Junxin Li

Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment

To examine the cross‐sectional associations between self‐reported postlunch napping and structured cognitive assessments in Chinese older adults.

Exercise and Sleep in Community-Dwelling Older Adults

Insomnia and other sleep complaints are highly prevalent in community-dwelling older adults yet often go under detected. Age-related physiological changes may affect sleep, but sleep disturbances and complaints should not be considered normal in this population. Various physiological, psychological, and social consequences have been associated with insomnia and sleep complaints. Treatment options are available so it is imperative to diagnose and treat these individuals to promote healthy aging. Exercise is known to have a wide variety of health benefits, but unfortunately most older adults engage in less exercise with advancing age. This paper describes age-related changes in sleep, clinical correlates of insomnia, consequences of untreated insomnia, and nonpharmacological treatments for insomnia in older adults, with a focus on the relationship between exercise and sleep in community-dwelling older adults with insomnia or sleep complaints. Possible mechanisms explaining the relationship between exercise and sleep are discussed. While the research to date shows promising evidence for exercise as a safe and effective treatment for insomnia and sleep complaints in community-dwelling older adults, future research is needed before exercise can be a first-line treatment for insomnia and sleep complaints in this population.

Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults

Background The association between daytime napping and cognition is not well-studied in older adults. This study aimed to examine the associations between self-reported afternoon nap duration and change in cognition after 2-year follow-up in Chinese older adults. Methods A total of 3,037 individuals aged 60 years and older from the China Health and Retirement Longitudinal Study baseline and 2-year follow-up were included. Overall cognition was assessed by three interview-based sub-measures of orientation to time and attention, episodic memory, and visuospatial abilities. Change scores in cognition were calculated within subjects as follow-up minus baseline levels. Based on self-reported nap duration, older adults were grouped into: (i) Non-nappers (0 minutes); (ii) Short nappers (<30 minutes); (iii) Moderate nappers (30-90 minutes); and (iv) Extended nappers (>90 minutes) at baseline and follow-up. Results Change in cognition was significantly associated with both baseline napping and changes in napping habits from baseline to follow-up, controlling for age, gender, education, body mass index, depression, mobility, instrumental activities of daily living, nocturnal sleep duration, and cognition at baseline. Extended nappers at baseline performed significantly worse with respect to change of overall cognition from baseline to follow-up than non-nappers, short nappers, and moderate nappers. People who napped less than 90 minutes at both assessments performed significantly better from baseline to follow-up compared to non- or extended nappers at both assessments. Conclusion Results suggest that afternoon naps less than 90 minutes may be beneficial for cognition in older adults, while long afternoon naps may be detrimental.

Physical activity in relation to sleep among community-dwelling older adults in China

This cross-sectional study was conducted to describe the physical activity and sleep in 290 community-dwelling Chinese older adults and to examine the association between physical activity and poor sleep outcomes. Almost half of the samples were poor sleepers. The majority of the samples regularly participated in walking, some household activity, and light sports, yet only a small portion were involved in work-related activity or in strenuous sports. A greater level of overall physical activity (odds ratio = 0.79; 95% confidence interval = [0.73, 0.86]), leisure-time exercise (odds ratio = 0.77; 95% confidence interval = [0.68, 0.85]), and household activity (odds ratio = 0.66; 95% confidence interval = [0.56, 0.78]) were associated with reduced likelihood of being poor sleepers and other poor sleep outcomes, independent of covariates including age, sex, education, family income, the number of children, drinking, and sleep hygiene. Future larger-scale studies that incorporate both objective and subjective measures are needed to further examine the association and to explore the effects of different types of activity on sleep and other well-beings in older adults.

Sleep Among Long-Term Care Residents in China: A Narrative Review of Literature.

The objective of this study is to synthesize and evaluate the current body of sleep research among long-term care (LTC) residents in China and provide insights for future research. Systematic searches identified 15 studies that examined sleep in LTC residents in China. Sleep disturbances and poor sleep quality were prevalent in Chinese LTC residents. Eight cross-sectional studies reported that demographics, comorbidities, lifestyle, and environment were associated with sleep quality in Chinese LTC residents. Seven intervention studies, including exercise, traditional Chinese medicine, light therapy, and behavioral interventions resulted in improved sleep quality. Only subjective sleep measures were used in all 15 studies. Some methodological issues were identified in studies, especially those conducted in Mainland China. Sleep research in LTC residents in China is still at the beginning stages. Future studies should consider more rigorous designs and objective sleep measures, and develop target interventions based on factors associated with sleep disturbances.

Symptomless Multi-Variable Apnea Prediction Index Assesses Obstructive Sleep Apnea Risk and Adverse Outcomes in Elective Surgery

Study Objective To validate that the symptomless Multi-Variable Apnea Prediction index (sMVAP) is associated with Obstructive Sleep Apnea (OSA) diagnosis and assess the relationship between sMVAP and adverse outcomes in patients having elective surgery. We also compare associations between Bariatric surgery, where preoperative screening for OSA risk is mandatory, and non-Bariatric surgery groups who are not screened routinely for OSA. Methods Using data from 40 432 elective inpatient surgeries, we used logistic regression to determine the relationship between sMVAP and previous OSA, current hypertension, and postoperative complications: extended length of stay (ELOS), intensive-care-unit-stay (ICU-stay), and respiratory complications (pulmonary embolism, acute respiratory distress syndrome, and/or aspiration pneumonia). Results Higher sMVAP was associated with increased likelihood of previous OSA, hypertension and all postoperative complications (p < .0001). The top sMVAP quintile had increased odds of postoperative complications compared to the bottom quintile. For ELOS, ICU-stay, and respiratory complications, respective odds ratios (95% CI) were: 1.83 (1.62, 2.07), 1.44 (1.32, 1.58), and 1.85 (1.37, 2.49). Compared against age-, gender- and BMI-matched patients having Bariatric surgery, sMVAP was more strongly associated with postoperative complications in non-Bariatric surgical groups, including: (1) ELOS (Orthopedics [p < .0001], Gastrointestinal [p = .024], Neurosurgery [p = .016], Spine [p = .016]); (2) ICU-stay (Orthopedics [p = .0004], Gastrointestinal [p < .0001], and Otorhinolaryngology [p = .0102]); and (3) respiratory complications (Orthopedics [p =.037] and Otorhinolaryngology [p =.011]). Conclusions OSA risk measured by sMVAP correlates with higher risk for select postoperative complications. Associations are stronger for non-Bariatric surgeries, where preoperative screening for OSA is not routinely performed. Thus, preoperative screening may reduce OSA-related risk for adverse postoperative outcomes.