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The sleep-muscle axis: how poor sleep quality predicts probable sarcopenia in the older adults

Year 2025, Volume: 8 Issue: 3, 456 - 460, 30.05.2025
https://doi.org/10.32322/jhsm.1655166

Abstract

Aims: Investigate whether there is a link between the quality of sleep and the likelihood of developing sarcopenia in older adults.
Methods: Among the 498 patients over 65 who enrolled in the internal medicine geriatrics clinic between December 2024 and March 2025, 74 patients with poor sleep quality (group 1) and 110 patients with good sleep quality (group 2) were included in the study. The remaining 314 patients were excluded from the study. Demographic characteristics, body measurements, comprehensive geriatric assessments, potential sarcopenia assessments, and Pittsburgh sleep quality measurements were conducted.
Results: The average age of group 1, consisting of a total of 74 people, is 73.5±5.1 years, and the average age of group 2, consisting of 110 people, is 71.6±5.2 years. A statistically significant difference was detected between the groups in terms of average age distribution (p=0.03). The average body-mass index (BMI) value of group 1 patients was statistically significantly lower than that of group 2 patients (p=0.038). When the comprehensive geriatric evaluation was compared between the groups, the rate of possible sarcopenia was 81 percent in group 1 and 17 percent in group 2 (p<0.034).
Conclusion: Findings suggest a potential link between sleep quality and probable sarcopenia in older adults.

