Advertisement

Feasibility of the duration of actigraphy data to illustrate circadian rhythm among cognitively intact older people in nursing home: cosinor analysis

  • Ilknur DoluEmail author
  • Nursen O. Nahcivan
Original Article
  • 13 Downloads

Abstract

Assessment of sleep is an important determinant of health. Moreover, sleep assessment is quite difficult in elderly people; getting consent for participation in the study, spending more time due to cognitive and communicative disruptions, having difficulties in accessing to individuals, and higher withdrawal rate of elderly people than adults occur as additional difficulties. The objective of the study was to determine whether 1-day measurement could be enough to determine the circadian rhythm of cognitively intact older adults in nursing home. A sample of the study consisted of individuals living in three nursing homes with similar environmental conditions and who were independent in daily living activities. The exclusion criteria were severe health problems, severe neurological and mental diseases, and severe hearing loss and cognitive impairment. Continuous actigraphy monitoring was performed in 52 older adults who met the sampling criteria over a 4-day period. Cycle mesor, amplitude, acrophase, and R2, calculated using 1 to 4 days of data and each day of data, were compared. For amplitude, acrophase and R2 parameters, there was no statistically significant difference between 4-day measurement and 1-day measurement (p > 0.05). However, for mesor parameter, there was no significant difference between 1-day, 2-day, and 3-day measurements, and differentiation was observed in 4-day measurements. A daily measurement could be used to determine the circadian rhythm of actigraphy in cognitively intact older adults in nursing home. However, further studies are required to better understand and support our findings.

Keywords

Circadian parameters Log transformed Activity count Method 

Notes

Acknowledgements

The authors thank the older adults for participating in this study. The authors also thank Assist. Prof. Dr. Irmak Hurmeric Altunsoz for permitting the use of the actigraph.

Author contributions

All authors contributed to study design. ID contributed to data management and analysis. ID and NON contributed to drafting and preparing the manuscript for publication. All authors approved the final manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors have any conflicts of interest to disclose.

