Falls, Sleep Disorders and Cognitive Frailty in Hospitalized Older Adults with Hypertension:A Cross-Sectional Study

Abstract

Purpose: Falls and fall-related injuries are highly prevalent among older adults. Falls negatively impact functional independence and quality of life, and are associated with increased morbidity, mortality, and healthcare costs. Sleep disorders in the older adults are a common phenomenon, with sleep quality gradually deteriorating as age increases. Cognitive frailty(CF) refers to the presence of both physical frailty(PF) and mild cognitive impairment(MCI) without simultaneous diagnosis of Alzheimer's disease(AD) or other dementia. Epidemiological studies have confirmed the association between falls and sleep disorders, as well as CF. However, no studies have yet investigated the relationship between falls, sleep disorders and CF in hospitalized older adults with hypertension. Our study is to explore the relationship between falls and both sleep disorders and CF in hospitalized older adults with hypertension, providing a basis for fall prevention.

Patients and methods: Demographic characteristics were collected from hypertensive patients aged 65 and above who were hospitalized in the Department of Geriatrics at Huaihe Hospital of Henan University, from July 2022 to June 2024. These patients were assessed for history of falls, sleep quality, CF, depression and nutritional status. Logistic regression analysis was used to examine the correlation between falls and both sleep disorders and CF.

Results: A total of 266 older adults with hypertension were surveyed in this study, of whom 108 reported having fallen once or more in the past year. Both sleep disorders and CF were significantly associated with an increased risk of falls (sleep disorders: OR=2.625, 95% CI 1.214-5.678, P=0.014; CF: OR=5.920, 95% CI 2.632-13.314, P<0.001). Other significant risk factors included: Age (OR=1.119, 95% CI 1.055-1.188, P<0.001), Comorbidities (OR=2.855, 95% CI 1.353-6.024, P=0.006), Polypharmacy (OR=4.126, 95% CI 1.937-8.793, P<0.001), Compared to hospitalized older adults with hypertension with good nutritional status, those with malnutrition had a 4.698-fold higher risk of falls (95% CI 1.724-12.800, P=0.002).

Conclusion: The incidence of falls was higher among hospitalized older adults with hypertension. Both sleep disorders and CF were strongly associated with falls in this patient population.

Keywords: CF; falls; hospitalization; hypertension; older adults; sleep disorders.