Xinhang Pan, Aowen Tian, Jin Tan, Yuyang Miao, Qiang Zhang
{"title":"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。","authors":"Xinhang Pan, Aowen Tian, Jin Tan, Yuyang Miao, Qiang Zhang","doi":"10.2147/NSS.S538098","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"17 ","pages":"2051-2064"},"PeriodicalIF":3.4000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415388/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Joint Effect of Frailty and Sleep Health on Cardiometabolic Multimorbidity in Aging Population.\",\"authors\":\"Xinhang Pan, Aowen Tian, Jin Tan, Yuyang Miao, Qiang Zhang\",\"doi\":\"10.2147/NSS.S538098\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":18896,\"journal\":{\"name\":\"Nature and Science of Sleep\",\"volume\":\"17 \",\"pages\":\"2051-2064\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415388/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nature and Science of Sleep\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/NSS.S538098\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature and Science of Sleep","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/NSS.S538098","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Evaluation of Joint Effect of Frailty and Sleep Health on Cardiometabolic Multimorbidity in Aging Population.
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.
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.
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