References

  1. 1.
    Ray MA, Youngstedt SD, Zhang H, Robb SW, Harmon BE, Jean-Louis G, Cai B, Hurley TG, Hébert JR, Bogan RK, Burch JB. Examination of wrist and hip actigraphy using a novel sleep estimation procedure. Sleep Sci. 2014;7(2):74–81.CrossRefGoogle Scholar
  2. 2.
    Ye L, Richards KC. Sleep and long-term care. Sleep Med Clin. 2018;13(1):117–25.CrossRefGoogle Scholar
  3. 3.
    Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP. The role of actigraphy in the study of sleep and circadian rhythms. Sleep. 2003;26(3):342–92.CrossRefGoogle Scholar
  4. 4.
    Thomas K, Burr R. Circadian Research in mothers and infants: how many days of actigraphy data are needed to fit cosinor parameters? J Nurs Meas. 2008;16(3):201–6.CrossRefGoogle Scholar
  5. 5.
    Martin JL, Hakim AD. Wrist actigraphy. Chest. 2011;139(6):1514–27.CrossRefGoogle Scholar
  6. 6.
    Martin JL, Jeste DV, Ancoli-Israel S. Older schizophrenia patients have more disrupted sleep and circadian rhythms than age-matched comparison subjects. J Psychiatr Res. 2005;39(3):251–9.CrossRefGoogle Scholar
  7. 7.
    Kripke DF, Youngstedt SD, Elliott JA, Tuunainen A, Rex KM, Hauger RL, Marler MR. Circadian phase in adults of contrasting ages. Chronobiol Int. 2005;22(4):695–709.CrossRefGoogle Scholar
  8. 8.
    Sherman SM, Mumford JA, Schnyer DM. Hippocampal activity mediates the relationship between circadian activity rhythms and memory in older adults. Neuropsychologia. 2015;75:617–25.CrossRefGoogle Scholar
  9. 9.
    Schmidt CP. Age-related changes in sleep and circadian rhythms: impact on cognitive performance and underlying neuroanatomical networks. Front Neurol. 2012;3:1–11.CrossRefGoogle Scholar
  10. 10.
    Pavlova M. Circadian rhythm sleep–wake disorders. Continuum. 2017;23(4):1051–63.PubMedGoogle Scholar
  11. 11.
    Myers BL, Badia P. Changes in circadian rhythms and sleep quality with aging: mechanisms and interventions. Neurosci Biobehav Rev. 1995;19(4):553–71.CrossRefGoogle Scholar
  12. 12.
    Hood S, Amir S. The aging clock: circadian rhythms and later life. J Clin Investig. 2017;127(2):437–46.CrossRefGoogle Scholar
  13. 13.
    American Academy of Sleep Medicine. Circadian Rhythm Sleep Disorders. American Academy of Sleep Medicine. 2018. https://aasm.org/resources/factsheets/crsd.pdf Accessed 12 Dec 2018.
  14. 14.
    Mattis J, Sehgal A. Circadian rhythms, sleep, and disorders of aging. Trends Endocrinol Metab. 2016;27(4):192–203.CrossRefGoogle Scholar
  15. 15.
    Camargos EF, Louzada FM, Nóbrega OT. Wrist actigraphy for measuring sleep in intervention studies with Alzheimer’s disease patients: application, usefulness, and challenges. Sleep Med Rev. 2013;17(6):475–88.CrossRefGoogle Scholar
  16. 16.
    Zermansky AG, Alldred PD, Petty DR, Raynor DK. Striving to recruit: the difficulties of conducting clinical research on elderly care home residents. J R Soc Med. 2007;100(6):258–61.CrossRefGoogle Scholar
  17. 17.
    Pereira SM, Pasman HR, van der Heide A, van Delden JJM, Onwuteaka-Philipsen BD. Old age and forgoing treatment: a nationwide mortality follow-back study in the Netherlands. J Med Ethic. 2015;41(9):766–70.CrossRefGoogle Scholar
  18. 18.
    Dolu I, Nahcivan N. Impact of a nurse-led sleep programme on the sleep quality and depressive symptomatology among older adults in nursing homes: a non-randomised controlled study. Int J Older People Nurs. 2019;14(1):e12215.PubMedGoogle Scholar
  19. 19.
    Ozmete E, Gurboga C, Tamkoc B. Country report Republic of Turkey. 2016. https://www.unece.org/fileadmin/DAM/pau/age/country_rpts/2017/TUR_report.pdf Accessed 15 Mar 2019.
  20. 20.
    Folstein MF. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefGoogle Scholar
  21. 21.
    Gungen CE. Reliability and validity of the standardized mini-mental state examination in the diagnosis of mild dementia in the Turkish population. Turk J Psychiatry. 2002;13(4):273–81.Google Scholar
  22. 22.
    Migueles JH, Cadenas-Sanchez C, Ekelund U, Nyström CD, Mora-Gonzalez J, Löf M, Labayen I, Ruiz JR, Ortega FB. Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med. 2017;47(9):1821–45.CrossRefGoogle Scholar
  23. 23.
    Slater AJ, Botsis T, Walsh J, King S, Straker LM, Eastwood PR. Assessing sleep using hip and wrist actigraphy. Sleep Biol Rhythms. 2015;13(2):72–180.CrossRefGoogle Scholar
  24. 24.
    Cornelissen G. Cosinor-based rhythmometry. Cornelissen Theor Biol Med Model. 2014;11(6):1–24.Google Scholar
  25. 25.
    Thomas K, Burr R, Spieker S. Maternal and infant activity: analytic approaches for the study of circadian rhythm. Infant Behav Dev. 2015;41:80–7.CrossRefGoogle Scholar
  26. 26.
    Elkum NB, Myles JD, Kumar P. Analyzing biological rhythms in clinical trials. Contemp Clin Trials. 2008;29(5):720–6.CrossRefGoogle Scholar
  27. 27.
    CRC. Dictionary of Cirdadian Physiology. Circadian Rhytym Laboratory, 2016. http://www.circadian.org/dictionary.html Accessed 11 Jan 2019.
  28. 28.
    Harper DG, Stopa EG, McKee AC, Satlin A, Harlan PC, Goldstein R, Volicer L. Differential circadian rhythm disturbances in men with Alzheimer disease and frontotemporal degeneration. Arch Gen Psychiatry. 2001;58(4):353–60.CrossRefGoogle Scholar
  29. 29.
    Dowling GA, Burr RL, Van Someren EJ, Hubbard EM, Luxenberg JS, Mastick J, Cooper BA. Melatonin and bright-light treatment for rest–activity disruption in institutionalized patients with Alzheimer’s disease. J Am Geriatr Soc. 2008;56(2):1–8.CrossRefGoogle Scholar
  30. 30.
    Duffy JF, Zitting K-M, Chinoy E-D. Aging and circadian rhythms. Sleep Med Clin. 2015;10(4):423–34.CrossRefGoogle Scholar
  31. 31.
    Cornelissen G, Otsuka K. Chronobiology of aging: a mini-review. Gerontology. 2017;68:118–28.CrossRefGoogle Scholar
  32. 32.
    Cochrane A, Robertson IH, Coogan AN. Association between circadian rhythms, sleep and cognitive impairment in healthy older adults: an actigraphic study. J Neural Transm. 2012;119:1233–9.CrossRefGoogle Scholar
  33. 33.
    Monk TH. Aging human circadian rhythms: conventional wisdom may not always be right. J Biol Rhythms. 2005;20(4):366–74.CrossRefGoogle Scholar
  34. 34.
    Huang YL, Liu RY, Wang QS, Van Someren EJ, Xu H, Zhou JN. Age-associated difference in circadian sleep–wake and rest–activity rhythms. Physiol Behav. 2002;76(4–5):597–603.CrossRefGoogle Scholar
  35. 35.
    Rocher SD, Bessot N, Sesboüé B, Bulla J, Davenne D. Circadian characteristics of older adults and aerobic capacity. J Gerontol A Biol Sci Med Sci. 2016;71(6):817–22.CrossRefGoogle Scholar
  36. 36.
    Yoon I-Y, Kripke DF, Elliott JA, Youngstedt SD, Rex KM, Hauger RL. Age-related changes of circadian rhythms and sleep–wake cycles. JAGS. 2003;51:1085–91.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Sleep Research 2019

Authors and Affiliations

  1. 1.Health Science FacultyBartin University, Agdaci CampusBartinTurkey
  2. 2.Public Health Nursing Department, Florence Nightingale Nursing FacultyIstanbul University-CerrahpasaIstanbulTurkey

Personalised recommendations