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Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study.
J Am Med Dir Assoc. 2021 03; 22(3):551-558.e1.JA

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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Balomenos V
School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
Ntanasi E
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece. Electronic address: e.ntanasi@hotmail.com.
Anastasiou CA
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Charisis S
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Velonakis G
2nd Department of Radiology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Karavasilis E
2nd Department of Radiology, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Tsapanou A
Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY.
Yannakoulia M
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Kosmidis MH
Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dardiotis E
School of Medicine, University of Thessaly, Larissa, Greece.
Hadjigeorgiou G
Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus.
Sakka P
Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece.
Scarmeas N
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY.

MeSH

AgedCross-Sectional StudiesFemaleFrail ElderlyFrailtyGeriatric AssessmentGreeceHumansMaleSleepSleep Wake Disorders

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32988763

Citation

Balomenos, Vassilis, et al. "Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study." Journal of the American Medical Directors Association, vol. 22, no. 3, 2021, pp. 551-558.e1.
Balomenos V, Ntanasi E, Anastasiou CA, et al. Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study. J Am Med Dir Assoc. 2021;22(3):551-558.e1.
Balomenos, V., Ntanasi, E., Anastasiou, C. A., Charisis, S., Velonakis, G., Karavasilis, E., Tsapanou, A., Yannakoulia, M., Kosmidis, M. H., Dardiotis, E., Hadjigeorgiou, G., Sakka, P., & Scarmeas, N. (2021). Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study. Journal of the American Medical Directors Association, 22(3), 551-e1. https://doi.org/10.1016/j.jamda.2020.08.012
Balomenos V, et al. Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study. J Am Med Dir Assoc. 2021;22(3):551-558.e1. PubMed PMID: 32988763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Sleep Disturbances and Frailty: Evidence From a Population-Based Study. AU - Balomenos,Vassilis, AU - Ntanasi,Eva, AU - Anastasiou,Costas A, AU - Charisis,Socrates, AU - Velonakis,Georgios, AU - Karavasilis,Efstratios, AU - Tsapanou,Angeliki, AU - Yannakoulia,Mary, AU - Kosmidis,Mary H, AU - Dardiotis,Efthimios, AU - Hadjigeorgiou,Georgios, AU - Sakka,Paraskevi, AU - Scarmeas,Nikolaos, Y1 - 2020/09/25/ PY - 2020/05/28/received PY - 2020/08/12/revised PY - 2020/08/13/accepted PY - 2020/9/30/pubmed PY - 2021/7/2/medline PY - 2020/9/29/entrez KW - Frailty KW - sleep KW - sleep disturbances KW - sleep quality SP - 551 EP - 558.e1 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 22 IS - 3 N2 - 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. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/32988763/Association_Between_Sleep_Disturbances_and_Frailty:_Evidence_From_a_Population_Based_Study_ DB - PRIME DP - Unbound Medicine ER -