References

  • GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1160-1203. doi:10.1016/S0140-6736(20)30977-6
  • Gong J, Wang G, Wang Y, et al. Nowcasting and forecasting the care needs of the older population in China: analysis of data from the China health and retirement longitudinal study (CHARLS). Lancet Public Health. 2022;7(12):e1005-e1013. doi:10.1016/S2468-2667(22)00203-1
  • Gooneratne NS, Vitiello MV. Sleep in older adults: normative changes, sleep disorders, and treatment options. Clin Geriatr Med. 2014;30(3):591-627. doi:10.1016/j.cger.2014.04.007
  • Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult-a mini-review. Gerontology. 2010;56(2):181-189. doi:10.1159/000236900
  • Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151-161. doi:10. 2147/NSS.S134864
  • Baar MP, Perdiguero E, Muñoz-Cánoves P, de Keizer PL. Musculoskeletal senescence: a moving target ready to be eliminated. Curr Opin Pharmacol. 2018;40:147-155. doi:10.1016/j.coph.2018.05.007
  • Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169
  • Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyère O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548. doi:10.1371/journal.pone.0169548
  • Yuan S, Larsson SC. Epidemiology of sarcopenia: prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. doi:10.1016/j.metabol.2023.155533
  • Xia L, Zhao R, Wan Q, et al. Sarcopenia and adverse health-related outcomes: an umbrella review of meta-analyses of observational studies. Cancer Med. 2020;9(21):7964-7978. doi:10.1002/cam4.3428
  • Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-256. doi:10.1016/j.jamda.2011.01.003
  • Cho YJ, Lim YH, Yun JM, Yoon HJ, Park M. Sex- and age-specific effects of energy intake and physical activity on sarcopenia. Sci Rep. 2020;10(1): 9822. doi:10.1038/s41598-020-66249-6
  • Otsuka Y, Iidaka T, Horii C, et al. Dietary intake of vitamin E and fats associated with sarcopenia in community-dwelling older japanese people: a cross-sectional study from the fifth survey of the ROAD study. Nutrients. 2021;13(5):1730. doi:10.3390/nu13051730
  • Jike M, Itani O, Watanabe N, Buysse DJ, Kaneita Y. Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression. Sleep Med Rev. 2018;39:25-36. doi:10.1016/j.smrv.2017.06.011
  • Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246-256. doi:10.1016/j.sleep.2016.08.006
  • Li M, Wang N, Dupre ME. Association between the self-reported duration and quality of sleep and cognitive function among middle-aged and older adults in China. J Affect Disord. 2022;304:20-27. doi:10.1016/j.jad.2022.02.039
  • Fu L, Yu X, Zhang W, et al. The relationship between sleep duration, falls, and muscle mass: a cohort study in an elderly Chinese population. Rejuvenation Res. 2019;22(5):390-398. doi:10.1089/rej.2018.2102
  • Pana A, Sourtzi P, Kalokairinou A, Pastroudis A, Chatzopoulos ST, Velonaki VS. Association between muscle strength and sleep quality and duration among middle-aged and older adults: a systematic review. Eur Geriatr Med. 2021;12(1):27-44. doi:10.1007/s41999-020-00399-8
  • Rubio-Arias JÁ, Rodríguez-Fernández R, Andreu L, Martínez-Aranda LM, Martínez-Rodriguez A, Ramos-Campo DJ. Effect of sleep quality on the prevalence of sarcopenia in older adults: a systematic review with meta-analysis. J Clin Med. 2019;8(12):2156. doi:10.3390/jcm8122156
  • Dattilo M, Antunes HK, Medeiros A, et al. Paradoxical sleep deprivation induces muscle atrophy. Muscle Nerve. 2012;45(3):431-433. doi:10.1002/mus.22322
  • Morrison M, Halson SL, Weakley J, Hawley JA. Sleep, circadian biology and skeletal muscle interactions: implications for metabolic health. Sleep Med Rev. 2022;66:101700. doi:10.1016/j.smrv.2022.101700
  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186.
  • Arik G, Varan HD, Yavuz BB, et al. Validation of Katz Index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-350. doi:10.1016/j.archger.2015.08.019
  • Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60. doi:10.1016/j.archger.2015.04. 006
  • Midão L, Giardini A, Menditto E, Kardas P, Costa E. Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Arch Gerontol Geriatr. 2018;78:213-220. doi:10. 1016/j.archger.2018.06.018
  • Rockwood K, Theou O. Using the Clinical Frailty Scale in allocating scarce health care resources. Can Geriatr J. 2020;23(3):210-215. doi:10. 5770/cgj.23.463
  • Özsürekci C, Balcı C, Kızılarslanoğlu MC, et al. An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale. Acta Clin Belg. 2020;75(3):200-204. doi:10.1080/17843286.2019.1597457
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi:10.1016/0165-1781 (89)90047-4
  • Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843-844. doi:10.5665/sleep.4716
  • Strong K, Noor A, Aponte J, et al. Monitoring the status of selected health related sustainable development goals: methods and projections to 2030. Glob Health Action. 2020;13(1):1846903. doi:10.1080/16549716.2020.184 6903
  • Ismail Z, Ahmad WIW, Hamjah SH, Astina IK. The impact of population ageing: a review. Iran J Public Health. 2021;50(12):2451-2460. doi:10.18502/ijph.v50i12.7927
  • Ancoli-Israel S, Alessi C. Sleep and aging. Am J Geriatr Psychiatry. 2005; 13(5):341-343. doi:10.1176/appi.ajgp.13.5.341
  • Chaput JP, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this? Nat Sci Sleep. 2018;10:421-430. doi:10.2147/NSS.S163071
  • Helbig AK, Döring A, Heier M, et al. Association between sleep disturbances and falls among the elderly: results from the German cooperative health research in the region of Augsburg-age study. Sleep Med. 2013;14(12):1356-1363. doi:10.1016/j.sleep.2013.09.004
  • Chien MY, Wang LY, Chen HC. The relationship of sleep duration with obesity and sarcopenia in community-dwelling older adults. Gerontology. 2015;61(5):399-406. doi:10.1159/000371847
  • Reid KF, Fielding RA. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev. 2012;40(1):4-12. doi:10.1097/JES.0b013e31823b5f13
  • Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International sarcopenia initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748-759. doi:10.1093/ageing/afu115
  • Rodrigues F, Monteiro AM, Forte P, Morouço P. Effects of muscle strength, agility, and fear of falling on risk of falling in older adults. Int J Environ Res Public Health. 2023;20(6):4945. doi:10.3390/ijerph20064945
  • Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300-307.e2. doi:10.1016/j.jamda.2019.12.012
  • Dodds R, Sayer AA. Sarcopenia and frailty: new challenges for clinical practice. Clin Med (Lond). 2016;16(5):455-458. doi:10.7861/clinmedicine.16-5-455
  • Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9): 513-537. doi:10.1038/s41574-018-0062-9
  • Grandner MA, Valencia DY, Seixas AA, et al. Development and initial validation of the assessment of sleep environment (ASE): describing and quantifying the impact of subjective environmental factors on sleep. Int J Environ Res Public Health. 2022;19(20):13599. doi:10.3390/ijerph 192013599
  • Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci. 2023;7(5):457-466. doi:10.1042/ETLS20230111
  • Lavoie CJ, Zeidler MR, Martin JL. Sleep and aging. Sleep Sci Pract. 2018; 2:1-8. doi:10.1186/s41606-018-0021-3

