Sedentary Time, Physical Activity, Fitness, and Physical Function in Older Adults: What Best Predicts Sleep Quality?

in Journal of Aging and Physical Activity
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The aim of this study was to identify the best predictor of sleep quality (SQ) among physical behavior or capacity-related variables, namely physical activity, sedentary time, fitness, and physical function (activities of daily living) of independent elders using a representative sample of Portuguese aged 65 years and older (N = 437). SQ and activities of daily living were evaluated by a questionnaire, sedentary time, and physical activity through accelerometry, and physical fitness by means of the Senior Fitness Test. The logistic regression analysis revealed that activities of daily living measured by the Composite Physical Function was the only explanatory variable discriminating between poor SQ and good SQ. Receiver operating characteristic analysis showed that the best trade-off between sensitivity and specificity to discriminate older adults with poor SQ and good SQ was 20 points in the Composite Physical Function (sensitivity = 57.9%; specificity = 60.9%; area under the curve = 0.600, 95% confidence interval [0.536, 0.665], p = .003). Better physical function seems to be associated with better SQ in independent elders.

Ramos, Carraça, and Baptista are with Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal. Ramos and Paiva are with CENC—Sleep Medicine Center, Lisbon, Portugal.

Baptista (fbaptista@fmh.ulisboa.pt) is corresponding author.
  • Baron, K.G., Reid, K.J., & Zee, P.C. (2013). Exercise to improve sleep in insomnia: Exploration of the bidirectional effects. Journal of Clinical Sleep Medicine, 9, 819–824. PubMed ID: 23946713 doi:10.5664/jcsm.2930

    • Search Google Scholar
    • Export Citation
  • Brady, A.O., Straight, C.R., & Evans, E.M. (2014). Body composition, muscle capacity, and physical function in older adults: An integrated conceptual model. Journal of Aging and Physical Activity, 22(3), 441–452. PubMed ID: 23945551 doi:10.1123/JAPA.2013-0009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Buysse, D.J. (2014). Sleep health: Can we define it? Does it matter? Sleep, 37(1), 9–17. doi:10.5665/sleep.3298

  • Chasens, E.R., Sereika, S.M., Weaver, T.E., & Umlauf, M.G. (2007). Daytime sleepiness, exercise, and physical function in older adults. Journal of Sleep Research, 16, 60–65. PubMed ID: 17309764 doi:10.1111/j.1365-2869.2007.00576.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Copeland, J.L., Ashe, M.C., Biddle, S.J., Brown, W.J., Buman, M.P., Chastin, S., . . . Dogra, S. (2017). Sedentary time in older adults: A critical review of measurement, associations with health, and interventions. British Journal of Sports Medicine, 51(21), 1539. PubMed ID: 28724714 doi:10.1136/bjsports-2016-097210

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Crowley, K. (2011). Sleep and sleep disorders in older adults. Neuropsychology Review, 21, 41–53. doi:10.1007/s11065-010-9154-6

  • Dolezal, B.A., Neufeld, E.V., Boland, D.M., Martin, J.L., & Cooper, C.B. (2017). Interrelationship between sleep and exercise: A systematic review. Advances in Preventive Medicine, 2017, 1364387. doi:10.1155/2017/1364387

    • Search Google Scholar
    • Export Citation
  • Driscoll, H.C., Serody, L., Patrick, S., Maurer, J., Bensasi, S., Houck, P.R., . . . Reynolds, C.F. (2008). Sleeping well, aging well: A descriptive and cross-sectional study of sleep in “Successful Agers” 75 and older. American Journal of Geriatric Psychiatry, 16, 74–82. PubMed ID: 18070833 doi:10.1097/JGP.0b013e3181557b69

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Foley, D.J., Monjan, A.A., Brown, S.L., Simonsick, E.M., Wallace, R.B., & Blazer, D.G. (1995). Sleep complaints among elderly persons: An epidemiologic study of three communities. Sleep, 18, 425–432. PubMed ID: 7481413 doi:10.1093/sleep/18.6.425

