Frailty is associated with poor sleep quality in the oldest old

Authors: ÇAĞATAY ÇAVUŞOĞLU, OLGUN DENİZ, RANA TUNA DOĞRUL, SÜHEYLA ÇÖTELİ, ALİ ÖNCÜL, MUHAMMET CEMAL KIZILARSLANOĞLU, BERNA GÖKER

Abstract: Background/aim: Sleep disorders and frailty increase with advancing age, along with physical disabilities, cognitive dysfunction, mood disorders, and social vulnerability. Thus, the study objective was to evaluate the relationship between frailty and sleep quality in the oldest old patients. Materials and methods: In this study, 100 patients aged ≥ 80 years were assessed using comprehensive geriatric assessment (CGA) including basic activities of daily living (ADL), instrumental ADL, handgrip strength, the Geriatric Depression Scale-15, the MiniMental State Examination, and the Mini-Nutritional Assessment-Short Form. The sleep quality and frailty status of the patients were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Fried Frailty Index, respectively. Results: The median age of the participants was 84 years (80-92), 55% of them were women, and 41% of them were frail. There was no statistically significant difference between the frail and nonfrail groups in terms of age, sex, and comorbidities (P > 0.050). The frail patients scored poorly according to the CGA tests when compared to the nonfrail ones (P < 0.050). The median score for the PSQI was significantly higher in the frail group, 12 points (3-19) versus 6 points (1-19) in the nonfrail patients (P < 0.001). The PSQI score (odds ratio [OR] of 1.308, 95% confidence interval [CI]: 1.092-1.566, P = 0.004), female sex (OR of 5.489, 95% CI: 1.063-28.337; P = 0.042), and the basic ADL score (OR of 0.383; 95% CI: 0.207-0.706; P = 0.002) were found to be independently associated with frailty using multivariate analysis. Conclusion: Sleep quality was significantly decreased in the oldest old frail patients compared to the nonfrail ones, and poor sleep quality was independently associated with frailty. Evaluating the sleep patterns of the oldest old patients with CGA in daily geriatric practice might help to improve the quality of life of frail patients.

Keywords: Frailty, insomnia, oldest old, sleep disorders, sleep quality

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