Gece korkuları: yaşlanmada uykusuzluk ve sarkopeni arasındaki bağlantı: kesitsel bir çalışma

Year 2025, Volume: 8 Issue: 3, 456 - 460, 30.05.2025
https://doi.org/10.32322/jhsm.1655166

Abstract

Amaç: Yaşlı yetişkinlerde uyku kalitesi ile sarkopeni gelişme olasılığı arasında bir bağlantı olup olmadığını araştırmak.
Yöntemler: Aralık 2024 ile Mart 2025 tarihleri ​​arasında dahiliye geriatri kliniğine kayıtlı 65 yaş üstü 498 hastadan, uyku kalitesi düşük 74 hasta (Grup-1) ve uyku kalitesi iyi 110 hasta (Grup-2) çalışmaya dahil edildi. Geriye kalan 314 hasta çalışmadan çıkarıldı. Demografik özellikler, vücut ölçümleri, kapsamlı geriatrik değerlendirmeler, olası sarkopeni değerlendirmeleri ve Pittsburgh uyku kalitesi ölçümleri yapıldı.
Sonuçlar: Toplam 74 kişiden oluşan grup-1'in yaş ortalaması 73,5±5,1 yıl, 110 kişiden oluşan grup-2'nin yaş ortalaması ise 71,6±5,2 yıldır. Gruplar arasında ortalama yaş dağılımı açısından istatistiksel olarak anlamlı bir fark saptandı (p = 0,03). Grup 1 hastalarının ortalama Vücut Kitle İndeksi (VKİ) değeri, Grup 2 hastalarından istatistiksel olarak anlamlı derecede düşüktü (p = 0,038). Gruplar arasında kapsamlı geriatrik değerlendirme karşılaştırıldığında, Grup 1'de olası sarkopeni oranı %81, Grup 2'de ise %17 idi (p < 0,034).
Sonuç: Uyku kalitesinin yaşlı kişilerde sarkopeni ile ilişkili olduğu keşfedildi.

