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      The Association between Sleep Patterns and Obesity in Older Adults

      research-article
      , MD MS 1 , , MN 2 , , MA 3 , , PhD 3 , , PhD 4 , , MB 5 , , PhD 3 , the Osteoporotic Fractures in Men (MrOS) and the Study of Osteoporotic Fractures (SOF) Research Groups
      International journal of obesity (2005)
      sleep duration, sleep pattern, napping, variability, obesity, geriatrics

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          Abstract

          Background

          Reduced sleep duration has been increasingly reported to predict obesity. However, timing and regularity of sleep may also be important. In this study, the cross-sectional association between objectively measured sleep patterns and obesity was assessed in two large cohorts of older individuals.

          Methods

          Wrist actigraphy was performed in 3053 men (mean age: 76.4 years) participating in the Osteoporotic Fractures in Men Study (MrOS) and 2985 women (mean age: 83.5 years) participating in the Study of Osteoporotic Fractures (SOF). Timing and regularity of sleep patterns were assessed across nights, as well as daytime napping.

          Results

          Greater night-to-night variability in sleep duration and daytime napping were associated with obesity independent of mean nocturnal sleep duration in both men and women. Each 1 hour increase in the variability of nocturnal sleep duration increased the odds of obesity 1.63-fold (95% CI [1.31-2.02]) among men and 1.22-fold (95% CI [1.01-1.47]) among women. Each 1 hour increase in napping increased the odds of obesity 1.23-fold (95%CI [1.12-1.37]) in men and 1.29-fold (95%CI [1.17-1.41]) in women. In contrast, associations between later sleep timing and night-to-night variability in sleep timing with obesity were less consistent.

          Conclusions

          In both older men and women, variability in nightly sleep duration and daytime napping were associated with obesity independent of mean sleep duration. These findings suggest that characteristics of sleep beyond mean sleep duration may play a role in weight homeostasis, highlighting the complex relationship between sleep and metabolism.

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          Most cited references30

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          The Modified Mini-Mental State (3MS) examination.

          E Teng, H Chui (1987)
          The Mini-Mental State (MMS) examination is a widely used screening test for dementia. The Modified Mini-Mental State (3MS) incorporates four added test items, more graded scoring, and some other minor changes. These modifications are designed to sample a broader variety of cognitive functions, cover a wider range of difficulty levels, and enhance the reliability and the validity of the scores. The 3MS retains the brevity, ease of administration, and objective scoring of the MMS but broadens the range of scores from 0-30 to 0-100. Greater sensitivities of the 3MS over the MMS are demonstrated with the pentagon item drawn by 249 patients. A summary form for administration and scoring that can generate both the MMS and the 3MS scores is provided so that the examiner can maintain continuity with existing data and can obtain a more informative assessment.
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            The Physical Activity Scale for the Elderly (PASE): development and evaluation.

            A Physical Activity Scale for the Elderly (PASE) was evaluated in a sample of community-dwelling, older adults. Respondents were randomly assigned to complete the PASE by mail or telephone before or after a home visit assessment. Item weights for the PASE were derived by regressing a physical activity principal component score on responses to the PASE. The component score was based on 3-day motion sensor counts, a 3-day physical activity dairy and a global activity self-assessment. Test-retest reliability, assessed over a 3-7 week interval, was 0.75 (95% CI = 0.69-0.80). Reliability for mail administration (r = 0.84) was higher than for telephone administration (r = 0.68). Construct validity was established by correlating PASE scores with health status and physiologic measures. As hypothesized, PASE scores were positively associated with grip strength (r = 0.37), static balance (r = +0.33), leg strength (r = 0.25) and negatively correlated with resting heart rate (r = -0.13), age (r = -0.34) and perceived health status (r = -0.34); and overall Sickness Impact Profile score (r = -0.42). The PASE is a brief, easily scored, reliable and valid instrument for the assessment of physical activity in epidemiologic studies of older people.
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              Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study--a large observational study of the determinants of fracture in older men.

              Very little information is available to direct the prevention or management of osteoporosis in men. The Osteoporotic Fractures in Men (MrOS) Study is a prospective cohort study designed to examine the extent to which fracture risk is related to bone mass, bone geometry, lifestyle, anthropometric and neuromuscular measures, and fall propensity, as well as to determine how fractures affect quality of life in men. The study is also designed to understand how osteoporosis is related to prostate disease. At baseline, participants completed questionnaires regarding medical history, medications, physical activity, diet, alcohol intake, and cigarette smoking. Objective measures of anthropometric, neuromuscular, vision, strength, and cognitive variables were obtained. Skeletal assessments included DEXA, calcaneal ultrasound, and vertebral radiographs. Vertebral and proximal femoral QCT was performed on a subset (65%). Serum, urine, and DNA specimens were collected. After the baseline assessments, a questionnaire is mailed to participants every 4 months to ascertain incident falls, fractures, prostate cancer, and deaths. After an average of 4.5 years, participants are scheduled to return for a second comprehensive visit. Men were eligible if > or =65 years. 5995 men enrolled with a mean (+/-SD) age of 73.7 (+/-5.9) years, 11% of which were minorities. Most rated their health as good/excellent. Few were current smokers, although 59% had smoked previously, and 35% reported no alcohol intake, while 47% consumed at least 2 drinks per week. The mean (range) body mass index was 26.9 kg/m2 (17-56). A non-traumatic fracture after age 50 was reported by 17% of the cohort. The MrOS cohort should provide valuable information concerning the determinants of fracture in men and should help set the stage for the development of effective methods to identify those at risk.
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                Author and article information

                Journal
                101256108
                32579
                Int J Obes (Lond)
                Int J Obes (Lond)
                International journal of obesity (2005)
                0307-0565
                1476-5497
                21 May 2014
                24 January 2014
                September 2014
                01 March 2015
                : 38
                : 9
                : 1159-1164
                Affiliations
                [1 ]Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
                [2 ]Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH
                [3 ]California Pacific Medical Center Research Institute, San Francisco CA
                [4 ]Departments of Psychiatry and Medicine, University of California San Diego, La Jolla, CA
                [5 ]Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
                Author notes
                Corresponding author: Sanjay R. Patel MD, MS 221 Longwood Avenue, Room 225-C Boston, MA 02115 Telephone: 857-307-0347 Fax: 617-278-6946 spatel@ 123456partners.org
                Article
                NIHMS558376
                10.1038/ijo.2014.13
                4110191
                24458262
                d3dd64e5-fff2-413a-9ad4-b2cba29a7020

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                Categories
                Article

                Nutrition & Dietetics
                sleep duration,sleep pattern,napping,variability,obesity,geriatrics
                Nutrition & Dietetics
                sleep duration, sleep pattern, napping, variability, obesity, geriatrics

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