontol A Biol Sci Med Sci ; 73(5): 630-635, 2018 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-29028920

RESUMO

Background: Fatigability, defined as fatigue in relation to a standardized task, predicts functional decline in older adults independent of reported tiredness or energy level. Although the sensation of fatigue, tiredness, and energy level adversely affect physical activity (PA), the association between fatigability and objectively measured PA is unknown. Methods: Participants in the Baltimore Longitudinal Study of Aging (n = 557, 50% women, aged 50-97 years) were instructed to wear an Actiheart accelerometer for 7 consecutive days in the free-living environment. Perceived fatigability was assessed using the Borg rating of perceived exertion (RPE) after 5 minutes of treadmill walking at 1.5 mph (0.67 m/s) and categorized as low (6-7 RPE), intermediate (8-9 RPE), and high (10+ RPE) fatigability. Time-of-day PA differences between fatigability groups were assessed using mixed-effects modeling. Results: Total daily PA was 1.3% lower for every unit increment in perceived fatigability after adjusting for demographic, behavioral, and medical factors (p = .01). In time-of-day analyses, the high fatigability group was less active compared to the low fatigability group throughout the day (8:00 am to 8:00 pm) and the intermediate fatigability group in the morning (8:00 am to 12:00 pm). Patterns of PA within the high fatigability group differed from both the intermediate and low groups in the morning but mirrored the intermediate group in the afternoon and evening. Discussion: These results suggest that RPE is a bio-marker of fatigability associated with progressively lower PA with aging. Whether the effects of fatigability occurring at the end of the day reflect waning energy levels or a voluntary choice that could be modified remains to be evaluated.


Assuntos
Envelhecimento/fisiologia , Fadiga/fisiopatologia , Atividade Motora/fisiologia , Acelerometria , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Baltimore , Ritmo Circadiano , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
20.
J Gerontol A Biol Sci Med Sci ; 73(3): 367-373, 2018 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-28958012

RESUMO

Background: Napping is associated with both positive and negative health outcomes among older adults. However, the association between particular napping characteristics (eg, frequency, duration, and whether naps were intentional) and daytime function is unclear. Methods: Participants were 2,739 community-dwelling Medicare beneficiaries aged ≥65 years from the nationally representative National Health and Aging Trends Study. Participants reported napping frequency, duration, and whether naps were intentional versus unintentional. Restricted participation in valued activities was measured by self-report. Results: After adjusting for potential confounders and nighttime sleep duration, those who took intentional and unintentional naps had a greater odds of any valued activity restriction (ie, ≥1 valued activity restriction), compared to those who rarely/never napped (unintentional odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.01, 1.79, intentional OR = 1.49, 95% CI 1.09, 2.04). There was no difference between unintentional napping and intentional napping with respect to any valued activity restriction after adjustment for demographics. Compared to participants napping "some days," those napping most days/every day had a greater odds of any valued activity restriction (OR = 1.68, 95% CI 1.30, 2.16). Moreover, each 30-minute increase in average nap duration was associated with a 25% greater odds of any valued activity restriction (OR = 1.25, 95% CI 1.10, 1.43). Conclusion: Older adults who took more frequent or longer naps were more likely to report activity restrictions, as were those who took intentional or unintentional naps. Additional longitudinal studies with objective measures of sleep are needed to further our understanding of associations between napping characteristics and daytime dysfunction.


Assuntos
Atividades Cotidianas , Sono/fisiologia , Idoso , Idoso de 80 Anos ou mais , Ritmo Circadiano , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Fatores de Tempo , Estados Unidos
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