References

  • GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1160-1203. doi:10.1016/S0140-6736(20)30977-6
  • Gong J, Wang G, Wang Y, et al. Nowcasting and forecasting the care needs of the older population in China: analysis of data from the China health and retirement longitudinal study (CHARLS). Lancet Public Health. 2022;7(12):e1005-e1013. doi:10.1016/S2468-2667(22)00203-1
  • Gooneratne NS, Vitiello MV. Sleep in older adults: normative changes, sleep disorders, and treatment options. Clin Geriatr Med. 2014;30(3):591-627. doi:10.1016/j.cger.2014.04.007
  • Neikrug AB, Ancoli-Israel S. Sleep disorders in the older adult-a mini-review. Gerontology. 2010;56(2):181-189. doi:10.1159/000236900
  • Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151-161. doi:10. 2147/NSS.S134864
  • Baar MP, Perdiguero E, Muñoz-Cánoves P, de Keizer PL. Musculoskeletal senescence: a moving target ready to be eliminated. Curr Opin Pharmacol. 2018;40:147-155. doi:10.1016/j.coph.2018.05.007
  • Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169
  • Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyère O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548. doi:10.1371/journal.pone.0169548
  • Yuan S, Larsson SC. Epidemiology of sarcopenia: prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. doi:10.1016/j.metabol.2023.155533
  • Xia L, Zhao R, Wan Q, et al. Sarcopenia and adverse health-related outcomes: an umbrella review of meta-analyses of observational studies. Cancer Med. 2020;9(21):7964-7978. doi:10.1002/cam4.3428
  • Fielding RA, Vellas B, Evans WJ, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-256. doi:10.1016/j.jamda.2011.01.003
  • Cho YJ, Lim YH, Yun JM, Yoon HJ, Park M. Sex- and age-specific effects of energy intake and physical activity on sarcopenia. Sci Rep. 2020;10(1): 9822. doi:10.1038/s41598-020-66249-6
  • Otsuka Y, Iidaka T, Horii C, et al. Dietary intake of vitamin E and fats associated with sarcopenia in community-dwelling older japanese people: a cross-sectional study from the fifth survey of the ROAD study. Nutrients. 2021;13(5):1730. doi:10.3390/nu13051730
  • Jike M, Itani O, Watanabe N, Buysse DJ, Kaneita Y. Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression. Sleep Med Rev. 2018;39:25-36. doi:10.1016/j.smrv.2017.06.011
  • Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017;32:246-256. doi:10.1016/j.sleep.2016.08.006
  • Li M, Wang N, Dupre ME. Association between the self-reported duration and quality of sleep and cognitive function among middle-aged and older adults in China. J Affect Disord. 2022;304:20-27. doi:10.1016/j.jad.2022.02.039
  • Fu L, Yu X, Zhang W, et al. The relationship between sleep duration, falls, and muscle mass: a cohort study in an elderly Chinese population. Rejuvenation Res. 2019;22(5):390-398. doi:10.1089/rej.2018.2102
  • Pana A, Sourtzi P, Kalokairinou A, Pastroudis A, Chatzopoulos ST, Velonaki VS. Association between muscle strength and sleep quality and duration among middle-aged and older adults: a systematic review. Eur Geriatr Med. 2021;12(1):27-44. doi:10.1007/s41999-020-00399-8
  • Rubio-Arias JÁ, Rodríguez-Fernández R, Andreu L, Martínez-Aranda LM, Martínez-Rodriguez A, Ramos-Campo DJ. Effect of sleep quality on the prevalence of sarcopenia in older adults: a systematic review with meta-analysis. J Clin Med. 2019;8(12):2156. doi:10.3390/jcm8122156
  • Dattilo M, Antunes HK, Medeiros A, et al. Paradoxical sleep deprivation induces muscle atrophy. Muscle Nerve. 2012;45(3):431-433. doi:10.1002/mus.22322
  • Morrison M, Halson SL, Weakley J, Hawley JA. Sleep, circadian biology and skeletal muscle interactions: implications for metabolic health. Sleep Med Rev. 2022;66:101700. doi:10.1016/j.smrv.2022.101700
  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186.
  • Arik G, Varan HD, Yavuz BB, et al. Validation of Katz Index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-350. doi:10.1016/j.archger.2015.08.019
  • Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60. doi:10.1016/j.archger.2015.04. 006
