Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China.
PLoS One. 2013 Nov 25;8(11):e81261. doi: 10.1371/journal.pone.0081261. eCollection 2013.
Sleep disorders causes a significant negative effect on mental and physical health, particularly among the elderly. The disease burden and risk factors of poor sleep quality of the elderly need to be verified using a validated form of measurement in urban mainland China.
This study included 1086 community residents aged ≥ 60 years who completed the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleeper was defined by a CPSQI global score of >5. Subjects also accepted the neurological and neuropsychological assessments, including the Mini-Mental State Examination, Center for Epidemiological Studies Depression Scale, and Zung Self-Rating Anxiety Scale (ZSAS). A history of chronic diseases was confirmed by the medical records of each participant.
The prevalence of poor sleep quality in this population was 41.5% (95% confidence interval (CI) = 38.6-44.5%), with a higher rate observed in elderly females (45.8% [95% CI = 41.9-49.7%]) than that in elderly males (35.8% [95% CI = 31.4-40.1%]). The prevalence rate increased with age, from 32.1% (95% CI = 27.8-36.4%) in those aged 60-69 years to 52.5% (95% CI = 45.9-59.1%) in those aged ≥ 80 years (p value for trend<0.001). Multivariate logistic regression analysis indicated that age (OR = 1.03[95% CI = 1.01-1.05], p<0.001), less education duration (OR = 1.04 [95% CI = 1.01-1.08, p = 0.014), living alone (OR = 1.62 [95% CI = 1.02-2.58], p = 0.04), anxiety (ZSAS score: OR = 1.09 [95% CI = 1.05-1.12], p<0.001), number of chronic disease (OR = 1.18 [95% CI = 1.07-1.30], p = 0.14) and arthritis (OR = 1.45[95% CI = 1.05-2.01], p = 0.025) were risk factors of poor sleep quality.
Poor sleep quality is highly prevalent among elderly Chinese residents in urban Shanghai. Growing attention and comprehensive countermeasures involving psycho-social and personal activities might alleviate the sleep problem in the elderly.
睡眠障碍对身心健康有显著的负面影响，尤其是在老年人中。在中国内地的城市中，需要使用经过验证的测量方法来证实老年人睡眠质量差的疾病负担和危险因素。
本研究纳入了 1086 名年龄≥60 岁的社区居民，他们完成了中文版匹兹堡睡眠质量指数（CPSQI）的测试。睡眠质量差定义为 CPSQI 总分>5。研究对象还接受了神经学和神经心理学评估，包括简易精神状态检查、流行病学研究中心抑郁量表和 Zung 焦虑自评量表（ZSAS）。每位参与者的慢性疾病史都通过医疗记录得到确认。
该人群中睡眠质量差的患病率为 41.5%（95%置信区间（CI）=38.6-44.5%），老年女性的患病率（45.8%[95% CI=41.9-49.7%]）高于老年男性（35.8%[95% CI=31.4-40.1%]）。患病率随着年龄的增长而增加，从 60-69 岁人群的 32.1%（95% CI=27.8-36.4%）到≥80 岁人群的 52.5%（95% CI=45.9-59.1%）（趋势 p 值<0.001）。多变量逻辑回归分析表明，年龄（OR=1.03[95% CI=1.01-1.05]，p<0.001）、教育持续时间较短（OR=1.04[95% CI=1.01-1.08]，p=0.014）、独居（OR=1.62[95% CI=1.02-2.58]，p=0.04）、焦虑（ZSAS 评分：OR=1.09[95% CI=1.05-1.12]，p<0.001）、慢性疾病数量（OR=1.18[95% CI=1.07-1.30]，p=0.14）和关节炎（OR=1.45[95% CI=1.05-2.01]，p=0.025）是睡眠质量差的危险因素。
在中国上海的城市老年居民中，睡眠质量差的情况较为普遍。重视和采取全面的社会心理和个人活动措施可能有助于缓解老年人的睡眠问题。