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fougère, B., Vellas, B., van Kan, G.A., & Cesari, M. (2015). Identification of biological markers for better characterization of older subjects with physical frailty and sarcopenia. Translational Neuroscience, 6, 103–110. doi:10.1515/tnsci-2015-0009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fragoso, C.A.V., Miller, M.E., Fielding, R.A., King, A.C., Kritchevsky, S.B., McDermott, M.M., . . . Gill, T.M. (2014). Sleep-wake disturbances in sedentary community-dwelling elders with functional limitations. Journal of the American Geriatrics Society, 62, 1064–1072. doi:10.1111/jgs.12845

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gill, T.M., Desai, M.M., Gahbauer, E.A., Holford, T.R., & Williams, C.S. (2001). Restricted activity among community-living older persons: Incidence, precipitants, and health care utilization. Annals of Internal Medicine, 135, 313–321. PubMed ID: 11529694 doi:10.7326/0003-4819-135-5-200109040-00007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hardy, R., Cooper, R., Sayer, A.A., Ben-Shlomo, Y., Cooper, C., Deary, I.J., . . . HALCyon Study Team. (2013). Body mass index, muscle strength and physical performance in older adults from eight cohort studies: The HALCyon programme. PLoS ONE, 8, 56483. PubMed ID: 23437142 doi:10.1371/journal.pone.0056483

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Holfeld, B., & Ruthig, J.C. (2014). A longitudinal examination of sleep quality and physical activity in older adults. Journal of Applied Gerontology, 33, 791–807. PubMed ID: 25231754 doi:10.1177/0733464812455097

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ibáñez, V., Silva, J., & Cauli, O. (2018). A survey on sleep questionnaires and diaries. Sleep Medicine, 42, 90–96. doi:10.1016/j.sleep.2017.08.026

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kim, M. (2015). Association between objectively measured sleep quality and obesity in community-dwelling adults aged 80 years or older: A cross-sectional study. Journal of Korean Medical Science, 30, 199–206. PubMed ID: 25653493 doi:10.3346/jkms.2015.30.2.199

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kline, C. (2013). Sleep quality. In M.D. Gellman (Ed.), Encyclopedia of behavioral medicine (pp. 1811–1813). New York, NY: Springer.

  • Kredlow, M.A., Capozzoli, M.C., Hearon, B.A., Calkins, A.W., & Otto, M.W. (2015). The effects of physical activity on sleep: A meta-analytic review. Journal of Behavioral Medicine, 38, 427–449. PubMed ID: 25596964 doi:10.1007/s10865-015-9617-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lambiase, M.J., Gabriel, K.P., Kuller, L.H., & Matthews, K.A. (2013). Temporal relationships between physical activity and sleep in older women. Medicine & Science in Sports & Exercise, 45, 2362–2368. PubMed ID: 23739529 doi:10.1249/MSS.0b013e31829e4cea

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Li, J., Yao, Y., Dong, Q., Dong, Y., Liu, J., Yang, L., & Huang, F. (2013). Characterization and factors associated with sleep quality among rural elderly in China. Archives of Gerontology and Geriatrics, 56, 237–243. PubMed ID: 22906471 doi:10.1016/j.archger.2012.08.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lira, F.S., Pimentel, G.D., Santos, R.V.T., Oyama, L.M., Damaso, A.R., Nascimento, C.M.O., . . . Mello, M.T. (2011). Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner. Lipids in Health and Disease, 6, 1–6. doi:10.1186/1476-511X-10-113

    • Search Google Scholar
    • Export Citation
  • Mallampalli, M.P., & Carter, C.L. (2014). Exploring sex and gender differences in sleep health: A society for women’s health research report. Journal of Women’s Health, 23, 553–562. PubMed ID: 30661244 doi:10.1089/jwh.2014.4816

