Department of Psychiatry, University of California San Diego, San Diego, California, USA.
University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
AIDS Res Hum Retroviruses. 2022 Feb;38(2):87-96. doi: 10.1089/AID.2020.0158. Epub 2021 Dec 15.
Older people with HIV (PWH) experience heightened risk for the acquisition of cumulative, multisystem decline, that is, frailty syndrome. Frailty relates to poorer sleep quality in the general older adult population; however, this association has yet to be explored among PWH. A cross-sectional analysis of 285 PWH ≥50 years of age (mean age 60.5 ± 7.0) examined the relationship between frailty (Fried frailty phenotype) and self-reported sleep quality [Pittsburgh Sleep Quality Index (PSQI)]. Three separate multivariable linear regression models examined global PSQI as a function of (1) frailty phenotype, (2) total number of frailty symptoms, or (3) specific individual frailty symptoms. Models covaried for demographic and biopsychosocial risk factors, including age, sex, race/ethnicity, education, premorbid verbal IQ estimate, current depressive symptoms, and diagnosis of a substance abuse disorder. Compared to nonfrail ( = 0.151; = .021) and prefrail ( = 0.144; = .021), frail phenotype was related to poorer sleep quality (increased global PSQI; (5,278) = 11.34, < .001; = 0.17). Increased number of frailty symptoms ( = 0.144; = .019; (4,276) = 12.719, < .001; = 0.16) and exhaustion was associated with increased global PSQI scores ( = 0.218, < .001; (6,247) = 10.436, < .001; = 0.19). In all models, older age, female sex, and elevated current depressive symptoms were associated with poorer sleep quality. In older PWH, greater frailty symptoms related to poorer sleep quality, independent of psychosocial risk factors for poor sleep. Frailty and poor sleep individually have adverse effects on health and everyday functioning; thus, establishing this association may better aid providers to screen for and treat problems with sleep quality and/or frailty among PWH.
HIV 感染者(PWH)年龄较大,累积的多系统衰退(即虚弱综合征)风险更高。虚弱与一般老年人群中较差的睡眠质量有关;然而,这种关联尚未在 PWH 中进行探讨。对 285 名年龄在 50 岁及以上(平均年龄 60.5±7.0)的 PWH 进行了横断面分析,研究了虚弱(弗里德虚弱表型)与自我报告的睡眠质量[匹兹堡睡眠质量指数(PSQI)]之间的关系。三个单独的多变量线性回归模型分别检查了全球 PSQI 作为(1)虚弱表型、(2)虚弱症状总数或(3)特定的单个虚弱症状的函数。模型协变量包括人口统计学和生物心理社会风险因素,包括年龄、性别、种族/族裔、教育、发病前言语智商估计、当前抑郁症状和物质滥用障碍的诊断。与非虚弱( = 0.151; = .021)和前虚弱( = 0.144; = .021)相比,虚弱表型与较差的睡眠质量相关(增加全球 PSQI;(5,278) = 11.34, < .001; = 0.17)。虚弱症状增多( = 0.144; = .019;(4,276) = 12.719, < .001; = 0.16)和疲劳与全球 PSQI 评分增加相关( = 0.218, < .001;(6,247) = 10.436, < .001; = 0.19)。在所有模型中,年龄较大、女性和当前抑郁症状升高与较差的睡眠质量相关。在年龄较大的 PWH 中,与睡眠质量较差相关的虚弱症状更多,这与睡眠质量不佳的心理社会风险因素无关。虚弱和睡眠质量差都会对健康和日常功能产生不利影响;因此,建立这种关联可以帮助提供者更好地筛查和治疗 PWH 中的睡眠质量和/或虚弱问题。