老年人衰弱与睡眠障碍的关联探究

背景　衰弱作为机体脆弱的综合表现，是衰老的主要问题。睡眠障碍影响着50%的老年人，且随着年龄的增加其影响越严重。但目前衰弱与睡眠问题的关系尚不明确。目的　在中国老年人群中探索衰弱与睡眠障碍的关联，以期为老年人衰弱干预提供理论依据。方法　本研究于2016年4—6月选取如皋长寿和衰老研究中1 792例老年人的睡眠和衰弱数据。收集老年人基线资料、睡眠情况〔采用匹兹堡睡眠质量指数（PSQI）量表评价，以PSQI量表得分>10分为有睡眠障碍，≤10分为睡眠正常〕、衰弱情况〔采用实验室衰弱指数（FI-LAB）评价，以FI-LAB<0.1为非衰弱，0.1~0.2为轻微衰弱，>0.2~0.3为轻度衰弱，>0.3~0.4为中度衰弱，>0.4为重度衰弱〕。结果　不同性别老年人BMI、职业、婚姻状况、文化程度、吸烟情况、饮酒情况、自报健康情况、PSQI量表得分、睡眠情况比较，差异有统计学意义（P<0.05）。不同睡眠情况老年人性别、吸烟情况、自报健康情况、衰弱情况比较，差异有统计学意义（P<0.05）。Logistic回归分析结果显示，当调整了年龄、职业、婚姻状况、文化程度、吸烟情况、饮酒情况、自报健康情况时，女性老年人FI-LAB与睡眠情况有关联〔OR=1.238，95%CI（1.020，1.503），P<0.05〕，男性老年人FI-LAB与睡眠情况有关联〔OR=0.621，95%CI（0.432，0.894），P<0.05〕，女性老年人重度衰弱与睡眠情况有关联〔OR=3.755，95%CI（1.188，11.868），P<0.05〕，男性老年人衰弱情况与睡眠情况无关联〔OR=0.291，95%CI（0.030，2.836），P>0.05〕。结论　女性老年人衰弱与睡眠障碍有关联，睡眠障碍高风险女性老年人衰弱的可能性较大。

Association between Frailty and Sleep Disturbances in the Elderly

Background　Frailty，as a comprehensive manifestation of the increased vulnerability of body，is the main problem of aging.Sleep disturbances affects 50% of the elderly，and its effects increase with age.However，the association between frailty and sleep problems is still unclear.Objective　To explore the association between frailty and sleep disturbances in the elderly in China，providing a theoretical basis for the delivery of frailty interventions in this population.Methods　Sleep or frailty data of 1 792 elderly people in the Rugao longevity and aging study，were collected during the period from April to June 2016.Baseline data，sleep status〔evaluated by Pittsburgh Sleep Quality Index（PSQI）scale，with score>10 was defined as sleep disturbances，≤10 as normal〕，and frailty〔evaluated by Laboratory Frailty Index（FI-LAB），FI-LAB<0.1 as non-frailty，0.1-0.2 as slight frailty，>0.2-0.3 as mild frailty，>0.3-0.4 as moderate frailty，and >0.4 as severe frailty〕were also collected.Results　Significant gender-related differences were found in terms of BMI，occupation，marital status，education level，smoking，drinking，self-reported health，PSQI scale score and sleep status（P<0.05）.There were significant differences in gender，smoking，self-reported health status and frailty of the elderly with different sleep status（P<0.05）.Logistic regression analysis showed that FI-LAB was associated with sleep status in both females〔OR=1.238，95%CI（1.020，1.503），P<0.05〕and males〔OR=0.621，95%CI（0.432，0.894），P<0.05〕，the association between severe frailty and sleep status was significant in females〔OR=3.755，95%CI（1.188，11.868），P<0.05〕，while the same association was not found in males〔OR=0.291，95%CI（0.030，2.836），P>0.05〕，after adjusting for age，occupation，marital status，education level，smoking，drinking，and self-reported health.Conclusion　Sleep disturbances is associated with increased risk of frailty in elderly females.