Estratificação de risco de fragilidade, incapacidade e avaliação de distúrbios de sono na pessoa idosa residente da comunidade: estudo transversal

Abstract

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.