Sleep Disturbances and Risk of Falls in Older Community‐Dwelling Men: The Outcomes of Sleep Disorders in Older Men (MrOS Sleep) Study
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Objectives: To test the hypothesis that subjective and objective sleep disturbances are associated with risk of incident falls in older men. Design: The prospective observational M r OS S leep S tudy. Setting: Six academic clinical centers in the U nited S tates. Participants: Community‐dwelling men aged 67 and older (mean 76) (n = 3,101). Measurements: Subjective sleep measurements included daytime sleepiness ( E pworth S leepiness S cale ( ESS )), sleep quality ( P ittsburgh S leep Q uality I ndex ( PSQI )), and total sleep time ( TST ). Objective sleep measurements included actigraphic TST and sleep efficiency (an index of fragmentation) and sleep disordered breathing (measured using in‐home polysomnography). Fall frequency during the subsequent year was ascertained three times per year using questionnaires. Recurrent falling was defined as having two or more falls in the subsequent year. Results: In multivariable‐adjusted models, participants with excessive daytime sleepiness ( ESS > 10) but not poor subjective sleep quality ( PSQI > 5) had greater odds of experiencing two or more falls in the subsequent year (odds ratio ( OR ) = 1.52 95% confidence interval ( CI ) = 1.14–2.03). Based on actigraphic recordings, the odds of having recurrent falls was higher for men who slept 5 hours or less ( OR = 1.79, 95% CI = 1.22–2.60) than for those who slept 7 to 8 hours. Actigraphically measured sleep efficiency was also associated with greater risk of falls, as was nocturnal hypoxemia (≥10% of sleep time with arterial oxygen saturation <90%; OR = 1.62, 95% CI = 1.17–2.24) but not apnea hypopnea index. Conclusion: Subjective and objective sleep disturbances were associated with risk of falls in older men, independent of confounders.
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Various sleep characteristics-short or long sleep duration, excessive daytime sleepiness, and more night awakenings-may be associated with poorer cognition or cognitive decline.
“In addition, a number of studies have suggested that various aspects of sleep (eg, short or long sleep duration, excessive daytime sleepiness, greater number of night awakenings) may be associated with poorer cognition or cognitive decline.107–111”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [111]
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- Authors
- Stone, K. L., Blackwell, T. L., Ancoli‐Israel, S., Cauley, J. A., Redline, S., Marshall, L. M., Ensrud, K. E., & for the Osteoporotic Fractures in Men Study Group
- Affiliations
- California Pacific Medical Center (US)
- University of California San Diego (US)
- University of Pittsburgh (US)
- Brigham and Women's Hospital (US)
- Oregon Health & Science University (US)
- University of Minnesota (US)
- Corresponding author
- Stone, Katie L.
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2014-01-15
- Volume
- 62
- Issue
- 2
- Pages
- 299-305
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3945231
- OpenAlex
- W2073101724
- Cited by
- 204
- References
- 3
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 20 · 2023: 14 · 2022: 18 · 2021: 31 · 2020: 16 · 2019: 12 · 2018: 16 · 2017: 17 · 2016: 16 · 2015: 11 · 2014: 3
- FWCI
- 21.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- The National Institute of Arthritis and Musculoskeletal and Skin Diseases
- National Institute on Aging (AG08415)
- National Cancer Institute
- National Center for Research Resources
- NIH Roadmap for Medical Research (U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, UL1 RR024140)
- The National Heart, Lung, and Blood Institute (R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, R01 HL070839)
- Dymedix, Inc.
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep disorders, falls, older men, excessive daytime sleepiness, sleep quality, total sleep time, sleep efficiency, nocturnal hypoxemia, sleep-disordered breathing, actigraphy, recurrent falls, community-dwelling older adults
- MeSH terms
- Accidental Falls, Aged, Follow-Up Studies, Humans, Male, Prognosis, Prospective Studies, Quality of Life, Risk Factors, Sleep, Sleep Apnea Syndromes, United States, Incidence, Polysomnography, Risk Assessment
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