Multidimensional sleep health is associated with physical frailty in a national sample of Taiwanese community-dwelling older adults: Sex matters

Objectives: Although individual sleep characteristics are related to frailty, these characteristics do not occur separately. A multidimensional measure of sleep might provide a better estimation of frailty compared to isolated sleep characteristics. This study investigated the association of a multidimensional measure of sleep health with frailty both across and within sex groups. Design: Data were from the Taiwan Longitudinal Study on Aging (2011), a survey with a nationally representative sample of Taiwanese older adults (N = 2,015). Frailty was defined using the Fried criteria. Self-reported sleep during the past month was used to conceptualize the five sleep health dimensions in the SATED model. Their relationship was estimated using logistic regression analysis adjusting for sociodemographic characteristics (age, sex, education), health status (comorbidity, cognitive function, pain, depressive symptoms [excluding items overlapping with frailty and sleep]), and health risk behaviors (drinking, smoking, lack of exercise). Results: Having a better sleep health composite score was significantly related to lower odds of being frail in both sexes adjusting for sociodemographic characteristics. This association remained significant among women but not among men after adding health and risk behaviors to the models. Satisfaction and alertness in both sexes and duration among women were significantly associated with frailty adjusting for sociodemographic characteristics. Only alertness among men was significantly related to frailty in the model with all covariates. Conclusions: Our findings show that having better sleep health across multiple dimensions is related to a lower risk of being frail, with differential risks for women and men.