Abstract
Objective
To explore the association between both self-reported quality and quantity sleep characteristics
and frailty status in a large non–sex-specific population of older individuals in
Greece.
Design
Cross-sectional study.
Setting and Participants
In total, 1984 older individuals (≥65 years old) were drawn from the Hellenic Longitudinal
Investigation of Aging and Diet (HELIAD).
Measures
Frailty was assessed using 3 different definitions, the Frailty Index (FI), the Tilburg
Frailty Indicator (TFI), and the Groningen Frailty Indicator (GFI). Sleep quality
was evaluated through the Sleep Index II, which includes 9 of the 12 self-reported
items of the Medical Outcomes Study-Sleep Scale. To examine sleep duration, participants
were asked to report on how many hours they slept each night during the past 4 weeks.
Logistic regression models adjusted for multiple covariates were explored. Additional
analyses, stratified by gender, adjusting for sleep-related medications and excluding
participants diagnosed with dementia, were also performed.
Results
In total, 389 (20%), 619 (31.9%), and 608 (31.3%) participants were categorized as
frail according to the FI, the TFI, and the GFI respectively. Sleep quality was significantly
associated with frailty in all models. Even after adjusting for subjective sleep duration,
compared with participants who subjectively reported high sleep quality, those with
low sleep quality had 3.7, 2.6, and 2.5 more times to be frail as measured with FI,
TFI, and GFI respectively. Regarding the associations between frailty and self-reported
sleep duration, sex-specific associations were observed: prolonged sleep duration
was associated with frailty in the subsample of male participants.
Conclusions and Implications
The present study shows a strong correlation between subjective sleep quality and
frailty status, contributing substantial information to the growing literature demonstrating
that sleep is associated with older people's overall health. Sleep complaints should
not be underestimated, and older individuals who self-report sleep disorders should
be further assessed for frailty.
Keywords
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Article info
Publication history
Published online: September 25, 2020
Footnotes
The authors declare no conflicts of interest.
IIRG-09133014 (Alzheimer’s Association), 189 10,276/8/9/2011 (ESPA-EU program Excellence Grant, ARISTEIA, co-funded by the European Social Fund and Greek National resources), and DY2b/oik.51657/14.4.2009 (Ministry for Health and Social Solidarity, Greece).
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
