Association of Self-Perceived Fatigue, Muscle Fatigue, and Sleep Disorders with Cognitive Function in Older Adults: A Cross-Sectional Study

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association Pub Date : 2025-02-06 DOI:10.1016/j.jamda.2024.105477

Ali Kapan PhD , Milos Ristic MSc , Richard Felsinger MD , Thomas Waldhoer PhD, Professor

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引用次数: 0

Abstract

Objectives

Fatigue and sleep disorders are common geriatric conditions and are associated with an increased risk of cognitive decline. This study aimed to examine the relationships among self-perceived fatigue, objective muscle fatigue, sleep apnea risk, insomnia, and cognitive function, focusing on their associations with mild cognitive impairment (MCI).

Design

Cross-sectional study.

Setting and Participants

The study involved 217 older adults (median age: 80 years, 65.6% women) from 2 residential care facilities in Vienna, Austria.

Methods

Cognitive function was assessed with the Mini-Mental State Examination. Sleep quality and disturbances were evaluated using the Athens Insomnia Scale (AIS) and STOP-BANG questionnaire. Subjective fatigue was measured with the Multidimensional Fatigue Inventory, and objective muscle fatigue through 2 rounds of 10 maximal handgrip strength tests, separated by a 1-hour rest. Multivariable regression models adjusted for age, sex, comorbidities, sleep medication, and total number of medications were used to analyze associations among fatigue, sleep disturbance, and MCI.

Results

Participants with MCI (n = 72) had significantly lower handgrip strength (median Fmax1: 18.75 kg vs 23.44 kg), higher muscle fatigue ratios (median: 1.40 vs 1.19), and poorer recovery ratios (median: 0.85 vs 1.01) compared with those without MCI (n = 145). Sleep disorders and fatigue measures were more common in those with MCI, with 80.6% reporting insomnia (AIS ≥6) compared with 21.4% in the cognitively intact group. Logistic regression showed that muscle fatigue combined with sleep apnea risk was associated with the highest odds of cognitive impairment [odds ratio (OR), 6.12; 95% CI, 2.77−13.51; adjusted OR, 3.02; 95% CI, 1.15−7.92]. Recovery capacity showed a positive association with cognitive function (β = 0.150, P < .05).

Conclusions and Implications

Sleep apnea, muscle fatigue, and reduced recovery capacity are significantly associated with cognitive decline in older adults. Assessing these factors may help in identifying individuals at risk of cognitive impairment.

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目的：疲劳和睡眠障碍是常见的老年病，与认知能力下降的风险增加有关。本研究旨在探讨自我感觉疲劳、客观肌肉疲劳、睡眠呼吸暂停风险、失眠和认知功能之间的关系，重点关注它们与轻度认知障碍（MCI）之间的关联：设计：横断面研究：研究对象：奥地利维也纳两家养老机构的 217 名老年人（中位年龄：80 岁，65.6% 为女性）：认知功能通过小型精神状态检查进行评估。采用雅典失眠量表（AIS）和 STOP-BANG 问卷评估睡眠质量和睡眠障碍。主观疲劳通过多维疲劳量表进行测量，客观肌肉疲劳通过2轮10次最大手握力测试进行测量，测试间歇1小时。使用调整了年龄、性别、合并症、睡眠药物和药物总数的多变量回归模型来分析疲劳、睡眠障碍和 MCI 之间的关联：与未患有 MCI 的参与者（n = 145）相比，患有 MCI 的参与者（n = 72）手握力明显较低（Fmax1 中位数：18.75 kg vs 23.44 kg），肌肉疲劳比率较高（中位数：1.40 vs 1.19），恢复比率较低（中位数：0.85 vs 1.01）。睡眠障碍和疲劳测量在 MCI 患者中更为常见，80.6% 的患者报告失眠（AIS ≥6），而在认知功能完好组中仅为 21.4%。逻辑回归显示，肌肉疲劳合并睡眠呼吸暂停风险与认知障碍的最高几率相关（几率比 [OR]，6.12；95% CI，2.77-13.51；调整后的几率比，3.02；95% CI，1.15-7.92）。恢复能力与认知功能呈正相关（β = 0.150，P < .05）：睡眠呼吸暂停、肌肉疲劳和恢复能力下降与老年人认知能力下降有显著关联。对这些因素进行评估有助于识别有认知功能障碍风险的人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Medical Directors Association 医学-老年医学

CiteScore

11.10

自引率

6.60%

发文量

472

审稿时长

44 days

期刊介绍： JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality