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Association of sleep problems and sleep duration with self-rated health and grip strength among older adults in India and China: results from the study on global aging and adult health (SAGE)

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Abstract

Background

Sleep is an important predictor of health and quality of life. This study examined the association between sleep problems and sleep duration with self-rated poor health and grip strength among respondents aged 50 years and above in India and China.

Methods: The data for this study were derived from the first wave of WHO’s Study on Global Aging and Adult Health (SAGE), a nationally representative panel survey conducted in six LMICs. Grip strength and poor self-rated health were the main outcome variables, while sleep problems and sleep duration were the main predictors. Multivariate logistic regression models and ordinary least squares regression models were used to understand the association between sleep problems and sleep duration with poor self-rated health and grip strength.

Results

Sleep problems and sleep duration were strongly and significantly associated with poor self-rated health and grip strength in India and China. Compared to older adults with no sleep problems, the odds ratio for poor self-rated health among older adults with sleep problems was 4.86 (95% CI = 4.12, 5.73, p < 0.01) and 5.06 (95% CI = 3.93, 6.51, p < 0.01) higher for India and China, respectively. The likelihood of reporting poor health was higher among older adults who got ≤ 6 or 10+ h of sleep in both India and China. A negative and significant association was found between longer sleep duration and grip strength only in China (β = −1.19, 95% CI = −1.78, −0.60, p < 0.01).

Conclusion

We observed a significant association between sleep problems and sleep duration with poor self-rated health and grip strength. Results suggested that sleep problems are important factors in determining the health of older adults in low- and middle-income countries.

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References

  • Abbatecola AM, Ferrucci L, Ceda G, Russo CR, Lauretani F, Bandinelli S, et al. (2005) Insulin resistance and muscle strength in older persons. J Gerontol Ser A Biol Sci Med Sci 60(10):1278–1282

    Article  Google Scholar 

  • Abell JG, Shipley MJ, Ferrie JE, Kivimäki M, Kumari M (2016) Association of chronic insomnia symptoms and recurrent extreme sleep duration over 10 years with well-being in older adults: a cohort study. BMJ Open 6(2):e009501

    Article  Google Scholar 

  • Banister J, Bloom DE, and Rosenberg L. (2010) Population aging and economic growth in China, program on the global demography of aging working paper series. Harvard School of Public Health

  • Bloom DE, Canning D, Hu L, Liu Y, Mahal A, Yip W (2010) The contribution of population health and demographic change to economic growth in China and India. J Comp Econ 38(1):17–33

    Article  Google Scholar 

  • Broussard JL, Ehrmann DA, Van Cauter E, Tasali E, Brady MJ (2012) Impaired insulin signaling in human adipocytes after experimental sleep restriction. A randomized, crossover study. Ann Intern Med 157(8):549–557

    Article  Google Scholar 

  • Buchmann N, Spira D, Norman K, Demuth I, Eckardt R, Steinhagen-Thiessen E (2016) Sleep, muscle mass and muscle function in older people: a cross-sectional analysis based on data from the Berlin Aging Study II (BASE-II). Dtsch Arztebl Int 113(15):253

    PubMed  PubMed Central  Google Scholar 

  • Buxton OM, Marcelli E (2010) Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States. Soc Sci Med 71(5):1027–1036

    Article  Google Scholar 

  • Byass P (2008) Towards a global agenda on ageing. Glob Health Action 1(1):1908

    Article  Google Scholar 

  • Cappuccio FP, D'Elia L, Strazzullo P, Miller MA (2010) Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 33(5):585–592

    Article  Google Scholar 

  • Chatterji S, Kowal P, Mathers C, Naidoo N, Verdes E, Smith JP, Suzman R (2008) The health of aging populations in China and India. Health Aff 27(4):1052–1063

    Article  Google Scholar 

  • Chen D, Yang TC (2014) The pathways from perceived discrimination to self-rated health: an investigation of the roles of distrust, social capital, and health behaviors. Soc Sci Med 104:64–73

    Article  Google Scholar 

  • Cheung CL, Nguyen USD, Au E, Tan KC, Kung AW (2013) Association of handgrip strength with chronic diseases and multimorbidity. Age 35(3):929–941

    Article  Google Scholar 

  • Dam TTL, Ewing S, Ancoli-Israel S, Ensrud K, Redline S, Stone K (2008) Association between sleep and physical function in older men: the osteoporotic fractures in men sleep study. J Am Geriatr Soc 56(9):1665–1673

    Article  Google Scholar 

  • DESA, UN (2015) World population prospects: the 2015 revision, key findings and advance tables. Working Paper, No. ESA/P/WP. 241

  • DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P (2006) Mortality prediction with a single general self-rated health question. J Gen Intern Med 21(3):267–275

    Article  Google Scholar 

  • Dey S, Nambiar D, Lakshmi JK, Sheikh K, Reddy KS (2012) Health of the elderly in India: challenges of access and affordability

  • Engelgau M, Rosenhouse S, El-Saharty S, Mahal A (2011) The economic effect of noncommunicable diseases on households and nations: a review of existing evidence. J Health Commun 16(sup2):75–81

    Article  Google Scholar 

  • Ferrie JE, Shipley MJ, Cappuccio FP, Brunner E, Miller MA, Kumari M, Marmot MG (2007) A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort. Sleep 30(12):1659–1666

    Article  Google Scholar 

  • Ferrie JE, Kumari M, Salo P, Singh-Manoux A, Kivimäki M (2011) Sleep epidemiology—a rapidly growing field

  • Frange C, de Queiroz SS, da Silva Prado JM, Tufik S, de Mello MT (2014) The impact of sleep duration on self-rated health. Sleep Sci 7(2):107–113

    Article  Google Scholar 

  • Gallicchio L, Kalesan B (2009) Sleep duration and mortality: a systematic review and meta-analysis. J Sleep Res 18(2):148–158

    Article  Google Scholar 

  • Gambhir IS, Chakrabarti SS, Sharma AR, Saran DP (2014) Insomnia in the elderly—a hospital-based study from North India. J Clin Gerontol Geriatr 5(4):117–121

    Article  Google Scholar 

  • Geiger SD, Sabanayagam C, & Shankar A (2012) The relationship between insufficient sleep and self-rated health in a nationally representative sample. J Environ Public Health 2012

  • Gildner TE, Liebert MA, Kowal P, Chatterji S, Snodgrass JJ (2014) Sleep duration, sleep quality, and obesity risk among older adults from six middle-income countries: findings from the study on global ageing and adult health (SAGE). Am J Hum Biol 26(6):803–812

    Article  Google Scholar 

  • Goldman SE, Stone KL, Ancoli-Israel S, Blackwell T, Ewing SK, Boudreau R, et al. (2007) Poor sleep is associated with poorer physical performance and greater functional limitations in older women. Sleep 30(10):1317–1324

    Article  Google Scholar 

  • Gottlieb DJ, Redline S, Nieto FJ, Baldwin CM, Newman AB, Resnick HE, Punjabi NM (2006) Association of usual sleep duration with hypertension: the sleep heart health study. Sleep 29(8):1009–1014

    Article  Google Scholar 

  • Hamidovic A, de Wit H (2009) Sleep deprivation increases cigarette smoking. Pharmacol Biochem Behav 93(3):263–269

    Article  CAS  Google Scholar 

  • Hanandita W, Tampubolon G (2016) Does reporting behaviour bias the measurement of social inequalities in self-rated health in Indonesia? An anchoring vignette analysis. Qual Life Res 25(5):1137–1149

    Article  Google Scholar 

  • He W, Muenchrath MN, Kowal PR (2012) Shades of gray: a cross-country study of health and wellbeing of the older populations in SAGE countries, 2007–2010. US Department of Commerce, Economics and Statistics Administration, US Census Bureau

  • Hill EL, Cumming RG, Lewis R, Carrington S, Couteur DGL (2007) Sleep disturbances and falls in older people. J Gerontol Ser A Biol Med Sci 62(1):62–66

    Article  Google Scholar 

  • Hillman DR, Murphy AS, Antic R, Pezzullo L (2006) The economic cost of sleep disorders. Sleep 29(3):299–305

    Article  Google Scholar 

  • Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 21–37

    Article  CAS  Google Scholar 

  • Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ., et al. (2010) Impaired glucose tolerance in sleep disorders. PLoS One 5(3):e9444

    Article  Google Scholar 

  • Kim JH, Kim KR, Cho KH, Yoo KB, Kwon JA, Park EC (2013) The association between sleep duration and self-rated health in the Korean general population. J Clin Sleep Med 9(10):1057

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Lopez Ridaura R, et al. (2012) Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE). Int J Epidemiol 41(6):1639–1649

  • Koyanagi A, Garin N, Olaya B, Ayuso-Mateos JL, Chatterji S, Leonardi M, et al. (2014) Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PloS one 9(12):e114742

