Evaluation of Joint Effect of Frailty and Sleep Health on Cardiometabolic Multimorbidity in Aging Population.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-09-02 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S538098

Xinhang Pan, Aowen Tian, Jin Tan, Yuyang Miao, Qiang Zhang

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Abstract

Background: Sleep and frailty are established influencing factors for cardiometabolic diseases (CMDs). However, their joint effects on cardiometabolic multimorbidity (CMM) in older adults remain poorly understood. This study aimed to assess the joint effect of sleep health and frailty on CMD prevalence and severity, with an emphasis on subgroup-specific health risk profiles.

Methods: This study analyzed 8944 adults aged ≥60 years from the National Health and Nutrition Examination Survey (NHANES, 2007-2018). Weighted Logistic and quasi-Poisson regression models were used to assess the associations between sleep health, frailty, and CMD/CMM burden. Mediation analyses were used to examine the indirect effects of frailty index (FI) on the associations between sleep and CMM. Further cross-stratification of the population was conducted to evaluate the differences in characteristic indicators of health risks and biological aging.

Results: Poor sleep and frailty exhibited dose-dependent joint effects on CMD risk. After full adjustment, poor sleep combined with frailty had an incidence rate ratio (IRR) of 2.01 (95% CI: 1.78, 2.27) for existing cumulative number of CMDs (p for interaction = 0.006). The indirect effect of the FI explained 57.80% of the relationship between sleep health and the cumulative number of CMDs. Frailty was mainly manifested as differences in individual inflammation and aging indicators (eg, Systemic inflammation response index, Phenoage acceleration), while poor sleep was more reflected in changes in metabolic indicators (eg, Metabolic score for insulin resistance).

Conclusion: Poor sleep and frailty jointly amplified associations with CMM in older US adults. The relationship between sleep and CMM could be partially explained by FI. Elderly individuals with poor sleep should focus on changes on metabolic indicators, while those combined with frailty need to pay extra attention to aging and inflammation indicators.

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老年人身体虚弱和睡眠健康对心脏代谢多病联合作用的评价。

背景：睡眠和虚弱是心脏代谢疾病（CMDs）的影响因素。然而，它们对老年人心脏代谢多病（CMM）的联合作用仍然知之甚少。本研究旨在评估睡眠健康和虚弱对CMD患病率和严重程度的共同影响，重点关注亚组特定的健康风险概况。方法：本研究分析了来自国家健康与营养检查调查（NHANES, 2007-2018）的8944名年龄≥60岁的成年人。采用加权Logistic和准泊松回归模型评估睡眠健康、虚弱和CMD/CMM负担之间的关系。采用中介分析来检验虚弱指数（FI）对睡眠与CMM之间关联的间接影响。进一步对人群进行交叉分层，以评估健康风险和生物衰老特征指标的差异。结果：睡眠不足和虚弱对CMD风险表现出剂量依赖的联合效应。完全调整后，睡眠不良合并虚弱的发病率比（IRR）为2.01 (95% CI: 1.78, 2.27)，现有累积CMDs数（相互作用p = 0.006）。FI的间接作用解释了57.80%的睡眠健康与慢性阻塞性肺病累积数量之间的关系。虚弱主要表现为个体炎症和衰老指标的差异（如全身炎症反应指数、表型加速），而睡眠不佳更多体现为代谢指标的变化（如胰岛素抵抗代谢评分）。结论：睡眠不足和虚弱共同放大了美国老年人CMM的关联。睡眠与CMM之间的关系可以用FI部分解释。睡眠不佳的老年人应关注代谢指标的变化，而合并虚弱的老年人则需要额外关注衰老和炎症指标。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.