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India, home to over 150 million people aged 60 and older, is facing a rapidly aging population, projected to more than double by 2050. As the elderly population grows, ensuring their well-being becomes increasingly important. A recent study conducted by the Penn State Department of Human Development and Family Studies (HDFS) and the Center for Healthy Aging has highlighted the potential role of good sleep in protecting older adults from frailty, a debilitating condition associated with aging.
Frailty—characterized by declining strength, endurance, and overall health—can lead to a reduced quality of life, illness, and even premature death. The researchers focused on sleep as a potential factor in preventing or delaying frailty among older adults in India. The findings suggest that older individuals who reported low-quality sleep were nearly three times more likely to be frail compared to those who slept better. Surprisingly, the study also revealed that older Indian men who slept nine or more hours per night were less likely to experience frailty, defying the common belief that 7 to 8 hours of sleep is ideal for aging adults.
“We’re seeing that sleep could be a key factor in preventing or delaying frailty, a major challenge for the aging population,” said Muhammad, a lead researcher. “As the aging population grows in India and globally, this is a critical finding.”
The research team used data from the World Health Organization’s Study of Global Aging and Adult Health, focusing on a sample of 6,512 people aged 50 and older from six states in India. Participants were classified into categories of robust, pre-frail, or frail based on five key indicators: handgrip strength, walking speed, physical activity, fatigue levels, and weight loss. The study then compared these frailty scores with participants’ self-reported sleep quality, duration, and demographic factors.
Frailty and Sleep: A Dangerous Cycle
The study confirmed that sleep problems are common among older adults and can create a vicious cycle. Poor sleep quality often exacerbates frailty, while frailty itself can contribute to worsening sleep. As aging disrupts deep sleep and increases nighttime awakenings, the risk of frailty increases, creating a challenging feedback loop.
“Our study found that a quarter of the participants were frail, and nearly two-thirds were pre-frail,” explained Thalil, a co-author. “This shows that many older adults are at risk, but improving sleep quality could delay or prevent frailty.”
Sleep Duration: A Gender-Specific Insight
The study’s results regarding sleep duration were unexpected. While research generally shows that too little or too much sleep is linked to frailty, this study found that men who slept for nine or more hours per night were less likely to be frail, contrary to the typical recommendation of 7 to 8 hours. On the other hand, women followed the expected pattern, with those getting the recommended amount of sleep being less frail.
The researchers noted that these findings highlight the importance of considering cultural and regional differences in sleep-frailty relationships. “Context matters,” said Lee, a senior researcher. “The relationship between sleep and frailty can vary across countries and cultures, and we need to understand these nuances to develop targeted interventions.”
Global Implications for Aging Populations
While the study focused on India, its findings have global implications. The aging population is growing rapidly, especially in low- and middle-income countries, where health challenges like frailty are becoming more prevalent. Medical practitioners worldwide should be proactive in assessing sleep patterns among older adults and intervene if poor sleep is identified. Addressing sleep issues could be a crucial step in reducing frailty, improving the quality of life, and extending healthy years for the aging population.
As Lee concluded, “Older adults need to prioritize getting enough high-quality sleep. Medical providers must inquire about their sleep habits, as addressing sleep problems could significantly reduce frailty and improve overall health.”
The full study, titled Association between Sleep Quality, Sleep Duration, and Physical Frailty Among Adults Aged 50 Years and Older in India, was published in BMC Public Health in 2024.
For more information, see the study in BMC Public Health: DOI 10.1186/s12889-024-20606-6.
