Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

Sleep disorders are a common syndrome and could affect the life quality of the older adults.

Aims

This study aimed to investigate the association between nutritional status and sleep quality in the Chinese community-dwelling older adults.

Methods

A total of 2,878 participants ≥ 65 years 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.

Results

Among the 2,878 participants (mean age 72.71 ± 5.79 years, 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).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Reference:s

  1. Hu Y, Wang J, Nicholas S et al (2021) The sharing economy in China’s aging industry: applications, challenges, and recommendations. J Med Internet Res 23:e27758

    Article  PubMed  PubMed Central  Google Scholar 

  2. McArdle N, Reynolds AC, Hillman D et al (2022) Prevalence of common sleep disorders in a middle-aged community sample. J Clin Sleep Med 18:1503–1514

    Article  PubMed  PubMed Central  Google Scholar 

  3. Zhao W-Y, Zhang Y, Jia S-I (2021) The association of sleep quality and sleep duration with nutritional status in older adults: findings from the WCHAT study. Maturitas 145:1–5

    Article  CAS  PubMed  Google Scholar 

  4. Ramos AR, Gardener H, Rundek T et al (2016) Sleep disturbances and cognitive decline in the Northern Manhattan Study. Neurology 87:1511–1516

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bjørngaard JH, Bjerkeset O, Romundstad P et al (2011) Sleeping problems and suicide in 75,000 Norwegian adults: a 20 year follow-up of the HUNT I study. Sleep 34:1155–1159

    Article  PubMed  PubMed Central  Google Scholar 

  6. Chen HC, Su TP, Chou P (2013) A nine-year follow-up study of sleep patterns and mortality in community-dwelling older adults in Taiwan. Sleep 36:1187–1198

    Article  PubMed  PubMed Central  Google Scholar 

  7. Valenza MC, Cabrera-Martos I, Martín-Martín L et al (2013) Nursing homes: impact of sleep disturbances on functionality. Arch Gerontol Geriatr 56:432–436

    Article  PubMed  Google Scholar 

  8. Bathgate CJ, Edinger JD, Wyatt JK et al (2016) Objective but not subjective short sleep duration associated with increased risk for hypertension in individuals with insomnia. Sleep 39:1037–1045

    Article  PubMed  PubMed Central  Google Scholar 

  9. Elwood P, Hack M, Pickering J et al (2006) Sleep disturbance, stroke, and heart disease events: evidence from the Caerphilly cohort. J Epidemiol Community Health 60:69–73

    Article  PubMed  PubMed Central  Google Scholar 

  10. Crowley K (2011) Sleep and sleep disorders in older adults. Neuropsychol Rev 21:41–53

    Article  PubMed  Google Scholar 

  11. Buysse DJ, Reynolds CF 3rd, Monk TH et al (1989) The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213

    Article  CAS  PubMed  Google Scholar 

  12. Mollayeva T, Thurairajah P, Burton K et al (2016) The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Med Rev 25:52–73

    Article  PubMed  Google Scholar 

  13. Lee SY, Ju YJ, Lee JE et al (2020) Factors associated with poor sleep quality in the Korean general population: providing information from the Korean version of the Pittsburgh sleep quality index. J Affect Disord 271:49–58

    Article  PubMed  Google Scholar 

  14. Şengül Ş, Uysal H (2019) The relationship between the nutritional status and sleep quality of patients with atrial fibrillation. Saudi Med J 40:922–929

    Article  PubMed  PubMed Central  Google Scholar 

  15. St-Onge MP, Mikic A, Pietrolungo CE (2016) Effects of diet on sleep quality. Adv Nutr 7:938–949

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Chennaoui M, Arnal PJ, Sauvet F et al (2015) Sleep and exercise: a reciprocal issue? Sleep Med Rev 20:59–72

    Article  PubMed  Google Scholar 

  17. Dashti HS, Jones SE, Wood AR et al (2019) Genome-wide association study identifies genetic loci for self-reported habitual sleep duration supported by accelerometer-derived estimates. Nat Commun 10:1100

    Article  PubMed  PubMed Central  Google Scholar 

  18. Soysal P, Smith L, Dokuzlar O et al (2019) Relationship between nutritional status and insomnia severity in older adults. J Am Med Dir Assoc 20:1593–1598

    Article  PubMed  Google Scholar 

  19. van der Pols-Vijlbrief R, Wijnhoven HA, Schaap LA et al (2014) Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies. Ageing Res Rev 18:112–131

    Article  PubMed  Google Scholar 

  20. Corish CA, Bardon LA (2019) Malnutrition in older adults: screening and determinants. Proc Nutr Soc 78:372–379

    Article  PubMed  Google Scholar 

  21. Dent E, Wright ORL, Woo J et al (2023) Malnutrition in older adults. The Lancet 401:951–966

    Article  Google Scholar 

  22. Kaiser MJ, Bauer JM, Rämsch C et al (2010) Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 58:1734–1738

    Article  PubMed  Google Scholar 

  23. Stratton RJ, King CL, Stroud MA et al (2006) “Malnutrition Universal Screening Tool” predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr 95:325–330