    Article  Google Scholar 

  • Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, et al. (2015) Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet 386(9990):266–273

    Article  Google Scholar 

  • Lo JC, Groeger JA, Cheng GH, Dijk DJ, Chee MW (2016) Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Med 17:87–98

    Article  Google Scholar 

  • Luo J, Zhu G, Zhao Q, Guo Q, Meng H, Hong Z, Ding D (2013) Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai Aging Study. PLoS One 8(11):e81261

    Article  Google Scholar 

  • Lyytikäinen P, Rahkonen O, Lahelma E, Lallukka T (2011) Association of sleep duration with weight and weight gain: a prospective follow-up study. J Sleep Res 20(2):298–302

    Article  Google Scholar 

  • Malinowska KB, Ikezoe T, Ichihashi N, Arai H, Murase K, Chin K, et al. (2017) Self-reported quality of sleep is associated with physical strength among community-dwelling young-old adults. Geriatr Gerontol Int

  • Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442

    Article  Google Scholar 

  • Mazzotti DR, Guindalini C, Sosa AL, Ferri CP, Tufik S (2012) Prevalence and correlates for sleep complaints in older adults in low and middle income countries: a 10/66 dementia research group study. Sleep Med 13(6):697–702

    Article  Google Scholar 

  • Moore PJ, Adler NE, Williams DR, Jackson JS (2002) Socioeconomic status and health: the role of sleep. Psychosom Med 64(2):337–344

    Article  Google Scholar 

  • National Research Council (2010) Preparing for the challenges of population aging in Asia: strengthening the scientific basis of policy development. National Academies Press, Washington

    Google Scholar 

  • Nieminen T, Prättälä R, Martelin T, Härkänen T, Hyyppä MT, Alanen E, Koskinen S (2013) Social capital, health behaviours and health: a population-based associational study. BMC Public Health 13(1):613

    Article  Google Scholar 

  • Niu J, Han H, Wang Y, Wang L, Gao X, Liao S (2016) Sleep quality and cognitive decline in a community of older adults in Daqing City, China. Sleep Med 17:69–74

    Article  Google Scholar 

  • Nunn CL, Samson DR, Krystal AD (2016) Shining evolutionary light on human sleep and sleep disorders. Evol Med Public Health 2016(1):227–243

    Article  Google Scholar 

  • Pa J, Goodson W, Bloch A, King AC, Yaffe K, Barnes DE (2014) Effect of exercise and cognitive activity on self-reported sleep quality in community-dwelling older adults with cognitive complaints: a randomized controlled trial. J Am Geriatr Soc 62(12):2319–2326

    Article  Google Scholar 

  • Patel SR, Blackwell T, Redline S, Ancoli-Israel S, CauleyJA, Hillier TA, et al. (2008) The association between sleep duration and obesity in older adults. Int J Obesity 32(12):1825–1834

    Article  CAS  Google Scholar 

  • Roy K, Chaudhuri A (2008) Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India. Soc Sci Med 66(9):1951–1962

    Article  Google Scholar 

  • Salomon JA, Murray CJL (2002) The epidemiologic transition revisited: compositional models for causes of death by age and sex. Popul Dev Rev 28(2):205–228

    Article  Google Scholar 

  • Sayer AA, Syddall HE, Dennison EM, Martin HJ, Phillips DIW, Cooper C, Byrne CD (2007) Grip strength and the metabolic syndrome: findings from the Hertfordshire cohort study. QJM 100(11):707–713

    Article  CAS  Google Scholar 

  • Schnittker J, Bacak V (2014) The increasing predictive validity of self-rated health. PLoS One 9(1):e84933

    Article  Google Scholar 

  • Sekine M, Chandola T, Martikainen P, McGeoghegan D, Marmot M, Kagamimori S (2005) Explaining social inequalities in health by sleep: the Japanese civil servants study. J Public Health 28(1):63–70

    Article  Google Scholar 

  • Shankar A, Charumathi S, Kalidindi S (2011) Sleep duration and self-rated health: the national health interview survey 2008. Sleep 34(9):1173–1177

    Article  Google Scholar 

  • Shen X, Wu Y, Zhang D (2016) Nighttime sleep duration, 24-hour sleep duration and risk of all-cause mortality among adults: a meta-analysis of prospective cohort studies. Sci Rep 6

  • Silva-Costa A, Griep RH, Rotenberg L (2015) Associations of a short sleep duration, insufficient sleep, and insomnia with self-rated health among nurses. PLoS One 10(5):e0126844

