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非参数静息-活动节律失衡与老年社区居民根据脆弱性指标的夜间型时型。

Imbalance of nonparametric rest-activity rhythm and the evening-type of chronotype according to frailty indicators in elderly community dwellers.

机构信息

a Graduate School of Medicine, Master Course in Health Sciences, Reha · pot co. Ltd., Akita University , Akita , Japan.

b Graduate School of Medicine, Doctorial Course in Health Sciences, Department of Occupational Therapy, Akita University , Akita , Japan.

出版信息

Chronobiol Int. 2019 Sep;36(9):1208-1216. doi: 10.1080/07420528.2019.1626416. Epub 2019 Jun 25.

Abstract

: Sleep health-related issues, such as poor subjective sleep quality during the night and nocturnal wakefulness, have been a focus of recent research on frailty. However, current trends regarding the chronotypes of older individuals with frailty have not been well documented, and information on the impact of frailty on circadian rest-activity patterns is limited. The aim of this research was to clarify the relationship among frailty, nonparametric rest-activity patterns, and chronotype in older community-dwelling subjects. : A survey was conducted between June and December 2018, and the participants of this study were recruited from among community-dwellers aged 60 years or older living in Akita prefecture, Japan. The frailty phenotype defined by the National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS) was used to evaluate the frailty status of each participant. To evaluate nonparametric rest-activity rhythm (RAR) parameters (e.g., interdaily stability [IS], intradaily variability [IV], and relative amplitude [RA]), each participant wore an Actiwatch Spectrum Plus device on his or her non-dominant wrist for seven continuous days without removal. The Munich chronotype questionnaire-Japanese version (MCTQ-J) was also used to measure the midpoint of sleep in free days (MSF). : The final study cohort was composed of 105 participants (85.7% women) and was divided into 58 non-frail subjects, 45 pre-frail subjects, and 2 frail subjects. According to a binomial logistic regression analysis, the pre-frail individuals had a weaker grip strength (coefficient [beta], -0.18; odds ratio, 0.84; 95% confidence interval [CI], 0.76-0.93; = .001) and a lower RA (beta, -8.78; odds ratio, 0.0002; 95% CI, 0.00-0.15; = .01). In addition, correlation analyses also showed that the MSF was negatively associated with the RA in the pre-frail group (r = -0.30, < .05) and positively correlated with the RA in the non-frail group (r = 0.26, < .05); furthermore, the MSF of the pre-frail group occurred at a later time than that of the non-frail one ( = .03). : The present study provides grounds for our proposal that pre-frailty is significantly associated with a low grip power and relative imbalance between rest and active statuses as indexed using nonparametric RAR parameters. Furthermore, elderly individuals with pre-frailty or frailty may have a later MSF time. However, these potential findings need to be validated in future research.

摘要

:睡眠健康相关问题,如夜间主观睡眠质量差和夜间觉醒,一直是虚弱研究的重点。然而,目前关于虚弱老年人的昼夜类型趋势尚未得到很好的记录,关于虚弱对昼夜休息-活动模式影响的信息也有限。本研究旨在阐明衰弱与非参数休息-活动模式和昼夜类型之间的关系。:这项研究于 2018 年 6 月至 12 月进行,参与者来自日本秋田县居住在社区的 60 岁或以上的老年人。使用国家老龄化与老龄化研究中心(NCGG-SGS)定义的虚弱表型来评估每个参与者的虚弱状态。为了评估非参数休息-活动节律(RAR)参数(例如日间稳定性[IS]、日内变异性[IV]和相对幅度[RA]),每个参与者在非优势手腕上佩戴 Actiwatch Spectrum Plus 设备连续 7 天不取下。还使用慕尼黑昼夜类型问卷-日本版(MCTQ-J)测量自由日的睡眠中点(MSF)。:最终的研究队列由 105 名参与者(85.7%为女性)组成,分为 58 名非虚弱组、45 名虚弱前组和 2 名虚弱组。根据二项逻辑回归分析,虚弱前个体的握力较弱(系数[β]为-0.18;优势比为 0.84;95%置信区间[CI]为 0.76-0.93; =.001),相对幅度(β)较低(β为-8.78;优势比为 0.0002;95%CI 为 0.00-0.15; =.01)。此外,相关分析还表明,MSF 与虚弱前组的 RA 呈负相关(r =-0.30, <.05),与非虚弱组的 RA 呈正相关(r = 0.26, <.05);此外,虚弱前组的 MSF 时间晚于非虚弱组( =.03)。:本研究为我们的假设提供了依据,即虚弱前状态与握力降低和非参数 RAR 参数所示的休息和活动状态之间的相对不平衡显著相关。此外,患有虚弱前或虚弱的老年人可能有较晚的 MSF 时间。然而,这些潜在的发现需要在未来的研究中得到验证。

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