    Article  CAS  PubMed  Google Scholar 

  24. Bonetti L, Terzoni S, Lusignani M et al (2017) Prevalence of malnutrition among older people in medical and surgical wards in hospital and quality of nutritional care: a multicenter, cross-sectional study. J Clin Nurs 26:5082–5092

    Article  PubMed  Google Scholar 

  25. Winter J, Flanagan D, McNaughton SA et al (2013) Nutrition screening of older people in a community general practice, using the MNA-SF. J Nutr Health Aging 17:322–325

    Article  CAS  PubMed  Google Scholar 

  26. Slee A, Birch D, Stokoe D (2015) A comparison of the malnutrition screening tools, MUST, MNA and bioelectrical impedance assessment in frail older hospital patients. Clin Nutr (Edinburgh, Scotland) 34:296–301

    Article  Google Scholar 

  27. Isautier JMJ, Bosnić M, Yeung SSY et al (2019) Validity of nutritional screening tools for community-dwelling older adults: a systematic review and meta-analysis. J Am Med Dir Assoc 20:1351.e1313-1351.e1325

    Article  Google Scholar 

  28. Silva DFO, Lima S, Sena-Evangelista KCM et al (2020) Nutritional risk screening tools for older adults with COVID-19: a systematic review. Nutrients 12:2956

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Cereda E, Pedrolli C, Klersy C et al (2016) Nutritional status in older persons according to healthcare setting: a systematic review and meta-analysis of prevalence data using MNA(®). Clin Nutr (Edinburgh, Scotland) 35:1282–1290

    Article  Google Scholar 

  30. Donini LM, Poggiogalle E, Molfino A et al (2016) Mini-nutritional assessment, malnutrition universal screening tool, and nutrition risk screening tool for the nutritional evaluation of older nursing home residents. J Am Med Dir Assoc 17:959.e911–958

    Article  Google Scholar 

  31. Anthony PS (2008) Nutrition screening tools for hospitalized patients. Nutr Clin Pract 23:373–382

    Article  PubMed  Google Scholar 

  32. Dent E, Hoogendijk EO, Visvanathan R et al (2019) Malnutrition screening and assessment in hospitalised older people: a review. J Nutr Health Aging 23:431–441

    Article  CAS  PubMed  Google Scholar 

  33. Veqar Z, Hussain ME (2018) Psychometric analysis of Epworth Sleepiness Scale and its correlation with Pittsburgh sleep quality index in poor sleepers among Indian university students. Int J Adolesc Med Health. https://doi.org/10.1515/ijamh-2016-0151

    Article  PubMed  Google Scholar 

  34. Climent-Sanz C, Marco-Mitjavila A, Pastells-Peiró R et al (2020) Patient reported outcome measures of sleep quality in fibromyalgia: a COSMIN systematic review. Int J Environ Res Public Health 17:2992

    Article  PubMed  PubMed Central  Google Scholar 

  35. Fabbri M, Beracci A, Martoni M et al (2021) Measuring subjective sleep quality: a review. Int J Environ Res Public Health 18:1082

    Article  PubMed  PubMed Central  Google Scholar 

  36. Rubenstein LZ, Harker JO, Salvà A et al (2001) Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 56:M366-372

    Article  CAS  PubMed  Google Scholar 

  37. Dong X, Wang Y, Chen Y et al (2018) Poor sleep quality and influencing factors among rural adults in Deqing, China. Sleep Breath 22:1213–1220

    Article  PubMed  Google Scholar 

  38. Tang J, Liao Y, Kelly BC et al (2017) Sex and regional differences in sleep quality and insomnia: a general population-based study in Hunan province of China. Sci Rep 7:43690

    Article  PubMed  PubMed Central  Google Scholar 

  39. Mazzotti DR, Guindalini C, Sosa AL et al (2012) Prevalence and correlates for sleep complaints in older adults in low and middle income countries: a 10/66 dementia research group study. Sleep Med 13:697–702

    Article  PubMed  Google Scholar 

  40. Landi F, Picca A, Calvani R et al (2017) Anorexia of aging: assessment and management. Clin Geriatr Med 33:315–323

    Article  PubMed  Google Scholar 

  41. Andreae C, Strömberg A, Årestedt K (2016) Prevalence and associated factors for decreased appetite among patients with stable heart failure. J Clin Nurs 25:1703–1712

    Article  PubMed  Google Scholar 

  42. Beydoun MA, Ng AE, Fanelli-Kuczmarski MT et al (2021) Vitamin D status and its longitudinal association with changes in patterns of sleep among middle-aged urban adults. J Affect Disord 282:858–868

    Article  CAS  PubMed  Google Scholar 

  43. Liu G, Yang S, Liu W et al (2020) Canonical correlation analysis on the association between sleep quality and nutritional status among centenarians in Hainan. Front Public Health 8:585207

