|
|
Aging Research 2025
衰弱水平在我国老年人睡眠时长与认知功能间的中介作用研究
|
Abstract:
目的：分析衰弱水平在我国老年人睡眠时长与认知功能中的中介作用。方法：基于2020年中国健康与养老追踪调查数据(CHARLS)，对纳入的4446名研究对象，采用线性回归分析变量间的相关性，并构建中介效应模型探讨衰弱水平在老年人睡眠时长与认知功能之间的中介作用。结果：老年人睡眠时长平均为6.07小时/天，认知功能平均得分为16.06分，存在衰弱363人(8.16%)。睡眠时长与认知功能呈正相关(β = 0.032, 95% CI: 0.008~0.161)，衰弱水平与认知功能呈负相关(β = ？0.104, 95% CI: ？1.031~？0.577)。衰弱水平在老年人睡眠时长和认知功能之间中介效应显著，中介效应量为0.084，95% CI为？0.078~？0.059，效应占比60.43%。结论：睡眠时长与认知功能正向相关，衰弱水平与认知功能负向相关；衰弱水平在睡眠时长和认知功能之间存在部分中介效应。充足睡眠可以有效延缓衰弱并降低认知功能减退。
Objective: This study aimed to analyze the mediating role of frailty level in the relationship between sleep duration and cognitive function among the elderly in China. Methods: Based on the 2020 China Health and Retirement Longitudinal Study (CHARLS) data, a sample of 4,446 participants was analyzed using linear regression to examine the correlations between variables. A mediation effect model was constructed to explore the mediating role of frailty levels in the relationship between sleep duration and cognitive function in the elderly. Results: The average sleep duration for the elderly was 6.07 hours per day, with an average cognitive function score of 16.06. Frailty was present in 363 individuals (8.16%). Sleep duration was positively correlated with cognitive function (β = 0.032, 95% CI: 0.008~0.161), while frailty levels were negatively correlated with cognitive function (β = ？0.104, 95% CI: ？1.031~？0.577). The mediation effect of frailty levels between sleep duration and cognitive function was significant, with a mediation effect size of 0.084 and a 95% CI of ？0.078~？0.059, accounting for 60.43% of the effect. Conclusion: Sleep duration is positively correlated with cognitive function, while frailty levels is negatively correlated with cognitive function. Frailty partially mediates the relationship between sleep duration and cognitive function. Adequate sleep can effectively delay frailty and reduce cognitive decline.
| [1] | 陈燕. 第七次全国人口普查公报[EB/OL]. https://www.gov.cn/guoqing/2021-05/13/content_5606149.htm, 2024-09-01. |
| [2] | Fisher, G.G., Chacon, M. and Chaffee, D.S. (2019) Theories of Cognitive Aging and Work. In: Work across the Lifespan, Elsevier, 17-45. https://doi.org/10.1016/b978-0-12-812756-8.00002-5 |
| [3] | 管君花. 台州市60岁以上人群老年痴呆发病情况及影响因素[J]. 医学与社会, 2018, 31(6): 52-54. |
| [4] | Mukherjee, U., Sehar, U., Brownell, M. and Reddy, P.H. (2024) Mechanisms, Consequences and Role of Interventions for Sleep Deprivation: Focus on Mild Cognitive Impairment and Alzheimer’s Disease in Elderly. Ageing Research Reviews, 100, Article 102457. https://doi.org/10.1016/j.arr.2024.102457 |
| [5] | 刘蕊. 老年人群睡眠特征与认知功能的相关性及其机制研究[D]: [博士学位论文]. 济南: 山东大学, 2024. |
| [6] | Zhang, H., Zhang, L., Chen, C. and Zhong, X. (2023) Association between Daytime Napping and Cognitive Impairment among Chinese Older Population: A Cross-Sectional Study. Environmental Health and Preventive Medicine, 28, 72. https://doi.org/10.1265/ehpm.23-00031 |
| [7] | Li, X., Yin, Y. and Zhang, H. (2024) Nonlinear Association between Self-Reported Sleep Duration and Cognitive Function among Middle-Aged and Older Adults in China: The Moderating Effect of Informal Care. Sleep Medicine, 115, 226-234. https://doi.org/10.1016/j.sleep.2024.02.028 |
