Sleep disorders and frailty status in older people: a narrative review

Aim: The aim of this study is to review the impact of sleep-related disorders on the level of elder frailty, and, conversely, the possible correlation between the level of fragility detected and eventually related poor sleep. Method: A narrative review have been conducted. Comprehensive database searches of MEDLINE, Cochrane, EMBASE, Cinahl were undertaken. Both prospective, cross selectional and retrospective observational cohort studies, published from 2000 to 2015, have been included. Appraisal and analysis using the STROBE statement have been undertaken. Results: 8 studies are included. Increasing evidence supports possible bidirectional correlation between elder frailty and poor sleep, excessive daytime sleepiness and decreased sleep efficiency. Potential outcomes relevant to these sleep disorders in old age include mortality, depression and altered functional autonomy. Conclusion: Interventions on the circadian rhythm could have significant clinical implications in the frail elderly. The nursing interest should be geared to the use of validated tools, in order to detect the first signs of any sleeping disorder, in order to postpone or overcome the outcomes derived. The planning of stimulating activities, to facilitate moments of aggregation, would only increase the desire of belonging, as continuous cognitive stimulation.