Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
Exp Gerontol. 2021 Jul 15;150:111364. doi: 10.1016/j.exger.2021.111364. Epub 2021 Apr 20.
This cross-sectional study aimed to examine associations between excessive daytime sleepiness (EDS) with falls and falls related conditions in older adults.
To assess EDS, the Epworth Sleepiness Scale was used, with a score of ≥11/24 points indicating EDS. Number of falls and fall history (at least one) in the last year were recorded. Timed Up and Go test (TUG) was used to assess fall risk. Sarcopenia was defined by SARC-F tool. A grip strength score of the dominant hand, measured with a hand-grip dynamometer, less than 16 kg in females and 27 kg in males was accepted as dynapenia. Frailty status was defined by five dimensions including shrinking, exhaustion, low levels of activity, weakness, and slowness with those scoring positive on ≥3 dimensions being categorized as frail. The relationship between EDS with outcomes including fall, number of falls, falls risk, dynapenia, sarcopenia and frailty was investigated.
Of the 575 outpatients (mean age 78.7 ± 7.5 years, female:70.4%), the prevalence of EDS was 19.8%. In the multivariable model adjusted for age, sex, living status, marital status, polypharmacy, osteoarthritis, Parkinson disease, depression and dementia; EDS was significantly associated with the number of falls last year (IRR = 1.94, 95% CI: 1.42-2.65) and sarcopenia (OR = 2.41, 95% CI: 1.41-4.12). EDS was not significantly associated with TUG based fall risk, frailty and dynapenia.
EDS was observed in approximately one in every five older adults. EDS should be evaluated as part of geriatric assessment. Moreover, older patients with EDS should be further assessed for falls and sarcopenia.
本横断面研究旨在探讨老年人日间嗜睡（EDS）与跌倒及其相关疾病的关系。
采用 Epworth 嗜睡量表评估 EDS，得分≥11/24 分表示 EDS。记录过去一年的跌倒次数和跌倒史（至少一次）。采用计时起立行走测试（TUG）评估跌倒风险。采用 SARC-F 工具定义肌肉减少症。用握力计测量惯用手握力，女性<16kg，男性<27kg 被认为是握力下降。采用包括消瘦、疲惫、活动水平低、虚弱和缓慢在内的五个维度来定义虚弱状态，得分≥3 分的患者被归类为虚弱。研究了 EDS 与跌倒、跌倒次数、跌倒风险、握力下降、肌肉减少症和虚弱之间的关系。
在 575 名门诊患者中（平均年龄 78.7±7.5 岁，女性 70.4%），EDS 的患病率为 19.8%。在调整年龄、性别、居住状况、婚姻状况、多药治疗、骨关节炎、帕金森病、抑郁和痴呆后，多变量模型显示，EDS 与去年的跌倒次数（IRR=1.94，95%CI：1.42-2.65）和肌肉减少症（OR=2.41，95%CI：1.41-4.12）显著相关。EDS 与 TUG 基于跌倒风险、虚弱和握力下降无显著相关性。
大约每五名老年人中就有一名患有 EDS。EDS 应作为老年评估的一部分进行评估。此外，患有 EDS 的老年患者应进一步评估跌倒和肌肉减少症的风险。
