Zhao Jing, Qu Wensheng, Zhou Xirui, Guo Yinping, Zhang Yi, Wu Lingshan, Yu Zhiyuan, Huang Hao, Luo Xiang
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Aging Neurosci. 2021 Oct 20;13:751369. doi: 10.3389/fnagi.2021.751369. eCollection 2021.
Physical frailty is a common problem among older adults which usually leads to adverse health outcomes. The imaging markers of cerebral small vessel disease (CSVD) are associated with frailty, but the underlying mechanisms remain unclear. The present study aimed to investigate the mediating role of sleep quality in the relationship between CSVD burden and frailty. We performed a cross-sectional study and enrolled community residents. Frailty and sleep quality were measured using the Fried frailty phenotype and the Pittsburgh Sleep Quality Index (PSQI), respectively. A multivariate linear regression analysis and a Bootstrap analysis were performed to examine the association among the key variables and the mediating role of sleep quality. Of the 726 participants (mean age: 65.5 ± 6.5 years, 59.8% female), the numbers (percentages) of the frail, prefrail, and robust residents were 49 (6.7%), 310 (42.7%), and 367 (50.6%), respectively. After adjusting for covariates, the CSVD burden and PSQI score were significantly associated with the frailty score. In addition, sleep quality played a partial mediating role in the association between CSVD burden and physical frailty. The mediating effect was 21.9%. The present study suggests that sleep quality is a mediator of this association between CSVD and frailty in community-dwelling older adults. Improving sleep quality might be helpful to mitigate the risk of frailty in CSVD patients.
身体虚弱是老年人中常见的问题，通常会导致不良健康后果。脑小血管疾病（CSVD）的影像学标志物与身体虚弱有关，但其潜在机制仍不清楚。本研究旨在探讨睡眠质量在CSVD负担与身体虚弱之间关系中的中介作用。我们进行了一项横断面研究，并纳入了社区居民。分别使用Fried身体虚弱表型和匹兹堡睡眠质量指数（PSQI）测量身体虚弱和睡眠质量。进行多变量线性回归分析和Bootstrap分析，以检验关键变量之间的关联以及睡眠质量的中介作用。在726名参与者中（平均年龄：65.5±6.5岁，59.8%为女性），身体虚弱、虚弱前期和健康居民的人数（百分比）分别为49人（6.7%）、310人（42.7%）和367人（50.6%）。在调整协变量后，CSVD负担和PSQI得分与身体虚弱得分显著相关。此外，睡眠质量在CSVD负担与身体虚弱之间的关联中起部分中介作用。中介效应为21.9%。本研究表明，睡眠质量是社区居住老年人中CSVD与身体虚弱之间这种关联的中介因素。改善睡眠质量可能有助于降低CSVD患者身体虚弱的风险。
