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Associations between Various Sleep-Wake-Related Indicators and Nutritional Status in Community-Dwelling Older Adults: The Yilan Study, Taiwan

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To elucidate the relationship between various sleep-wake-related indicators and nutritional status.

Design

Cross-sectional study.

Setting

Community-based survey between 2017 and 2022 in Yilan City, Taiwan.

Participants

1,905 community-dwelling older adults aged ≥65 years.

Measurements

Nutritional status was evaluated using the Mini Nutritional Assessment, and participants were classified into normal nutritional status and undernutrition groups. Regarding sleep-wake-related indicators, specific items or component scores of the Pittsburgh Sleep Quality Index were used to assess sleep-wake schedule, subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, presence of sleep disturbances, hypnotic use, and dysfunction in maintaining enthusiasm. The 5-item Athens Insomnia Scale and the Epworth Sleepiness Scale were used to evaluate insomnia and excessive daytime sleepiness, respectively.

Results

Of the 1,905 participants, the mean age was 75.6±7.1, with 52.2% being ≥75 years old, 58.9% were women, and 11.4% had undernutrition. After controlling for covariates, short sleepers were less likely to have undernutrition (OR: 0.63; 95% CI: 0.41–0.97); in contrast, long sleepers were more likely to exhibit undernutrition (OR: 1.52; 95% CI: 1.06–2.17). In addition, poor habitual sleep efficiency (OR:1.69; 95% CI:1.15–2.50), taking hypnotics in the past month (OR: 1.58; 95% CI: 1.12–2.24), and dysfunction in maintaining enthusiasm (OR: 1.93; 95% CI: 1.24–2.99) were associated with increased risk of undernutrition.

Conclusions

Among older adults, various sleep-wake-related indicators differed in their relationships with nutritional status. Specific sleep-wake disturbances may indicate undernutrition in this population.

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Abbreviations

AIS:

Athens Insomnia Scale

BMI:

Body Mass Index

CI:

confidence interval

EDS:

Excessive Daytime Sleepiness

ESS:

Epworth Sleepiness Scale

MNA:

Mini Nutritional Assessment

OR:

odds ratio

PSQI:

Pittsburgh sleep quality index

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Acknowledgment

The authors would like to thank Dr. Pesus Chou for helping with the study design, Yang-Ming Crusaders, Mr. Da-Wei Lin, Ms. Yu-Hui Lin, Mr. Chia-Hsiang Lin, and Ms. Tzu-Chun Lo for their help with data collection, and Chia-Ling Liao for her assistance with statistical analyses.

Funding

Funding: This work was supported by the National Science and Technology Council of Taiwan (MOST-108-2314-B-002 -110 -MY2) and (MOST-110-2314-B-002 -096 -MY3). The funding agency had no role in the preparation of this manuscript, including data collection, writing, and analysis.

Author information

Authors and Affiliations

  1. Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan

    R.-A. Lin

  2. Community Medicine Center & Department of Physical Medicine and Rehabilitation, National Yang Ming Chiao Tung University, Taipei, Taiwan

    P.-J. Pan

  3. Community Medicine Research Center & Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    N.-W. Hsu

  4. Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan

    N.-W. Hsu

  5. Public Health Bureau, Yilan County, Taiwan

    N.-W. Hsu

  6. Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, No.7 Chung San South Road, Taipei, 10002, Taiwan

    Hsi-Chung Chen

Authors
  1. R.-A. Lin
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  2. P.-J. Pan
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Contributions

Author’s contribution: R.A.L. and H.C.C. prepared the first draft of this manuscript. H.C.C., P.J.P. and N.W.H. designed the study. H.C.C. performed statistical analyses. All authors participated in the drafting and revision of the manuscript. All the authors have read and approved the manuscript.

Corresponding author

Correspondence to Hsi-Chung Chen.

Ethics declarations

Ethical Standards: This study was approved by the Institutional Review Boards of National Yang-Ming University Hospital (IRB No. 2011A016) and National Taiwan University Hospital (IRB No. 201512116RINC). Written informed consent was obtained from all the participants.

Conflict of Interest: None declared.

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Lin, RA., Pan, PJ., Hsu, NW. et al. Associations between Various Sleep-Wake-Related Indicators and Nutritional Status in Community-Dwelling Older Adults: The Yilan Study, Taiwan. J Nutr Health Aging 27, 861–867 (2023). https://doi.org/10.1007/s12603-023-1984-z

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  • DOI: https://doi.org/10.1007/s12603-023-1984-z

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