50岁及以上人群睡眠时间与衰弱的关联研究

目的 了解中老年人群睡眠时间与衰弱之间的关系。方法 利用WHO全球老龄化与成人健康研究中国项目第一轮基线调查,采用健康缺陷累计数与所考虑的40个健康相关变量的比值构建衰弱指数,采用两水平（个体层面和社区层面）logistic回归模型分析自报睡眠时间与衰弱的关系,并对年龄、性别和居住地区进行分层分析。采用限制性立方样条曲线绘制自报睡眠时间与衰弱关系的剂量-反应曲线。结果 共纳入13 175名≥50岁中老年人,在未调整任何混杂因素的情况下,相比正常睡眠时间,睡眠时间较短或者较长均显著增大衰弱发生风险（OR=2.05,95% CI：1.71～2.44;OR=1.35,95% CI：1.12～1.63）,在调整了性别、年龄、居住地区、文化程度、家庭经济水平、水果蔬菜摄入状况、吸烟、饮酒和体力活动后,相比正常睡眠时间,只有睡眠时间较短与衰弱发生风险显著正相关（aOR=1.60,95% CI：1.27～2.01）。对性别、年龄和居住地区进行分层分析,结果显示,调整了性别、年龄、居住地区、文化程度、家庭经济水平、水果蔬菜摄入状况、吸烟、饮酒和体力活动后,相比正常睡眠时间,只有睡眠时间较短与衰弱发生风险显著正相关。此外,在≥65岁人群中,调整相关混杂因素后,相比正常睡眠时间,睡眠时间较短人群衰弱的发生风险增加91%（aOR=1.91,95% CI：1.46～2.49）。平均睡眠时间与衰弱发生呈近似“U”形关系。结论 睡眠时间较短可能与衰弱发生有关。

Association between frailty and sleep duration among people aged 50 years and over

Objective To investigate the association between sleep duration and frailty among people aged 50 years and over. Methods Cross-sectional data was collected from the first wave of World Health Organization Study on global AGEing and adult health in China. Frailty index was constructed on the proportion of deficits, out of the 40 variables. A two-level (individual level and community level) linear model was performed to identify the related factors on frailty. All the models were stratified by age, gender, residence (urban/rural). Restricted cubic spline was performed to graphically evaluate the dose-response association between self-reported sleep duration and frailty. Results A total of 13 175 individuals aged 50 years and over participated in this study. Without adjusting on any confounding factors, shorter or longer sleep duration significantly increased the risk of weakness compared with normal sleep time (OR=2.05, 95%CI:1.71-2.44; OR=1.35, 95%CI:1.12-1.63). After adjusting for confounding factors such as gender, age, residence, education, family assets, vegetable, smoking, drinking and physical activity, a positive association between short sleep duration and frailty was noticed compared with normal sleep time (aOR=1.60, 95%CI:1.27-2.01). The results of stratified analysis on sex, age and urban and rural areas showed that, after adjusting for gender, age, residence, education level, family assets, intake of vegetables and fruits, smoking, drinking and physical activity, only shorter sleep duration was positively correlated with the risk of weakness. In addition, among people aged 65 years and over, adjusted for confounding factors, the risk of weakness increased by 91%, compared with normal sleep time (aOR=1.91, 95%CI:1.46-2.49). The dose-response curve also showed that the sleep duration and frailty present an approximate "U" shaped relationship. Conclusion Short sleep duration might be associated with frailty.