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marques, E.A., Baptista, F., Santos, D.A., Silva, A.M., Mota, J., & Sardinha, L.B. (2014a). Risk for losing physical independence in older adults: The role of sedentary time, light, and moderate to vigorous physical activity. Maturitas, 79(1), 91–95. doi:10.1016/j.maturitas.2014.06.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marques, E.A., Baptista, F., Santos, R., Vale, S., Santos, D.A., Silva, A.M., . . . Sardinha, L.B. (2014b). Normative functional fitness standards and trends of Portuguese older adults: Cross-cultural comparisons. Journal of Aging and Physical Activity, 22, 126–137. doi:10.1123/japa.2012-0203

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Moreh, E., Jacobs, J.M., & Stessman, J. (2010). Fatigue, function, and mortality in older adults. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 65, 887–895. doi:10.1093/gerona/glq064

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Murphy, R.A., Reinders, I., Register, T.C., Ayonayon, H.N., Newman, A.B., Satterfield, S., . . . Harris, T.B. (2014). Associations of BMI and adipose tissue area and density with incident mobility limitation and poor performance in older adults. The American Journal of Clinical Nutrition, 99, 1059–1065. PubMed ID: 24522448 doi:10.3945/ajcn.113.080796

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Neikrug, A.B., & Ancoli-Israel, S. (2010). Sleep disorders in the older adult—A mini-review. Gerontology, 56, 181–189. PubMed ID: 19738366 doi:10.1159/000236900

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ohayon, M., Wickwire, E.M., Hirshkowitz, M., Albert, S.M., Avidan, A., Daly, F.J., . . . Vitiello, M.V. (2017). National sleep foundation’s sleep quality recommendations: First report. Sleep Health, 3, 6–19. PubMed ID: 28346153 doi:10.1016/j.sleh.2016.11.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ohayon, M.M., Carskadon, M.A., Guilleminault, C., & Vitiello, M.V. (2004). Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep, 27, 1255–1273. PubMed ID: 15586779 doi:10.1093/sleep/27.7.1255

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ohayon, M.M., & Paiva, T. (2005). Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal. Sleep Medicine, 6, 435–441. PubMed ID: 16085459 doi:10.1016/j.sleep.2005.03.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Paiva, T., & Penzel, T. (2011). Centro de Medicina do Sono—Manual Prático. Lisboa, Portugal: LIDEL.

  • Park, M., Buchman, A.S., Lim, A.S.P., Leurgans, S.E., & Bennett, D.A. (2014). Sleep complaints and incident disability in a community-based cohort study of older persons. American Journal of Geriatric Psychiatry, 22, 718–726. PubMed ID: 23567404 doi:10.1016/j.jagp.2012.12.023

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Park, S.H. (2018). Tools for assessing fall risk in the elderly: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 30, 1–16. PubMed ID: 28374345 doi:10.1007/s40520-017-0749-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pedersen, B.K., & Saltin, B. (2015). Exercise as medicine—Evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports, 25, 1–72. PubMed ID: 26606383 doi:10.1111/sms.12581

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Reid, K.J., Baron, K.G., Lu, B., Naylor, E., Wolfe, L., & Zee, P.C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine, 11, 934–940. PubMed ID: 20813580 doi:10.1016/j.sleep.2010.04.014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rikli, R.E., & Jones, C.J. (1999). Development and validation of a functional fitness test for community-residing older adults. Journal of Aging and Physical Activity, 7, 129–161. doi:10.1123/japa.7.2.129

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rikli, R.E., & Jones, C.J. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The Gerontologist, 53, 255–267. PubMed ID: 22613940 doi:10.1093/geront/gns071

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Santos, R.V.T., Viana, V.A.R., Boscolo, R.A., Marques, V.G., Santana, M.G., Lira, F.S., . . . Mello, M.T. (2012). Moderate exercise training modulates cytokine profile and sleep in elderly people. Cytokine, 60, 731–735. PubMed ID: 22917967 doi:10.1016/j.cyto.2012.07.028

