Yonsei Med J.  2017 Nov;58(6):1222-1228. 10.3349/ymj.2017.58.6.1222.

Association between Sleep Duration and Injury from Falling among Older Adults: A Cross-Sectional Analysis of Korean Community Health Survey Data

Affiliations
  • 1Department of Healthcare Management, Eulji University, Seongnam, Korea.
  • 2Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
  • 3Graduate School of Public Health, Korea University, Seoul, Korea.
  • 4Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Korea. snukyd1@naver.com

Abstract

PURPOSE
While sleeping problems increase with advancing age, there are inherent differences in sleep between males and females. Previous studies have shown inconsistent results of the relationship between sleep duration and risk of injury from falling. While controlling various sociodemographic and health-related factors, national representative data were used in order to analyze the association between sleep duration and injury from falling among older adults.
MATERIALS AND METHODS
The data were obtained from the Korean Community Health Survey of 2011. A total of 55654 individuals aged 65 years and older participated in the study. Multivariable logistic regression analysis was conducted to identify the factors associated with injury from falling.
RESULTS
After adjusting for covariates, such as age, sex, marital status, whether or not an individual is a recipient of benefits from the National Basic Livelihood Act, hypertension, diabetes mellitus, dyslipidemia, stress level, and self-rated health status, those who slept five hours or less per day [odds ratio (OR)=1.26; 95% confidence interval (CI)=1.18-1.34; p<0.001] or eight hours or more per day (OR=1.11; 95% CI=1.04-1.17; p=0.001) presented significantly higher ORs for injury from falling. A similar result was found when we conducted stratification by sex.
CONCLUSION
The current study supports that there is a relationship between short sleep duration and injury from falling and also identified a marginal risk of long sleep in older adults. Therefore, sleep management in older adults with inadequate sleep duration may be necessary.

Keyword

Accidental falls; aged; gender; Korea; sleep

MeSH Terms

Accidental Falls/*statistics & numerical data
Adult
Age Factors
Aged
Cross-Sectional Studies
Female
*Health Status
Health Surveys
Humans
Logistic Models
Male
Middle Aged
Public Health
Republic of Korea/epidemiology
Sleep/*physiology
Sleep Deprivation/*complications
Surveys and Questionnaires
Time Factors

