Qi Lu, MD, School of Nursing, Tianjin Medical University, Tianjin, 300070, China. Tel:86-23542855. Email address:
J Nutr Health Aging. 2022;26(4):383-390. doi: 10.1007/s12603-022-1766-z.
Frailty and sleep duration complaints are both prevalent and often coexist among older adults. The purpose of this study was to examine the prospective association between sleep duration and frailty risk in a nationally representative cohort study.
Prospective cohort study, ten-year follow-up.
Community-based setting in 23 provinces of China.
A total of 7623 older adults age 65 and over without frailty at baseline were included in the analysis.
The participants were divided into three groups according to self-reported sleep duration: short (≤6 hours per day), middle (>6 but <10 hours per day) and long (≥10 hours per day). Frailty was measured according to the accumulation of health deficits by the construction of a frailty index of 38 items with 0.25 as the cutoff. A Cox proportional hazard model, a competing risk model and a generalized estimating equation (GEE) model with multiple adjustments were performed to evaluate the association between sleep duration and frailty risk.
During a median follow-up period of 4.4 years (IQR 2.9-9.0), 2531 (33.2%) individuals developed frailty. Compared with participants with middle sleep duration, the risk of frailty was increased among participants with long sleep duration (HR 1.26, 95% CI 1.14-1.38) in the fully adjusted Cox proportional hazard model. However, short sleep duration was insignificantly associated with frailty risk. The competing risk model and the GEE model yielded similar results.
Long sleep duration is significantly associated with frailty incidence among older adults even after adjustment for confounding factors. This study provides reinforcing longitudinal evidence for the need to design sleep quality improvement interventions in health care programs to prevent frailty among older adults.
衰弱和睡眠时长抱怨在老年人中都很普遍，且常常并存。本研究旨在通过一项全国代表性队列研究，考察睡眠时长与衰弱风险之间的前瞻性关联。
前瞻性队列研究，十年随访。
中国 23 个省份的社区环境。
共纳入 7623 名基线时无衰弱的 65 岁及以上老年人进行分析。
根据自我报告的睡眠时长，参与者被分为三组：短（≤6 小时/天）、中（＞6 但＜10 小时/天）和长（≥10 小时/天）。衰弱是根据健康缺陷的积累，通过构建一个 38 项的衰弱指数来衡量的，该指数的截止值为 0.25。采用 Cox 比例风险模型、竞争风险模型和广义估计方程（GEE）模型进行多重调整，评估睡眠时长与衰弱风险之间的关联。
在中位数为 4.4 年（IQR 2.9-9.0）的随访期间，2531 名（33.2%）参与者发生了衰弱。与中睡眠时长组相比，长睡眠时长组的衰弱风险增加（HR 1.26，95%CI 1.14-1.38），在完全调整的 Cox 比例风险模型中。然而，短睡眠时长与衰弱风险无关。竞争风险模型和 GEE 模型得出了相似的结果。
即使在调整了混杂因素后，长睡眠时长与老年人衰弱的发生显著相关。本研究提供了强化的纵向证据，表明需要在医疗保健计划中设计改善睡眠质量的干预措施，以预防老年人衰弱。
