Ganidagli Sencer, Ozturk Zeynel Abidin
Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Gaziantep, Turkey.
Postgrad Med. 2023 Sep;135(7):717-726. doi: 10.1080/00325481.2023.2257125. Epub 2023 Sep 12.
Aging and type 2 diabetes mellitus (DM) are two different conditions that impair sleep quality. The primary objective of this study was to investigate the impact of sleep quality on geriatric syndromes in older diabetic adults.
Comprehensive geriatric assessment was performed on 236 patients. The assessment included the Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life Questionnaire (EQ-5D), Mini Mental Statement Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment, and measurement of handgrip strength (HGS).
Of the participants, 55% had DM, and 61.4% had poor sleep quality. Poor sleep prevalence was higher in diabetic patients (68.5%) than in non-diabetics (52.8%). Diabetic patients with poor sleep quality had higher frequencies of chronic pain, recurrent urinary tract infections, confirmed sarcopenia, and frailty ( = 0.015, < 0.001, = 0.027, and < 0.001, respectively), a higher number of comorbidities and higher GDS and BAI scores ( = 0.046, < 0.001 and < 0.001, respectively), and lower scores of activities of daily living, HGS, and EQ-5D index ( = 0.023, = 0.004, and < 0.001, respectively) compared to diabetic patients with good sleep quality. According to the correlation analysis results, PSQI score had a positive correlation with GDS score ( = 0.461, < 0.001) and a negative correlation with Mini Nutritional Assessment score ( = -0.317, < 0.001), skeletal muscle mass index ( = -0.283, = 0.002) and HGS ( = -0.307, < 0.001) scores in diabetic older adults.
Poor sleep quality in older diabetic patients has a negative impact on several geriatric syndromes. Our findings suggest that poor sleep quality is an independent risk factor for depression, malnutrition, and lower muscle mass in older diabetic adults. Improving sleep quality may play a crucial role in preventing and managing geriatric syndromes in this population.
衰老和2型糖尿病(DM)是两种影响睡眠质量的不同状况。本研究的主要目的是调查睡眠质量对老年糖尿病患者老年综合征的影响。
对236例患者进行了全面的老年综合评估。评估内容包括老年抑郁量表(GDS)、贝克焦虑量表(BAI)、欧洲生活质量问卷(EQ-5D)、简易精神状态检查表(MMSE)、匹兹堡睡眠质量指数(PSQI)、微型营养评定法以及握力(HGS)测量。
在参与者中,55%患有糖尿病,61.4%睡眠质量差。糖尿病患者的睡眠不佳患病率(68.5%)高于非糖尿病患者(52.8%)。睡眠质量差的糖尿病患者慢性疼痛、复发性尿路感染、确诊的肌肉减少症和虚弱的发生率更高(分别为P = 0.015、P < 0.001、P = 0.027和P < 0.001),合并症数量更多,GDS和BAI评分更高(分别为P = 0.046、P < 0.001和P < 0.001),与睡眠质量好的糖尿病患者相比,日常生活活动能力、HGS和EQ-5D指数得分更低(分别为P = 0.023、P = 0.004和P < 0.001)。根据相关性分析结果,在老年糖尿病患者中,PSQI评分与GDS评分呈正相关(P = 0.461,P < 0.001),与微型营养评定法评分、骨骼肌质量指数和HGS评分呈负相关(分别为P = -0.317,P < 0.001;P = -0.283,P = 0.002;P = -0.307,P < 0.001)。
老年糖尿病患者睡眠质量差对多种老年综合征有负面影响。我们的研究结果表明,睡眠质量差是老年糖尿病患者发生抑郁、营养不良和肌肉量降低的独立危险因素。改善睡眠质量可能在预防和管理该人群的老年综合征中起关键作用。