Poor sleep quality is associated with increased mortality in community-dwelling older adults: a retrospective...

Sleep disturbances are common in older adults and may be associated with frailty, malnutrition, sarcopenia, and adverse outcomes.

This study aimed to evaluate the relationship between sleep quality and comprehensive geriatric assessment parameters and to investigate whether poor sleep quality is independently associated with 12-month mortality.

This retrospective observational study included 1058 adults aged ≥ 65 years who underwent a comprehensive geriatric assessment. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Participants were categorized as having good or poor sleep quality. Demographic characteristics, comorbidities, geriatric syndromes, and assessment parameters were compared between groups. Correlations between PSQI and geriatric measures were analyzed using Spearman's correlation. Kaplan-Meier analysis and multivariable Cox regression were used to assess 12-month mortality.

Of the 1058 participants, 641 (60.6%) had good sleep quality and 417 (39.4%) had poor sleep quality. Poor sleep quality was associated with older age, female sex, higher mortality, greater frailty and sarcopenia risk, polypharmacy, worse nutritional status, lower handgrip strength, poorer physical performance, and higher frequencies of dementia, depression, and falls (all p < 0.05). PSQI correlated significantly with all geriatric assessment parameters (all p < 0.01). In multivariable Cox regression, higher PSQI remained independently associated with increased 12-month mortality (hazard ratio = 1.222, 95% confidence interval 1.113-1.341; p < 0.001).

Poor sleep quality is associated with multidimensional geriatric vulnerability and is independently associated with 12-month mortality in older adults.