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Sleep Duration and Frailty Risk among Older Adults: Evidence from a Retrospective, Population-Based Cohort Study

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Frailty and sleep duration complaints are both prevalent and often coexist among older adults. The purpose of this study was to examine the prospective association between sleep duration and frailty risk in a nationally representative cohort study.

Design

Prospective cohort study, ten-year follow-up.

Setting

Community-based setting in 23 provinces of China.

Participants

A total of 7623 older adults age 65 and over without frailty at baseline were included in the analysis.

Measurements

The participants were divided into three groups according to self-reported sleep duration: short (≤6 hours per day), middle (>6 but <10 hours per day) and long (≥10 hours per day). Frailty was measured according to the accumulation of health deficits by the construction of a frailty index of 38 items with 0.25 as the cutoff. A Cox proportional hazard model, a competing risk model and a generalized estimating equation (GEE) model with multiple adjustments were performed to evaluate the association between sleep duration and frailty risk.

Results

During a median follow-up period of 4.4 years (IQR 2.9–9.0), 2531 (33.2%) individuals developed frailty. Compared with participants with middle sleep duration, the risk of frailty was increased among participants with long sleep duration (HR 1.26, 95% CI 1.14–1.38) in the fully adjusted Cox proportional hazard model. However, short sleep duration was insignificantly associated with frailty risk. The competing risk model and the GEE model yielded similar results.

Conclusion

Long sleep duration is significantly associated with frailty incidence among older adults even after adjustment for confounding factors. This study provides reinforcing longitudinal evidence for the need to design sleep quality improvement interventions in health care programs to prevent frailty among older adults.

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Acknowledgments

The authors gratefully acknowledge the participants involved in this study, the hard work of investigators and valuable suggestions given by Ying Chen.

Funding

Funding sources: This study was funded by The National Natural Science Foundation of China (Grant numbers: 71974142 and 71910107004) and Humanity and Social Science Youth foundation of Ministry of Education of China (21YJCZH098).

Author information

Authors and Affiliations

  1. School of Nursing, Tianjin Medical University, Tianjin, 300070, China

    Shixiang Chen, Yulu Wang, Z. Wang, X. Zhang, B. Ma, J. Yang, Qi Lu & Yue Zhao

  2. Ocology Department, The Second Hospital of Tianjin Medical University, Tianjin, China

    C. Deng

Authors
  1. Shixiang Chen
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  2. Yulu Wang
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  3. Z. Wang
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  4. X. Zhang
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  5. C. Deng
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  6. B. Ma
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  7. J. Yang
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  8. Qi Lu
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  9. Yue Zhao
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Contributions

Author contributions: All the authors meet the criteria for authorship and all authors’ specific areas of contributions are listed below. Study concept and design: Qi Lu and Yue Zhao. Acquisition and screen of data: Xiaojun Zhang, Bingxin Ma and Jin Yang. Analysis and interpretation of data: Shixiang Chen, Yulu Wang, Zhaonan Wang and Cuiyu Deng. Drafting of the manuscript: Shixiang Chen. Critical revision of the manuscript for important intellectual content: Qi Lu and Yue Zhao.

Corresponding authors

Correspondence to Qi Lu or Yue Zhao.

Ethics declarations

Competing interests: None.

Ethic approval: The study was approved by the Research Ethics Committee of Peking University (IRB00001052-13074), and written consent was obtained from all participants or their legal representatives.

Additional information

Joint first authors: Shixiang Chen and Yulu Wang

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Chen, S., Wang, Y., Wang, Z. et al. Sleep Duration and Frailty Risk among Older Adults: Evidence from a Retrospective, Population-Based Cohort Study. J Nutr Health Aging 26, 383–390 (2022). https://doi.org/10.1007/s12603-022-1766-z

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