Sleep disturbances in elderly linked to multiple chronic diseases: Study

Sleep disturbances are prevalent among older adults and are associated with various individual diseases. Cross-sectional studies showed that short sleep duration, feelings of drowsiness, and difficulties sleeping were associated with multimorbidity. Sex differences have also been demonstrated, including differences in the relationship between sleep disturbances and commonly co-occurring chronic conditions. The association between sleep disturbances and multimorbidity may be bidirectional.

Therefore, Shireen Sindi and associates from the Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden conducted this study which aimed to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults.

The authors studied a total of 3363 subjects all aged at 60+. The study also included a subsample of 1189 subjects without multimorbidity at baseline (< 2 chronic diseases). Baseline sleep disturbances were derived from the Comprehensive Psychiatric Rating Scale and categorized as none, mild, and moderate-severe.

The number of chronic conditions throughout the 9-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic disease accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. The analyses were repeated which included only cardiovascular, neuropsychiatric, or musculoskeletal diseases as the outcome.

The following findings were observed-

a. Moderate–severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year = 0.142, p = 0.008), regardless of potential confounders.

b. Significant positive associations were also found between moderate-severe sleep disturbances and neuropsychiatric (ß/year = 0.041, p = 0.016) and musculoskeletal (ß/year = 0.038, p = 0.025) disease accumulation, but not with cardiovascular diseases.

c. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded.

Hence, it was concluded that "sleep disturbances are associated with faster chronic disease accumulation points towards the importance of early detection and treatment of sleep disturbances as a possible strategy to reduce chronic multimorbidity among older adults."

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Sindi, S., Pérez, L.M., Vetrano, D.L. et al. Sleep disturbances and the speed of multimorbidity development in old age: results from a longitudinal population-based study. BMC Med 18, 382 (2020). https://doi.org/10.1186/s12916-020-01846-w