Yulia Komleva

Abstract: Frailty is a multidimensional geriatric syndrome characterized by decreased physiological reserve, increased vulnerability to stressors, and a higher risk of adverse health outcomes. Accumulating evidence indicates that sleep disturbances are consistently associated with frailty in older adults. The scoping review linked to DOI 10.1186/s12877-024-05049-3 summarizes 39 publications on sleep and frailty and concludes that poor sleep quality, insomnia symptoms, and disturbed sleep are repeatedly associated with both frailty and pre-frailty, while the association with sleep duration appears less consistent than the association with sleep quality.

Available epidemiological data support a robust relationship between disturbed sleep and frailty. In the review literature, poor sleep quality is more consistently associated with frailty than sleep duration alone, and longitudinal findings suggest that sleep disturbances may precede frailty onset and progression. Recent systematic reviews also report that both short and long sleep duration are associated with higher frailty prevalence, although effect sizes vary across studies and measurement approaches.

Current evidence supports a bidirectional relationship between sleep and frailty. Poor sleep may accelerate frailty through inflammation, circadian disruption, muscle loss, and endocrine dysregulation; conversely, frailty itself may worsen sleep through multimorbidity, reduced physical activity, nocturnal symptoms, and impaired physiological adaptation. The strongest and most consistent clinical signal appears to come from sleep quality, especially insomnia symptoms and fragmented or non-restorative sleep, rather than from sleep duration alone.

Sleep disturbances should be considered not merely a comorbidity of aging, but a potentially modifiable component of frailty pathogenesis. The most plausible shared mechanisms include chronic inflammation, circadian rhythm disruption, sarcopenia-related muscle decline, and neuroendocrine imbalance. These findings support the idea that screening and improving sleep quality may become an important strategy for frailty prevention and management in older adults.

Keywords: frailty, sleep, insomnia, sleep quality, circadian rhythm, inflammation, sarcopenia, older adults

Reference: Komleva Y, Gollasch M, König M. Nocturia and frailty in older adults: a scoping review. BMC Geriatr. 2024 Jun 6;24(1):498. doi: 10.1186/s12877-024-05049-3. PMID: 38844878; PMCID: PMC11155172.

Speaker: Yulia K. Komleva is a Professor of the Russian Academy of Sciences and a leading researcher in neuroinflammation, molecular neuroscience, and aging. She holds senior positions at the Brain Institute (Russian Center of Neurology and Neurosciences) and Bauman Moscow State Technical University. Her work, supported by grants, focuses on the understanding of molecular mechanisms of neuroinflammation and their role in cognitive impairment and neurodegeneration. The novel mechanisms involving inflammasomes in brain aging and developed an integrative, systems-level approach to studying age-related cognitive decline using experimental and translational models have been identified. The research has substantially contributed to elucidating the role of inflammatory and systemic metabolic dysregulation in both physiological and accelerated aging. Yulia Komleva is a recipient of several prestigious awards, including the Medal of the Russian Academy of Sciences for young scientists in biomedical sciences (2024), the Gerhard Domagk Award for Promising Young Scientists (Germany, 2023).