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sateia, M.J. (2014). International classification of sleep disorders-third edition: Highlights and modifications. Chest, 146, 1387–1394. PubMed ID: 25367475 doi:10.1378/chest.14-0970

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Smagula, S.F., Stone, K.L., Fabio, A., & Cauley, J.A. (2015). Risk factors for sleep disturbances in older adults: Evidence from prospective studies. Sleep Medicine Reviews, 25, 21–30. PubMed ID: 26140867 doi:10.1016/j.smrv.2015.01.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Solway, S., Brooks, D., Lacasse, Y., & Thomas, S.A. (2001). A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest, 119, 256–270. PubMed ID: 11157613 doi:10.1378/chest.119.1.256

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Song, Y., Dzierzewski, J.M., Fung, C.H., Rodriguez, J.C., Jouldjian, S., Mitchell, M.N., . . . Martin, J.L. (2015). Association between sleep and physical function in older veterans in an adult day healthcare program. Journal of the American Geriatrics Society, 63, 1622–1627. PubMed ID: 26200520 doi:10.1111/jgs.13527

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spira, A.P., Covinsky, K., Rebok, G.W., Punjabi, N.M., Stone, K.L., Hillier, T.A., . . . Yaffe, K. (2012). Poor sleep quality and functional decline in older women. Journal of the American Geriatrics Society, 60, 1092–1098. PubMed ID: 22690985 doi:10.1111/j.1532-5415.2012.03968.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spira, A.P., Kaufmann, C.N., Kasper, J.D., Ohayon, M.M., Rebok, G.W., Skidmore, E., . . . Reynolds, C.F. (2014). Association between insomnia symptoms and functional status in U.S. older adults. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 69, S35–41. doi:10.1093/geronb/gbu116

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stenholm, S., Kronholm, E., Bandinelli, S., Guralnik, J.M., & Ferrucci, L. (2011). Self-reported sleep duration and time in bed as predictors of physical function decline: Results from the InCHIANTI study. Sleep, 34, 1583–1593. PubMed ID: 22043129 doi:10.5665/sleep.1402

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tudor-Locke, C., Camhi, S.M., Leonardi, C., Johnson, W.D., Katzmarzyk, P.T., Earnest, C.P., & Church, T.S. (2011). Patterns of adult stepping cadence in the 2005–2006 NHANES. Preventive Medicine, 53, 178–181. PubMed ID: 21708187 doi:10.1016/j.ypmed.2011.06.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vestergaard, S., Nayfield, S.G., Patel, K.V., Eldadah, B., Cesari, M., Ferrucci, L., & Guralnik, J.M. (2009). Fatigue in a representative population of older persons and its association with functional impairment, functional limitation, and disability. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 64, 76–82. doi:10.1093/gerona/gln017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wang, X., & Youngstedt, S.D. (2014). Sleep quality improved following a single session of moderate-intensity aerobic exercise in older women: Results from a pilot study. Journal of Sport and Health Science, 3, 338–342. PubMed ID: 25685605 doi:10.1016/j.jshs.2013.11.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2010). Global recommendations on physical activity for health. Geneva, Switzerland: Author.

  • Wu, C., Su, T., Fang, C., & Chang, M.Y. (2012). Sleep quality among community-dwelling elderly people and its demographic, mental, and physical correlates. Journal of the Chinese Medical Association, 75, 75–80. PubMed ID: 22340741 doi:10.1016/j.jcma.2011.12.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yang, P., Ho, K., Chen, H., & Chien, M. (2012). Exercise training improves sleep quality in middle-aged and older adults with sleep problems: A systematic review. Journal of Physiotherapy, 58, 157–163. PubMed ID: 22884182 doi:10.1016/S1836-9553(12)70106-6

    • Crossref
    • Search Google Scholar
    • Export Citation
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