How Severe is Insomnia in People 80-Years-Old and Older?

Journal of the American Geriatrics Society Research Summary

Insomnia means having difficulty falling or staying asleep at night. It tends to worsen as we age, and insomnia is a common problem among older adults. As many as 50 percent of people report having trouble sleeping. However, when researchers study insomnia, they may not include older adults in their studies. This means we don’t fully understand insomnia among older people.

A team of researchers from the Yale School of Medicine and the Yale School of Nursing decided to fill the knowledge gap by studying insomnia and its severity in older adults. The researchers’ theory was that insomnia would be more common and severe as people aged and would be linked to other health problems. Their study was published in the Journal of the American Geriatrics Society.

The researchers reviewed information from the Yale Precipitating Events Project (PEP), an ongoing study that began around 20 years ago. The study population consists of 754 non-disabled older adults between the ages of 78 and 102 (with an average age of about 84). Over the years, the study’s participants have regularly completed tests at home and interviews to determine their health.

The participants answered questions about sleep disorders, such as restless leg syndrome, daytime sleepiness, and sleep apnea (the medical term for when your breathing pauses during sleep). They also answered questions to determine whether they had insomnia, and if so, how severe it was.

The researchers reported that 43 percent of the older adults in the study had insomnia, and that restless leg syndrome and symptoms of depression were linked to insomnia. However, the researchers were surprised to discover that the participants’ insomnia was mild.

They also reported another surprising finding. The researchers looked at risk factors for insomnia in younger adults. These risk factors included chronic heart and breathing problems, sleep apnea, taking multiple medications, and cognitive impairment (trouble with thinking abilities). These risk factors were not linked with insomnia in the older study participants.

The researchers concluded that the high rate but mild severity of insomnia highlights the need for healthcare providers to use appropriate tests to confirm sleep problems among older adults. They also suggested that healthcare providers should take depression and restless leg syndrome into account when they treat older adults who have insomnia.

This summary is from “Insomnia in Community-Living Persons with Advanced Age.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Brienne Miner, MD, MHS; Thomas M. Gill, MD; H. Klar Yaggi, MD, MPH; Nancy S. Redeker, PhD, RN; Peter H. Van Ness, PhD, MPH; Ling Han, MD, PhD; and Carlos A. Vaz Fragoso, MD.

The Link Between Handgrip Strength and Healthy Lungs in Older Women

Journal of the American Geriatrics Society Research Summary

As we age, we may become weaker as our muscles tend to lose their mass and strength. This condition of losing muscle mass is called sarcopenia. Sarcopenia can lead to problems performing your daily activities, such as shopping, socializing, and taking care of yourself and your home. Having sarcopenia can lessen your quality of life—and your independence.

A simple, fast way to test your overall muscle strength is by measuring the strength of your handgrip. In the test, you grip a small device as hard as you can, and it measures the strength of your grip. Studies have shown that handgrip strength is closely linked to muscle mass and other signs of your general health, including nutrition and walking ability. What’s more, handgrip strength is considered an important test for diagnosing sarcopenia. Weak handgrip strength can predict low muscle mass and poor physical performance.

Research has linked handgrip strength to other health problems in older adults. Losing muscle strength as you age also means losing muscle strength in your respiratory system. (The respiratory system is the part of your body responsible for breathing.) This can lead to poor lung function. When your lungs don’t function properly, you are at higher risk for respiratory issues like bronchitis and pneumonia, as well as heart disease and even death. Continue reading

During National Women’s Health Week, Honor Your Own Health

National Women’s Health Week (May 13-19, 2018) is a perfect reminder to female healthcare providers to practice what we preach. As caregivers and as women who serve our communities’ health, we all too often focus on the health needs of others before our own. In the immortal words of every flight attendant, “Put on your oxygen mask before assisting others.” Meaning, of course, that if you’re neglecting your own well-being, it will be difficult for you to help your clients and loved ones.

And as we age, it becomes increasingly important to monitor our health. That’s because older women are more likely than men to have chronic health conditions, including arthritis, high blood pressure, and osteoporosis.

Happily, a great deal of what it takes to boost your chances for staying physically and mentally healthy is within your power. Below is what the experts with the American Geriatrics Society’s Health in Aging Foundation recommend.

See your healthcare provider regularly. Even if you feel perfectly healthy, get a check-up at least once a year, or as often as your provider recommends.

Take medications, vitamins, and supplements only as directed. When you visit your provider, bring all the pills and other supplements you take—even those you buy over the counter without a prescription. Your provider should check all of your pills to make sure they’re safe for you, and you should check with her before taking any new medication or supplement.

Let your provider know right away if a medication or supplement seems to be causing a problem or a side effect. Continue reading

Commonly Prescribed Heartburn Drug Linked to Pneumonia in Older Adults

Journal of the American Geriatrics Society Research Summary

Researchers at the University of Exeter have found a statistical link between pneumonia in older people and a group of medicines commonly used to neutralize stomach acid in people with heartburn or stomach ulcers. Although proton-pump inhibitors (PPIs) are still a valuable group of medicines, research is indicating that PPIs are not as completely safe for older people as previously thought.

PPIs are medicines commonly prescribed to reduce gastric (stomach) acid production and to protect the stomach. Approximately 40 percent of older adults receive PPIs, although according to some experts, up to 85 percent of people who receive PPI prescriptions may not need them.

Researchers say people should not stop using their PPI medication, but should discuss with their prescribing healthcare professional whether the PPIs are still needed. Just stopping PPIs could be dangerous as PPIs may be useful, for example, to prevent stomach bleeds in some people.

Once thought to be relatively harmless, PPIs have more recently been linked to increased rates for certain health concerns like fractures, cardiovascular disease, and some bacterial infections. The association between PPI use and pneumonia was studied because stomach acid helps to prevent infections spreading from the gut in some individuals. Since pneumonia is a major cause of death for older adults, it is important for healthcare providers to understand the links between PPIs and pneumonia.

The Exeter team designed a study to look at statistical links in medical records between long-term PPI use and pneumonia in older adults. Their study was published in the Journal of the American Geriatrics Society. Continue reading

When Do Age-Related Problems with Memory and Decision-Making Begin to Affect Older Adults’ Ability to Drive?

Journal of the American Geriatrics Society Research Summary

For older adults, driving can mean living a more independent, satisfying life. Therefore, it’s no surprise that about 86 percent of adults age 65 and older hold active driver’s licenses, and many of us expect to drive for longer as we age.

Car crashes can be devastating or even deadly for anyone, including older adults and other road users. However, the fatal crash rate based on the distance someone travels in a vehicle begins to rise at age 65. At the same time, when older adults stop driving due to health issues or other concerns, they may experience isolation and depression. They also may be more likely to enter long-term care facilities earlier than they otherwise would.

Researchers have a history of studying driver safety in older adults after they’ve been diagnosed with dementia, a decline in memory and other mental abilities that make daily living difficult. However, we have limited knowledge about the effects on older drivers whose problems with mental abilities are less severe than those associated with dementia.

Recently, a team of researchers designed a study to learn more about cognitive health and older drivers’ crash risks. The study was published in the Journal of the American Geriatrics Society. In this study, the researchers focused on links between levels of cognitive function and crash risk among older drivers without dementia over a 14-year study period. They also assessed the link between changes in cognitive function over time and later risks of crashes. Continue reading