The association between mobility and asleep blood pressure alterations in frail and non-frail adults 80 years and older

The influence of mobility on asleep blood pressure among adults aged 80 years and older, particularly considering frailty, remains poorly understood. This cross-sectional study aimed to examine the association between objectively measured mobility parameters and asleep blood pressure alterations in a frail and non-frail population aged 80 years and older. Seventy-one participants (mean age 85 ± 4 years; 33 non-frail and 38 frail) completed both ambulatory blood pressure monitoring (ABPM) and objective mobility assessment using actigraphy. Baseline characteristics were similar between groups, except for a higher prevalence of hypertension and greater comorbidity burden in frail individuals. Mobility measures reflected a more sedentary profile in the frail group. In the total population, sedentary time, walking time, steps/day, cadence, and energy expenditure (METs-h) showed significant linear associations with asleep SBP and/or SBP dipping. Higher sedentary time correlated with elevated asleep SBP and reduced SBP dipping, whereas greater walking time, steps/day, cadence, and METs-h were protective. Among frail individuals, cadence was the only parameter consistently associated with both asleep SBP and dipping. In multivariable logistic regression adjusted for age, hypertension, and frailty status, higher cadence remained independently protective against elevated asleep SBP (OR 0.56, 95% CI 0.39-0.80) and non-dipping pattern (OR 0.87, 95% CI 0.79-0.95). In conclusion, mobility parameters were closely associated with asleep blood pressure alterations, specifically elevated asleep SBP and changes in the dipping pattern, among frail and non-frail adults aged 80 years and older. Cadence emerged as the most robust and clinically applicable measure.