    Article  Google Scholar 

  • Singh L, Singh PK, Arokiasamy P (2016) Social network and mental health among older adults in rural Uttar Pradesh, India: a cross-sectional study. J Cross Cult Gerontol 31(2):173–192

    Article  Google Scholar 

  • Spira AP, Covinsky K, Rebok GW, Punjabi NM, Stone KL, Hillier TA et al (2012) Poor sleep quality and functional decline in older women. J Am Geriatr Soc 60(6):1092–1098

    Article  Google Scholar 

  • Spira AP, Kaufmann CN, Kasper JD, Ohayon MM, Rebok GW, Skidmore E, et al. (2014) Association between insomnia symptoms and functional status in US older adults. J Gerontol Ser B Psychol Sci Soc Sci 69(Suppl_1):S35–S41

    Article  Google Scholar 

  • Stenholm S, Kronholm E, Bandinelli S, Guralnik JM, Ferrucci L (2011) Self-reported sleep duration and time in bed as predictors of physical function decline: results from the InCHIANTI study. Sleep 34(11):1583–1593

    Article  Google Scholar 

  • Stranges S, Dorn JM, Shipley MJ, Kandala NB, Trevisan M, Miller MA, et al. (2008) Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study. Am J Epidemiol 168(12):1353–1364

    Article  Google Scholar 

  • Stranges S, Tigbe W, Gómez-Olivé FX, Thorogood M, Kandala NB (2012) Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep 35(8):1173–1181

    Article  Google Scholar 

  • Suzman R, Beard JR, Boerma T, Chatterji S (2015) Health in an ageing world—what do we know? Lancet 385(9967):484–486

    Article  Google Scholar 

  • Swanson LM, Arnedt J, Rosekind MR, Belenky G, Balkin TJ, Drake C (2011) Sleep disorders and work performance: findings from the 2008 National Sleep Foundation sleep in America poll. J Sleep Res 20(3):487–494

    Article  Google Scholar 

  • Taekema DG, Gussekloo J, Maier AB, Westendorp RG, de Craen AJ (2010) Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing 39(3):331–337

    Article  Google Scholar 

  • Varrasse M, Li J, Gooneratne N (2015) Exercise and sleep in community-dwelling older adults. Curr Sleep Med Rep 1(4):232–240

    Article  Google Scholar 

  • Vgontzas AN, Liao D, Bixler EO, Chrousos GP, Vela-Bueno A (2009) Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep 32(4):491–497

    Article  Google Scholar 

  • Vgontzas AN, Liao D, Pejovic S, Calhoun S, Karataraki M, Basta M, et al. (2010) Insomnia with short sleep duration and mortality: the Penn State cohort. Sleep 33(9):1159–1164

    Article  Google Scholar 

  • Von Ruesten A, Weikert C, Fietze I, Boeing H (2012) Association of sleep duration with chronic diseases in the European prospective investigation into cancer and nutrition (EPIC)-Potsdam study. PLoS One 7(1):e30972

    Article  Google Scholar 

  • Wang L, Kong L, Wu F, Bai Y, Burton R (2005) Preventing chronic diseases in China. Lancet 366(9499):1821–1824

    Article  Google Scholar 

  • Williams JS, Kowal P, Hestekin H, O’Driscoll T, Peltzer K, Yawson A, et al. (2015) Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-income countries: results from the WHO Study on global AGEing and adult health (SAGE). BMC medicine 13(1):147

  • Xu L, Jiang CQ, Lam TH, Liu B, Jin YL, Zhu T, et al. (2011) Short or long sleep duration is associated with memory impairment in older Chinese: the Guangzhou Biobank Cohort Study. Sleep 34(5):575–580

    Article  Google Scholar 

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Authors and Affiliations

  1. International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India

    Y. Selvamani, Perianayagam Arokiasamy &  Himanshu

  2. Tata Institute for Social Sciences (TISS), Mumbai, Maharashtra, 400088, India

    Mamta Chaudhary

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  1. Y. Selvamani
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  2. Perianayagam Arokiasamy
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Correspondence to Mamta Chaudhary.

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Selvamani, Y., Arokiasamy, P., Chaudhary, M. et al. Association of sleep problems and sleep duration with self-rated health and grip strength among older adults in India and China: results from the study on global aging and adult health (SAGE). J Public Health (Berl.) 26, 697–707 (2018). https://doi.org/10.1007/s10389-018-0906-8

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