    Article  PubMed  PubMed Central  Google Scholar 

  44. Wang M, Zhou T, Li X et al (2020) Baseline vitamin D status, sleep patterns, and the risk of incident type 2 diabetes in data from the UK biobank study. Diabetes Care 43:2776–2784

    Article  PubMed  PubMed Central  Google Scholar 

  45. Girschik J, Fritschi L, Heyworth J et al (2012) Validation of self-reported sleep against actigraphy. J Epidemiol 22:462–468

    Article  PubMed  PubMed Central  Google Scholar 

  46. Fleta Zaragozano J, Jiménez Vidal A, Velilla Picazo M et al (2005) Anorexia nervosa and cerebral atrophy in adolescents. Med Clin (Barc) 124:571–572

    Article  PubMed  Google Scholar 

  47. de Van der Schueren MA, Lonterman-Monasch S, van der Flier WM et al (2016) Malnutrition and risk of structural brain changes seen on magnetic resonance imaging in older adults. J Am Geriatr Soc 64:2457–2463

    Article  Google Scholar 

  48. Kang JMK, Joo SWJ, Son YDS et al (2018) Low white-matter integrity between the left thalamus and inferior frontal gyrus in patients with insomnia disorder. J Psychiatry Neurosci 43:366–374

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Vlahoyiannis A, Giannaki CD et al (2021) Systematic review, meta-analysis and meta-regression on the effects of carbohydrates on sleep. Nutrients 13:1283

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Chaput JP (2014) Sleep patterns, diet quality and energy balance. Physiol Behav 134:86–91

    Article  CAS  PubMed  Google Scholar 

  51. Pereira N, Naufel MF, Ribeiro EB et al (2020) Influence of dietary sources of melatonin on sleep quality: a review. J Food Sci 85:5–13

    Article  CAS  PubMed  Google Scholar 

  52. Ikonte CJ, Mun JG, Reider CA et al (2019) Micronutrient inadequacy in short sleep: analysis of the NHANES 2005–2016. Nutrients 11:2335

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Jeon YS, Yu S, Kim C et al (2022) Lower serum calcium levels associated with disrupted sleep and rest-activity rhythm in shift workers. Nutrients. 14:3021

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Chen C, Lu FC (2004) The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci: BES 17:1–36

    PubMed  Google Scholar 

  55. Pagliai G, Dinu M, Casini A et al (2018) Relationship between sleep pattern and efficacy of calorie-restricted Mediterranean diet in overweight/obese subjects. Int J Food Sci Nutr 69:93–99

    Article  PubMed  Google Scholar 

  56. Spiegel K, Leproult R, L’Hermite-Balériaux M et al (2004) Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 89:5762–5771

    Article  CAS  PubMed  Google Scholar 

  57. Nedeltcheva AV, Kilkus JM, Imperial J et al (2010) Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med 153:435–441

    Article  PubMed  PubMed Central  Google Scholar 

  58. Aihemaitijiang S, Zhang L, Ye C et al (2022) Long-Term High Dietary Diversity Maintains Good Physical Function in Chinese Elderly: A Cohort Study Based on CLHLS from 2011 to 2018. Nutrients. 14:1730

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Uterflam JM, Comis JJ, Lan Q et al (2022) The short-term effects of opioid and non-opioid pharmacotherapies on sleep in people with chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 65:1016

    Google Scholar 

  60. Schroeck JL, Ford J, Conway EL et al (2016) Review of safety and efficacy of sleep medicines in older adults. Clin Ther 38:2340–2372

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the Fundamental Research Funds for the Central Universities (2021FZZX001-39, 2020QNA7018) and Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang(2019R01007). The funding source had no further role in the design, data collection or conduct the study.

Funding

This work was supported by the Fundamental Research Funds for the Central Universities (2021FZZX001-39, 2020QNA7018) and Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang (2019R01007).

Author information

Authors and Affiliations

  1. Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China

    Haiyan Jiang, Lifang Ye, Simei Zhang & Mengling Tang

  2. Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China

    Mingjuan Jin & Kun Chen

  3. Department of Public Health, National Clinical Research Center for Child Health of Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China

    Jianbing Wang

Authors
  1. Haiyan Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lifang Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mingjuan Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jianbing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mengling Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kun Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

HJ, MT and KC conceived and supervised the project. HJ, LY, SZ collected data. HJ and LY conducted data analysis. HJ wrote the manuscript and edited it in collaboration with LY. SZ directed the methods section. MJ, JW, MT and KC reviewed, edited, and checked the final version. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.

Corresponding authors

Correspondence to Mengling Tang or Kun Chen.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The study was approved by the Ethics Committee of the fourth affiliated hospital of Zhejiang University and written informed consent was obtained from all study participants.

Consent to participate

Older adults were informed of the characteristics and nature of the study, and all provided a written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 16 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, H., Ye, L., Zhang, S. et al. The association between nutritional status and sleep quality of Chinese community-dwelling older adults. Aging Clin Exp Res 35, 1945–1954 (2023). https://doi.org/10.1007/s40520-023-02479-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-023-02479-8

Keywords

Search

Navigation