Background: Older outpatients with chronic diseases are susceptible to muscle weakness and functional disabilities. Recently, various wearable devices have been developed to generate health lifelogs in daily life; however, data from patients with chronic diseases remain scarce. Previous studies have shown that subjective sleep efficiency assessed by self-questionnaires is associated with grip strength, but whether objective sleep efficiency detected by wearable devices is associated with physical function and body composition remains unclear. Objective: The aim of this study is to clarify the association between sleep duration, sleep efficiency estimated by wearable watch, grip strength, frailty, and sarcopenia in outpatients with predominantly cardiometabolic diseases and the influence of diabetes as part of the Smart Watch Innovation for Geriatrics and Gerontology (SWING-Japan) project. Methods: In this cross-sectional study, the wrist-worn device Silmee 22 was used in an outpatient clinic of an acute care facility for 7‐90 nights for the analyses, and individual average sleep duration and efficiency (wearable-estimated sleep efficiency: total sleep duration/time spent in bed) were calculated. Low grip strength was defined as

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