Background: Fragility is considered a state of vulnerability to health stressors, rendering
elderly individuals susceptible to disability, hospitalization, and mortality. Recent studies have
indicated an increase in the prevalence of frailty risk among older adults with sleep
disturbances. Given that frailty is a dynamic condition with the potential for reversal, it is
imperative to screen for possible modifiable factors to prevent, mitigate, or interrupt the frailty
process. Consequently, there is a need for the stratification of frailty and an investigation into
the potential associations between sleep quality, excessive daytime sleepiness, and the risk of
sleep disorders in older adults. Objective: To stratify the risk of frailty and disability and
investigate potential associations with sleep quality, excessive daytime sleepiness, and the risk
of Obstructive Sleep Apnea (OSA) in community-dwelling older adults. Methods: This study
employs a quantitative cross-sectional design, adhering to the recommendations of The
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The
research involves the stratification of frailty and disability using the Frail Non-disable
Questionnaire (FiND) and the FRAIL Scale, along with the evaluation of excessive daytime
sleepiness, sleep quality, and the risk of OSA through the Epworth Sleepiness Scale (ESE),
Pittsburgh Sleep Quality Index (PSQI), and STOP-BANG questionnaire, respectively. Data
normality was assessed using the Kolmogorov-Smirnov test. For binomial categorical
comparisons, the Binomial Test was employed, while the Proportions Test was utilized for
multiple comparisons. Correlation analysis was conducted using Spearman's Correlation Test.
Results: A total of 109 older adults (61% females, p = 0.02) were evaluated, with a median age
of 68, from the capital city (86%), self-identified as mixed race (68%), and in a state of preobesity (36%). According to FiND, 26% of participants were deemed frail and 32% were
considered incapable. In contrast, according to the FRAIL Scale, 33% were pre-frail and 25%
were frail. In addition, most patients had poor sleep quality (80%, p = 0.010), moderate risk of
obstructive sleep apnea (49%, p < 0.010) and absence of excessive daytime sleepiness (62%, p
< 0.010). There was a weak relationship between frailty and disability with poor sleep quality
(rho = 0.39; p < 0.001) and risk of obstructive sleep apnea (rho = 0.26; p = 0.000). No
relationship was observed between frailty and disability and excessive daytime sleepiness (rho
= 0.04; p = 0.660). A weak relationship with sleep quality (rho = 0.33; p < 0.001) and the risk
of obstructive sleep apnea (rho = 0.27; p = 0.001) was also observed in the analysis of
correlation with frailty, but no relationship was found with excessive daytime sleepiness (rho =
0.05; p = 0.590). Conclusion: This study showed a weak relationship between the risk of frailty
8 and disability with sleep quality and the risk of obstructive apnea, but no relationship was
observed with excessive daytime sleepiness.
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