| [8] | Li, M., Wang, N. and Dupre, M.E. (2022) Association between the Self-Reported Duration and Quality of Sleep and Cognitive Function among Middle-Aged and Older Adults in China. Journal of Affective Disorders, 304, 20-27. https://doi.org/10.1016/j.jad.2022.02.039 |
| [9] | Wen, Q., Yan, X., Ren, Z., Wang, B., Liu, Y. and Jin, X. (2022) Association between Insomnia and Frailty in Older Population: A Meta-Analytic Evaluation of the Observational Studies. Brain and Behavior, 13, e2793. https://doi.org/10.1002/brb3.2793 |
| [10] | Russell, A.E., Denny, R., Lee, P.G. and Montagnini, M.L. (2024) Palliative Care Considerations in Frail Older Adults. Annals of Palliative Medicine, 13, 976-990. https://doi.org/10.21037/apm-23-559 |
| [11] | 陈时奉, 彭文涛. 老年睡眠障碍患者睡眠质量与认知功能相关性分析[J]. 公共卫生与预防医学, 2024, 35(4): 149-152. |
| [12] | Chang, S., Lin, H. and Cheng, C. (2018) The Relationship of Frailty and Hospitalization among Older People: Evidence from a Meta-Analysis. Journal of Nursing Scholarship, 50, 383-391. https://doi.org/10.1111/jnu.12397 |
| [13] | Meng, Q., Wang, H., Strauss, J., Langa, K.M., Chen, X., Wang, M., et al. (2019) Validation of Neuropsychological Tests for the China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol. International Psychogeriatrics, 31, 1709-1719. https://doi.org/10.1017/s1041610219000693 |
| [14] | 刘威威. PM2.5、NO2、O3长期暴露与国人认知功能评分的关联性研究[D]: [硕士学位论文]. 武汉: 武汉科技大学, 2023. |
| [15] | Searle, S.D. and Rockwood, K. (2018) What Proportion of Older Adults in Hospital Are Frail? The Lancet, 391, 1751-1752. https://doi.org/10.1016/s0140-6736(18)30907-3 |
| [16] | 高苗, 潘荣玲, 陈梓旋, 等. 我国中老年群体社会参与和认知功能与衰弱发生关系的研究[J]. 现代预防医学, 2024, 51(11): 2055-2060. |
| [17] | 朱正杰, 施正丽, 张浩, 等. 我国老年人社会参与情况及其与认知障碍的关系[J]. 医学与社会, 2023, 36(12): 53-58. |
| [18] | Zhou, Y., Chen, Z., Shaw, I., Wu, X., Liao, S., Qi, L., et al. (2020) Association between Social Participation and Cognitive Function among Middle and Old-Aged Chinese: A Fixed-Effects Analysis. Journal of Global Health, 10, Article 020801. https://doi.org/10.7189/jogh.10.020801 |
| [19] | 罗丽丽, 田雪, 赵宇晗, 等. 我国中老年人累积血压与认知功能下降的关系[J]. 中华高血压杂志, 2024, 32(10): 971-977. |
| [20] | 周晟宇. 常用衰弱测量工具的测量性能及对不良健康结局的预测[D]: [硕士学位论文]. 济南: 山东大学, 2024. |
| [21] | 先德强, 倪志松, 赖晋锋, 等. 老年人睡眠时长与抑郁症状的关系[J]. 四川精神卫生, 2023, 36(5): 453-459. |
| [22] | Chen, M., Li, B., Fan, G. and Zhou, Y. (2024) Restricted Linear Association between Night Sleep Duration and Diabetes Risk in Middle-Aged and Older Adults: A 7-Year Follow-Up Analysis from the China Health and Retirement Longitudinal Study. Frontiers in Endocrinology, 15, Article 1364106. https://doi.org/10.3389/fendo.2024.1364106 |
| [23] | 熊燕, 杨敬源, 周全湘, 等. 贵州省农村老年人睡眠质量与认知功能的关系及抑郁的中介作用[J]. 中华疾病控制杂志, 2023, 27(6): 645-649+661. |
| [24] | 王洁, 莫永珍, 史青凌, 等. 社区老年人衰弱与认知功能的相关性分析[J]. 护理研究, 2019, 33(5): 832-835. |
| [25] | 李潇颖, 汪蕾, 席元第, 等. 骨科急诊老年人衰弱与认知功能障碍现状及相关性[J]. 卫生研究, 2019, 48(5): 785-792. |
| [26] | van den Ende, E.S., van Veldhuizen, K.D.I., Toussaint, B., Merten, H., van de Ven, P.M., Kok, N.A., et al. (2021) Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer from Total Sleep Deprivation Compared to Non-Covid-19 Patients; an Observational Comparative Study. Frontiers in Neuroscience, 15, Article 680932. https://doi.org/10.3389/fnins.2021.680932 |