Reference

1. United Nations Population Division. World population prospects: The 2012 revision. NY: United Nations Population Division;2013.
2. Schlicht J, Camaione DN, Owen SV. Effect of intense strength training on standing balance, walking speed, and sit-to-stand performance in older adults. J Gerontol A Biol Sci Med Sci. 2001; 56:M281–M286. PMID: 11320107.
Article
3. Ryan JJ, McCloy C, Rundquist P, Srinivasan V, Laird R. Fall risk assessment among older adults with mild Alzheimer disease. J Geriatr Phys Ther. 2011; 34:19–27. PMID: 21937888.
Article
4. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988; 319:1701–1707. PMID: 3205267.
Article
5. Kiel DP, O'Sullivan P, Teno JM, Mor V. Health care utilization and functional status in the aged following a fall. Med Care. 1991; 29:221–228. PMID: 1997751.
6. O'Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993; 137:342–354. PMID: 8452142.
7. Rubenstein LZ, Josephson KR. Falls and their prevention in elderly people: what does the evidence show? Med Clin North Am. 2006; 90:807–824. PMID: 16962843.
Article
8. Ruchinskas R. Clinical prediction of falls in the elderly. Am J Phys Med Rehabil. 2003; 82:273–278. PMID: 12649652.
Article
9. Latimer Hill E, Cumming RG, Lewis R, Carrington S, Le Couteur DG. Sleep disturbances and falls in older people. J Gerontol A Biol Sci Med Sci. 2007; 62:62–66. PMID: 17301039.
10. Strine TW, Chapman DP. Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Med. 2005; 6:23–27. PMID: 15680291.
Article
11. Vitiello MV. Sleep disorders and aging: understanding the causes. J Gerontol A Biol Sci Med Sci. 1997; 52:M189–M191. PMID: 9224429.
Article
12. Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011; 21:41–53. PMID: 21225347.
Article
13. Ancoli-Israel S, Ayalon L, Salzman C. Sleep in the elderly: normal variations and common sleep disorders. Harv Rev Psychiatry. 2008; 16:279–286. PMID: 18803103.
Article
14. Duffy JF, Cain SW, Chang AM, Phillips AJ, Münch MY, Gronfier C, et al. Sex difference in the near-24-hour intrinsic period of the human circadian timing system. Proc Natl Acad Sci U S A. 2011; 108(Suppl 3):15602–15608. PMID: 21536890.
Article
15. Vitiello MV, Larsen LH, Moe KE. Age-related sleep change: gender and estrogen effects on the subjective-objective sleep quality relationships of healthy, noncomplaining older men and women. J Psychosom Res. 2004; 56:503–510. PMID: 15172206.
16. Shinkoda K, Naminohira K, Anan M, Shinkoda H. Is sleep duration a risk factor for falls in the elderly? Physiother. 2015; 101:eS1393.
Article
17. Mesas AE, López-García E, Rodríguez-Artalejo F. Self-reported sleep duration and falls in older adults. J Sleep Res. 2011; 20(1 Pt 1):21–27. PMID: 20626611.
Article
18. Kuo HK, Yang CC, Yu YH, Tsai KT, Chen CY. Gender-specific association between self-reported sleep duration and falls in high-functioning older adults. J Gerontol A Biol Sci Med Sci. 2010; 65:190–196. PMID: 19793798.
Article
19. Lee KA, Gay C, Portillo CJ, Coggins T, Davis H, Pullinger CR, et al. Types of sleep problems in adults living with HIV/AIDS. J Clin Sleep Med. 2012; 8:67–75. PMID: 22334812.
Article
20. McDonald M, Hertz RP, Unger AN, Lustik MB. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci. 2009; 64:256–263. PMID: 19181717.
21. Lim S, Shin H, Song JH, Kwak SH, Kang SM, Yoon JW, et al. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care. 2011; 34:1323–1328. PMID: 21505206.
22. Ancoli-Israel S, Ayalon L. Diagnosis and treatment of sleep disorders in older adults. Am J Geriatr Psychiatry. 2006; 14:95–103. PMID: 16473973.
Article
23. Kawamoto R, Doi T. Sleep problems as a risk factor for fall in community-dwelling older persons. Geriatr Gerontol Int. 2002; 2:16–22.
Article
24. OECD. Special focus: measuring leisure in OECD countries. Paris: OECD;2009.
25. Stone KL, Ewing SK, Lui LY, Ensrud KE, Ancoli-Israel S, Bauer DC, et al. Self-reported sleep and nap habits and risk of falls and fractures in older women: the study of osteoporotic fractures. J Am Geriatr Soc. 2006; 54:1177–1183. PMID: 16913982.
Article
26. Youngstedt SD, Kripke DF. Long sleep and mortality: rationale for sleep restriction. Sleep Med Rev. 2004; 8:159–174. PMID: 15144959.
Article
27. Vitiello MV, Smallwood RG, Avery DH, Pascualy RA, Martin DC, Prinz PN. Circadian temperature rhythms in young adult and aged men. Neurobiol Aging. 1986; 7:97–100. PMID: 3960269.
Article
28. Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011; 32:1484–1492. PMID: 21300732.
Article
29. Leng Y, Cappuccio FP, Wainwright NW, Surtees PG, Luben R, Brayne C, et al. Sleep duration and risk of fatal and nonfatal stroke: a prospective study and meta-analysis. Neurology. 2015; 84:1072–1079. PMID: 25716357.
30. Wang Y, Li W, Shen L, Song L, Li H, Liu B, et al. Association between nighttime sleep duration, sleep timing and falls among middle-aged and older Chinese population: a cross-sectional analysis from the Dongfeng-Tongji cohort study, China. Geriatr Gerontol Int. 2017; 2. 08. [Epub ahead of print]. DOI: 10.1111/ggi.12984.
Article
Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr