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Poor sleep quality (PSQI > 9.5) is associated with increased odds of fall history in older adults with type 2 diabetes

In a cross-sectional study of 60 participants (30 with T2DM, 30 controls), PSQI was the only variable significantly associated with fall status within the T2DM group (OR = 1.239, 95% CI: 1.033–1.488). ROC analysis showed PSQI had acceptable discriminative ability (AUC = 0.785, p = 0.010) with an optimal cut-off of 9.5, yielding 72.7% sensitivity and 84.2% specificity.

Last updated: Aug 25, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Dual-task timed up and go performance and sleep quality in relation to fall history in older adults with type 2 diabetes: a cross-sectional study.

observational

Zhang X, Wang S, Sun C, Li S, Hu Y · Frontiers in public health (2026)

Participants: N/A
Duration: N/A (cross-sectional)
Intervention: None (observational study); assessed sleep quality via PSQI and other variables
Outcome: Fall history (faller vs. non-faller) within T2DM group; also TUG, TUG-DT, postural stability, depression, lifestyle factors
Effect Size: OR = 1.239 (95% CI: 1.033–1.488)
Population: Middle-aged and older adults (aged >50) with type 2 diabetes mellitus (n=30) and age- and gender-matched healthy controls (n=30)

Result:

PubMed: 42625614DOI: 10.3389/fpubh.2026.1856870

Mechanism Graph

T2DM is associated with impairments in motor and cognitive function, increasing fall risk
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Poor sleep quality may further impair cognitive and motor performance, increasing fall risk
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PSQI score >9.5 identified as a critical threshold for fall risk
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Fall risk in T2DM is multidimensional, with behavioral and psychological factors playing a key role

Limitations

  • ⚠Cross-sectional design prevents causal inference
  • ⚠Small sample size (n=60) and single-center study may limit generalizability
  • ⚠Fall history was self-reported, subject to recall bias
  • ⚠Potential unmeasured confounders (e.g., medication use, neuropathy severity) not accounted for

Frequently Asked Questions

What is the optimal PSQI cutoff for predicting fall risk in older adults with type 2 diabetes?▼

The study found a PSQI score greater than 9.5 to be the optimal cutoff, with 72.7% sensitivity and 84.2% specificity for identifying fallers.

Is poor sleep quality more important than mobility performance for fall risk in T2DM?▼

In this study, PSQI was the only significant predictor of fall status in logistic regression, while TUG-DT performance was not significantly associated with falls, suggesting sleep quality may be a stronger correlate.

How does TUG-DT performance differ between T2DM patients and healthy controls?▼

T2DM patients showed significantly impaired TUG-DT performance, with increased cognitive errors, cognitive pauses, and movement pauses compared to controls, indicating reduced functional mobility.

What lifestyle factors were associated with T2DM in this study?▼

Smoking and exercise behavior differed significantly between T2DM and control groups, but these were not significant predictors of fall status within the T2DM group.

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References

  1. 1.Zhang X, Wang S, Sun C, Li S, Hu Y. "Dual-task timed up and go performance and sleep quality in relation to fall history in older adults with type 2 diabetes: a cross-sectional study.." Frontiers in public health, 2026. PMID: 42625614 DOI: 10.3389/fpubh.2026.1856870
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.