Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Applied Statistics, Faculty of Economics and Administration, University of Malaya, Kuala Lumpur, Malaysia.
Int J Geriatr Psychiatry. 2019 Jan;34(1):60-66. doi: 10.1002/gps.4986. Epub 2018 Sep 19.
Elder abuse and neglect (EAN) is a growing public health problem, and numerous adverse health effects of abuse in late life have been documented. Little is known, however, about the impact of elder abuse on sleep quality. This study examines the longitudinal relationship between EAN and sleep quality.
This was a 2-year prospective cohort study involving 1927 older adults in a rural Malaysian district, Kuala Pilah. A multi-stage cluster sampling strategy was employed. After 2 years, 1189 respondents were re-assessed. EAN was determined using the modified Conflict Tactic Scale, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).
The prevalence of elder abuse was 8.1% (95% CI:6.9,9.3). Longitudinal analysis using generalized estimating equations showed that elder abuse contributed to higher PSQI scores (B:0.49, 95% CI:0.17,0.58). Sub-analyses demonstrated that psychological abuse and neglect had significant longitudinal relationships with increase of PSQI scores, while other subtypes did not.
Abuse in late life, particularly psychological abuse and neglect, result in greater PSQI scores. Even though this may imply decline in sleep quality, our findings were not considered clinically significant as they did not exceed the clinical cut-off score of five. Nevertheless, sleep quality is an important determinant of health and a predictor of mortality among older adults; thus, understanding its relationship with abuse is useful to health care providers and policy-makers in improving health services and upgrading preventive measures.
虐待和忽视老年人问题（Elder abuse and neglect，EAN）是一个日益严重的公共卫生问题，大量研究已经证实虐待会对老年人健康造成诸多不良影响。然而，关于虐待对老年人睡眠质量的影响，我们知之甚少。本研究旨在探讨 EAN 与睡眠质量之间的纵向关系。
这是一项为期 2 年的前瞻性队列研究，涉及马来西亚瓜拉庇拉县的 1927 名老年人。采用多阶段聚类抽样策略。2 年后，对 1189 名受访者进行了重新评估。采用改良冲突策略量表确定 EAN，使用匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）测量睡眠质量。
EAN 的患病率为 8.1%（95%置信区间：6.9，9.3）。使用广义估计方程的纵向分析显示，EAN 导致 PSQI 评分升高（B：0.49，95%置信区间：0.17，0.58）。亚组分析表明，心理虐待和忽视与 PSQI 评分升高存在显著的纵向关系，而其他亚型则没有。
晚年虐待，特别是心理虐待和忽视，会导致 PSQI 评分升高。尽管这可能意味着睡眠质量下降，但我们的研究结果并不被认为具有临床意义，因为它们没有超过 5 分的临床临界值。然而，睡眠质量是老年人健康的重要决定因素，也是预测死亡率的因素；因此，了解其与虐待的关系对于改善医疗服务和提升预防措施对医疗保健提供者和决策者都很有用。
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