  • Midão L, Giardini A, Menditto E, Kardas P, Costa E. Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Arch Gerontol Geriatr. 2018;78:213-220. doi:10. 1016/j.archger.2018.06.018
  • Rockwood K, Theou O. Using the Clinical Frailty Scale in allocating scarce health care resources. Can Geriatr J. 2020;23(3):210-215. doi:10. 5770/cgj.23.463
  • Özsürekci C, Balcı C, Kızılarslanoğlu MC, et al. An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale. Acta Clin Belg. 2020;75(3):200-204. doi:10.1080/17843286.2019.1597457
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi:10.1016/0165-1781 (89)90047-4
  • Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843-844. doi:10.5665/sleep.4716
  • Strong K, Noor A, Aponte J, et al. Monitoring the status of selected health related sustainable development goals: methods and projections to 2030. Glob Health Action. 2020;13(1):1846903. doi:10.1080/16549716.2020.184 6903
  • Ismail Z, Ahmad WIW, Hamjah SH, Astina IK. The impact of population ageing: a review. Iran J Public Health. 2021;50(12):2451-2460. doi:10.18502/ijph.v50i12.7927
  • Ancoli-Israel S, Alessi C. Sleep and aging. Am J Geriatr Psychiatry. 2005; 13(5):341-343. doi:10.1176/appi.ajgp.13.5.341
  • Chaput JP, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this? Nat Sci Sleep. 2018;10:421-430. doi:10.2147/NSS.S163071
  • Helbig AK, Döring A, Heier M, et al. Association between sleep disturbances and falls among the elderly: results from the German cooperative health research in the region of Augsburg-age study. Sleep Med. 2013;14(12):1356-1363. doi:10.1016/j.sleep.2013.09.004
  • Chien MY, Wang LY, Chen HC. The relationship of sleep duration with obesity and sarcopenia in community-dwelling older adults. Gerontology. 2015;61(5):399-406. doi:10.1159/000371847
  • Reid KF, Fielding RA. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev. 2012;40(1):4-12. doi:10.1097/JES.0b013e31823b5f13
  • Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International sarcopenia initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748-759. doi:10.1093/ageing/afu115
  • Rodrigues F, Monteiro AM, Forte P, Morouço P. Effects of muscle strength, agility, and fear of falling on risk of falling in older adults. Int J Environ Res Public Health. 2023;20(6):4945. doi:10.3390/ijerph20064945
  • Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300-307.e2. doi:10.1016/j.jamda.2019.12.012
  • Dodds R, Sayer AA. Sarcopenia and frailty: new challenges for clinical practice. Clin Med (Lond). 2016;16(5):455-458. doi:10.7861/clinmedicine.16-5-455
  • Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9): 513-537. doi:10.1038/s41574-018-0062-9
  • Grandner MA, Valencia DY, Seixas AA, et al. Development and initial validation of the assessment of sleep environment (ASE): describing and quantifying the impact of subjective environmental factors on sleep. Int J Environ Res Public Health. 2022;19(20):13599. doi:10.3390/ijerph 192013599
  • Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci. 2023;7(5):457-466. doi:10.1042/ETLS20230111
  • Lavoie CJ, Zeidler MR, Martin JL. Sleep and aging. Sleep Sci Pract. 2018; 2:1-8. doi:10.1186/s41606-018-0021-3
There are 44 citations in total.

Details

Primary Language English
Subjects Geriatrics and Gerontology, Clinical Sciences (Other)
Journal Section Research Article
Authors

Zeynep Şahiner 0000-0003-1256-4412

Ayşe Dikmeer Altuntaş 0000-0003-3016-8173

Submission Date March 10, 2025
Acceptance Date May 5, 2025
Publication Date May 30, 2025
Published in Issue Year 2025 Volume: 8 Issue: 3

Cite

AMA Şahiner Z, Dikmeer Altuntaş A. The sleep-muscle axis: how poor sleep quality predicts probable sarcopenia in the older adults. J Health Sci Med / JHSM. May 2025;8(3):456-460. doi:10.32322/jhsm.1655166

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Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


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Articles published in the Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.