The prevalence of insomnia and its risk factors among older adults in a city in Turkey's Aegean Region

AIM: Experienced by many older adults, insomnia is a significant public health problem that requires the attention of health-care professionals and researchers. This study aimed to identify insomnia and its risk factors among community-dwelling older adults. METHODS: This cross-sectional study was conducted in Denizli, Turkey. The study sample consisted of 360 elderly individuals aged 60 years and older who were admitted to one of six family health centres for any reason between 29 March 2016 and 17 June 2016. Data were collected by using a descriptive form for the elderly and the Insomnia Severity Index. The ?(2) test was used to compare independent variables and insomnia status. Logistic regression analysis was used for the variables that were found to be significant at the end of the single-variable analysis. RESULTS: The mean age of the subjects, all of whom lived at home, was 69.52 ± 8.36 years. Insomnia was quite common among them (51%), and its severity was low (8.51 ± 5.56). At the end of logistic regression analysis, a moderate perception of health (OR = 10.859, 95%CI: 3.532-33.385) and the number of medications used (OR = 3.326, 95%CI: 1.014-10.907) were identified as risk factors for insomnia. CONCLUSION: Based on the results of this study, we can state that insomnia is common among older adults. Therefore, older adults who are admitted to health-care institutions should be evaluated for insomnia. Factors identified as affecting insomnia were health perception and the number of medications used. Given that health perception and polypharmacy are associated with chronic disease management, helping the elderly to effectively manage chronic diseases may alleviate insomnia

Lithocholic acid controls adaptive immune responses by inhibition of Th1 activation through the Vitamin D receptor.

Bile acids are established signaling molecules next to their role in the intestinal emulsification and uptake of lipids. We here aimed to identify a potential interaction between bile acids and CD4+ Th cells, which are central in adaptive immune responses. We screened distinct bile acid species for their potency to affect T cell function. Primary human and mouse CD4+ Th cells as well as Jurkat T cells were used to gain insight into the mechanism underlying these effects. We found that unconjugated lithocholic acid (LCA) impedes Th1 activation as measured by i) decreased production of the Th1 cytokines IFNγ and TNFαα, ii) decreased expression of the Th1 genes T-box protein expressed in T cells (T-bet), Stat-1 and Stat4, and iii) decreased STAT1α/β phosphorylation. Importantly, we observed that LCA impairs Th1 activation at physiological relevant concentrations. Profiling of MAPK signaling pathways in Jurkat T cells uncovered an inhibition of ERK-1/2 phosphorylation upon LCA exposure, which could provide an explanation for the impaired Th1 activation. LCA induces these effects via Vitamin D receptor (VDR) signaling since VDR RNA silencing abrogated these effects. These data reveal for the first time that LCA controls adaptive immunity via inhibition of Th1 activation. Many factors influence LCA levels, including bile acid-based drugs and gut microbiota. Our data may suggest that these factors also impact on adaptive immunity via a yet unrecognized LCA-Th cell axis