Association analysis of frailty with obstructive sleep apnea syndrome in elderly patients – A Multicenter Cohort Study

Abstract

Abstract Objective We assessed the incidence of frailty and identified the independent risk factors for the occurrence of frailty in elderly patients with obstructive sleep apnea syndrome (OSAS), which aims to provide a reference for the clinical treatment of OSAS and frailty.Methods We selected 1006 elderly patients with OSAS diagnosed using polysomnographic (PSG) between January 2015 and October 2017. We divided the patients into the non-frailty group (n = 731) and the frailty group (n = 275) based on the FRAIL scale score, compared the difference between the two groups. Multivariate cox regression analysis was used to identify the factors affecting the onset of frailty among elderly patients with OSAS.Results༚ 275 patients experienced frailty, yielding an incidence of 27.34%. Multivariate cox regression analysis showed that age(HR = 1.058, 95% CI:1.043–1.074, P < 0.001), constipation(HR = 1.490, 95%CI: 1.101–2.018, P = 0.010), carotid atherosclerosis (CA)(HR = 1.739, 95% CI: 1.299–2.330, P < 0.001), and renal insufficiency (RI)(HR = 1.878, 95% CI: 1.177–2.996, P = 0.008) are independent risk factors for frailty in elderly patients with OSAS. And platelet count(PLTC)(HR = 0.998, 95% CI: 0.996-1.000, P = 0.040), the mean arterial oxygen saturation(MSaO2)(HR = 0.950, 95% CI: 0.918–0.984, P = 0.005) are protect factors.Conclusion The incidence of frailty among elderly patients with OSAS is relatively high, and it was significantly higher in patients with severe OSAS than in those with mild or moderate OSAS. Age, constipation, CA, and RI are independent risk factors, whereas mean oxygen saturation and platelet count are protective factors for frailty in elderly patients with OSAS.