Highlights
- •What is the primary question addressed by this study?
-
Sedative-hypnotic drugs are widely used to treat insomnia; however, the effect of sedative-hypnotic drugs on frailty remained unclear.
- •What is the main finding of this study?
-
Using a nationwide survey, we found that both insomnia and medication use were significantly and independently associated with an increased frailty risk.
- •What is the meaning of the finding?
-
Given the potential frailty risk of sedative-hypnotic drug, nonpharmacological treatment might should be firstly considered for treating insomnia.
Abstract
Background
Insomnia and frailty are prevalent in older adults. This study aimed to elucidate
the impact of insomnia and sedative-hypnotic use on the frailty rate over time.
Methods
We used data from community-dwelling older adults (mean ± SD age = 69.4 ± 8.2 years)
from the Healthy Aging Longitudinal Study in Taiwan (HALST). A total of 4,744 participants
were included in the study and were followed up for an average of 3.2 years. Frailty
was assessed using the Fried criteria. Self-reported sleep problems, sedative-hypnotic
use, and claims records from the National Health Insurance database were used. The
generalized equation estimation (GEE) approach was applied to account for correlations
between repeated measures. The average impact of insomnia and drug use on frailty
over time was estimated by adjusting for potential confounding factors using the logic
link in the GEE approach.
Results
The adjusted odds ratio (OR) of frailty was 1.41 (95% CI: [1.16, 1.72], Z-test statistics
Z = 3.39, p <0.001) for insomnia and 1.52 ([1.16, 2.00], Z = 3.00, p = 0.0027) for
sedative-hypnotic use. Interactions between insomnia and sedative-hypnotic use with
frailty were not statistically significant. Long sleep duration > 8 hours, daytime
sleepiness, and sleep apnea was also associated with an increased likelihood of developing
frailty. Notably, a dose-response relationship between sedative-hypnotic drug use
and frailty was observed.
Conclusions
Insomnia and sedative-hypnotic use were independently associated with increased frailty.
The implementation of nonpharmacological treatments to attenuate insomnia may reduce
frailty rates.
Key Words
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Article info
Publication history
Published online: February 07, 2023
Accepted:
January 30,
2023
Received in revised form:
January 29,
2023
Received:
November 21,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
