Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure

Lei Gao,1,2 Andrew SP Lim,3 Patricia M Wong,4 Arlen Gaba,2 Longchang Cui,2 Lei Yu,5 Aron S Buchman,5 David A Bennett,5 Kun Hu,2,6 Peng Li2,6 1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; 2Division of Sleep a...

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Autores principales:	Gao L, Lim ASP, Wong PM, Gaba A, Cui L, Yu L, Buchman AS, Bennett DA, Hu K, Li P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	sleep fragmentation heart failure mobile health unobtrusive monitoring Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/681b97f575ab49c0b4a9331c031eb9f0
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spelling	oai:doaj.org-article:681b97f575ab49c0b4a9331c031eb9f02021-12-02T11:03:35ZFragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure1179-1608https://doaj.org/article/681b97f575ab49c0b4a9331c031eb9f02020-05-01T00:00:00Zhttps://www.dovepress.com/fragmentation-of-restactivity-patterns-in-community-based-elderly-indi-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Lei Gao,1,2 Andrew SP Lim,3 Patricia M Wong,4 Arlen Gaba,2 Longchang Cui,2 Lei Yu,5 Aron S Buchman,5 David A Bennett,5 Kun Hu,2,6 Peng Li2,6 1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; 2Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA; 3Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, USA; 4Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; 5Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; 6Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USACorrespondence: Lei GaoDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USATel +1 617 888-2941Fax +1 617 732-7337Email lgao@mgh.harvard.eduPeng LiDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USATel +1 617 278-0061Fax +1 617 732-7337Email pli9@bwh.harvard.eduStudy Objectives: Heart failure has previously been linked to sleep disorders that are often associated with frequent disturbances to human rest/activity patterns. We tested whether fragmentation of sustained rest/activity patterns derived from actigraphic recordings at baseline predicts incident heart failure in community-based elderly individuals.Methods: We studied 1099 community-based elderly adults participating in the Rush Memory and Aging Project who had baseline motor activity monitoring up to 11 days and were followed annually for up to 14 years. Fragmentation was assessed using previously validated indexes, derived from the probability of transitions once sustained rest or activity has been established. Heart failure was recorded via a clinical interview during the annual follow-up. Cox proportional hazards models were constructed to examine the relationship between rest fragmentation index and incident heart failure. Covariates grouped in terms of demographics, lifestyle factors and co-morbidities and cardiovascular risk factors/diseases were included.Results: Increased rest fragmentation (but not activity fragmentation) was associated with higher risk for incident heart failure. Specifically, a subject with a rest fragmentation at the 90th percentile showed a 57% increased risk of developing incident heart failure compared to a subject at the 10th percentile in this cohort. This effect was equivalent to that of being over a decade older. These observations were consistent after adjusting for all covariates.Conclusion: Increased rest fragmentation, a potential surrogate for sleep fragmentation, is independently associated with a higher risk of developing heart failure in community-based elderly adults during up to 14 years of follow-up. Further work is required to examine the specific contributions from daytime napping versus nighttime sleep periods in the elderly, as well as the underlying autonomic and cardio-dynamic pathways that may explain the effects on heart function.Keywords: sleep fragmentation, heart failure, mobile health, unobtrusive monitoringGao LLim ASPWong PMGaba ACui LYu LBuchman ASBennett DAHu KLi PDove Medical Pressarticlesleep fragmentationheart failuremobile healthunobtrusive monitoringPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 299-307 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	sleep fragmentation heart failure mobile health unobtrusive monitoring Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	sleep fragmentation heart failure mobile health unobtrusive monitoring Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Gao L Lim ASP Wong PM Gaba A Cui L Yu L Buchman AS Bennett DA Hu K Li P Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
description	Lei Gao,1,2 Andrew SP Lim,3 Patricia M Wong,4 Arlen Gaba,2 Longchang Cui,2 Lei Yu,5 Aron S Buchman,5 David A Bennett,5 Kun Hu,2,6 Peng Li2,6 1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; 2Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USA; 3Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, USA; 4Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; 5Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA; 6Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USACorrespondence: Lei GaoDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USATel +1 617 888-2941Fax +1 617 732-7337Email lgao@mgh.harvard.eduPeng LiDivision of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115, USATel +1 617 278-0061Fax +1 617 732-7337Email pli9@bwh.harvard.eduStudy Objectives: Heart failure has previously been linked to sleep disorders that are often associated with frequent disturbances to human rest/activity patterns. We tested whether fragmentation of sustained rest/activity patterns derived from actigraphic recordings at baseline predicts incident heart failure in community-based elderly individuals.Methods: We studied 1099 community-based elderly adults participating in the Rush Memory and Aging Project who had baseline motor activity monitoring up to 11 days and were followed annually for up to 14 years. Fragmentation was assessed using previously validated indexes, derived from the probability of transitions once sustained rest or activity has been established. Heart failure was recorded via a clinical interview during the annual follow-up. Cox proportional hazards models were constructed to examine the relationship between rest fragmentation index and incident heart failure. Covariates grouped in terms of demographics, lifestyle factors and co-morbidities and cardiovascular risk factors/diseases were included.Results: Increased rest fragmentation (but not activity fragmentation) was associated with higher risk for incident heart failure. Specifically, a subject with a rest fragmentation at the 90th percentile showed a 57% increased risk of developing incident heart failure compared to a subject at the 10th percentile in this cohort. This effect was equivalent to that of being over a decade older. These observations were consistent after adjusting for all covariates.Conclusion: Increased rest fragmentation, a potential surrogate for sleep fragmentation, is independently associated with a higher risk of developing heart failure in community-based elderly adults during up to 14 years of follow-up. Further work is required to examine the specific contributions from daytime napping versus nighttime sleep periods in the elderly, as well as the underlying autonomic and cardio-dynamic pathways that may explain the effects on heart function.Keywords: sleep fragmentation, heart failure, mobile health, unobtrusive monitoring
format	article
author	Gao L Lim ASP Wong PM Gaba A Cui L Yu L Buchman AS Bennett DA Hu K Li P
author_facet	Gao L Lim ASP Wong PM Gaba A Cui L Yu L Buchman AS Bennett DA Hu K Li P
author_sort	Gao L
title	Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
title_short	Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
title_full	Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
title_fullStr	Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
title_full_unstemmed	Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure
title_sort	fragmentation of rest/activity patterns in community-based elderly individuals predicts incident heart failure
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/681b97f575ab49c0b4a9331c031eb9f0
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Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure

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