Association between sleep duration and frailty in older adults: Systematic review and meta-analysis of observational studies

Abstract

Objective

To assess the relationship between short, and long sleep duration and the risk of frailty in older adults.

Methods

We conducted a systematic search of the PubMed, Web of Science, Embase, and Scopus databases, with the search completed on January 25, 2025, focusing on cross-sectional studies, case-control studies, and cohort studies regarding sleep duration and frailty risk in adults aged 60 and older. Two authors independently performed data extraction, quality assessment, and comprehensive analysis based on predefined criteria. A random effects model was used to estimate the combined effect size and 95 % confidence intervals (CIs). The I² statistic quantifies heterogeneity and explores potential sources of heterogeneity through subgroup analysis, meta-regression, and sensitivity analysis to validate the robustness of the results. A qualitative approach was used to describe studies or effect sizes that could not be analyzed quantitatively.

Results

This systematic review included a total of fifteen studies. In the elderly population, the prevalence of frailty was reported as 15 % among short sleepers (<7 h) and 22 % among long sleepers (>8 h). There was a significant association between short sleep duration(<7 h) and frailty prevalence (OR1.44,95 %CI1.22–1.67), as well as a significant association between long sleep duration (>8 h) and frailty prevalence (OR 1.96, 95 %CI 1.52–2.52).

Conclusion

In the elderly population, frailty is associated with sleep duration. Compared with those with normal sleep duration, both short and long sleepers exhibit a higher prevalence of frailty.