Frailty and sleep disturbances in the elderly: Possible connections and clinical implications [English;Portuguese] Fragilidade e disturbios do sono em idosos: Possiveis conexoes e implicacoes clinicas

Abstract

Frailty results from decreased physiological and functional reserves during pathologic aging processes and leads to vulnerability to minor stress, increasing morbidity and mortality. The majority of older persons more than 85 years are frail or pre-frail. Sleep disturbances are also more prevalent in the elderly and possible associations between frailty and sleep problems have been studied. This article aims to summarize clinical and biological data favoring this hypothesis and discuss future research implications. Keywords related to frailty and sleep were searched by means of a non-systematic search in the National Library of Medicine's MedLine database's PubMed system. Observational studies found associations between frailty parameters and subjective and objective measurements indicating poor sleep, circadian rhythm disruption and sleep disorders in aged persons. Unbalances between catabolic and anabolic hormones, enhanced inflammatory response and reduced energy expenditure are shared pathways that can explain a bidirectional correlation between frailty states and poor sleep in advanced ages. Interventions over circadian rhythm or sleep disorders have potential clinical implications in the frail elderly. As a complex entity with sparse and still emergent therapeutic options, frailty can benefit from sleep quality improvement along advanced ages.