Co-occurring sleep duration and weight-adjusted waist index and their associations with cardiovascular risk in older adults: a group-based dual-trajectory modelling study

Abstract Aims Although sleep duration and weight-adjusted waist index (WWI) are recognized cardiovascular disease (CVD) risk factors in older adults, the individual and dual trajectories of these factors and their associations with CVD risk remain unclear. We aim to investigate these associations using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Methods and results We included 3313 older adults without hypertension, heart disease, or stroke in 2011 and assessed sleep duration, WWI, and CVD incidence in 2011, 2014, and 2018. Group-based dual trajectory modelling and logistic regression were used for analysis. All data were analysed in 2024. Three trajectories of sleep duration (low-stable, normal-stable, high-increasing) and two trajectories of WWI (normal-increasing, high-increasing) were identified, along with their six dual trajectories. Compared to the ‘normal-increasing WWI and normal-stable sleep duration’ pattern, the ‘high-increasing WWI and low-stable sleep duration’ pattern was associated with an increased risk of any one type of CVD [odds ration (OR) = 1.25, 95% confidence interval (CI) 1.03–1.83], the ‘normal-increasing WWI and low-stable sleep duration’ pattern was associated with an increased risk of any two types of CVD (OR = 1.58, 95% CI 1.06–2.36), and the ‘normal-increasing WWI and high-increasing sleep duration’ pattern was associated with an increased risk of all three types of CVD (OR = 4.48, 95% CI 1.44–13.94). Conclusion These findings highlight the importance of nursing professionals considering both sleep duration and WWI trajectories when assessing CVD risk in older adults, supporting the implementation of multi-point monitoring and targeted joint interventions to mitigate CVD risk in this population.