Objective Sleep Patterns Across Frailty Levels in Older Adults Using Wearable Data

OBJECTIVE: This study examined sleep-parameter differences across frailty levels in older adults. METHODS: Community-dwelling adults aged ≥65 years were classified as frail, pre-frail, or robust based on five frailty phenotypes. Sleep was assessed using a wrist-worn wearable device, which measured total time in bed (TIB), total sleep time (TST), light sleep, deep sleep, rapid eye movement sleep, wake after sleep onset, restless time, and sleep efficiency. RESULTS: A total of 70 participants were included in the analysis: 37 robust, 23 pre-frail, and 10 frail older adults. Significant between-group differences were observed in TIB, TST, light sleep, deep sleep, and restless time. Frail adults demonstrated significantly longer TIB and TST compared with both robust and pre-frail adults, spent a greater proportion of time in light sleep, and showed longer restless time relative to the robust group. CONCLUSIONS: These findings suggest that wearable-based sleep monitoring may serve as a practical tool for identifying sleep-related characteristics of frailty in community settings. CLINICAL IMPLICATIONS: Wearable sleep data may help clinicians guide personalized, sleep-pattern - specific interventions, such as using sleep-control strategies for individuals with frailty. Incorporating objective sleep monitoring into routine geriatric care may enable more precise and individualized approaches to support healthy aging.