Shinmura Ken, Nagai Koutatsu, Shojima Kensaku, Yamazaki Hiromitsu, Tamaki Kayoko, Mori Takara, Wada Yosuke, Kusunoki Hiroshi, Onishi Masaaki, Tsuji Shotaro, Matsuzawa Ryota, Sano Kyoko, Hashimoto Kana, Goto Masashi, Nagasawa Yasuyuki
Department of General Internal Medicine, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, Kobe, Japan.
Sleep Med. 2025 Jan;125:185-191. doi: 10.1016/j.sleep.2024.11.036. Epub 2024 Nov 25.
Studies have linked frailty to sleep duration and/or quality using questionnaire-based subjective sleep assessments. This study clarified the relationship between frailty status and subjective and objective sleep indicators among community-dwelling older adults in a rural Japanese area. This cross-sectional cohort study analyzed the data of older adult participants in the FESTA Study, assessing subjective and objective sleep indicators using the Pittsburgh Sleep Quality Index (PSQI) and an actigraph, respectively. Frailty status was determined using the Japanese version of the Cardiovascular Health Study (J-CHS) and the Kihon Checklist (KCL). Its relationship was examined through multivariate logistic regression analysis. The data of 537 older adults (median age = 76 years; 177 men and 360 women) were analyzed. Aside from age, depression, and dietary variety score, the PSQI score and the number of awakening episodes after sleep onset were significantly associated with non-robustness when the J-CHS was utilized (OR 1.086 95%CI 1.017-1.159 P = .014 and OR .964 95%CI .934-.994 P = .019, respectively). When the KCL was utilized, non-robustness was significantly associated with the PSQI score (OR 1.100 95%CI 1.028-1.178 P = .006), along with age, gender, number of comorbidities, and depression. Among the seven items of the PSQI, non-robustness was significantly related to daytime dysfunction due to sleepiness. The associations between non-robustness and objective sleep indicators varied by the frailty assessment method, while non-robustness was significantly associated with subjective sleep quality, regardless of the diagnostic tool used for frailty status and age. Therefore, subjective sleep quality may be more reliable for preventing and/or managing frailty in older adults.
此前已有研究通过基于问卷的主观睡眠评估，将虚弱与睡眠时间和/或质量联系起来。本研究阐明了日本农村地区社区居住老年人的虚弱状态与主观和客观睡眠指标之间的关系。这项横断面队列研究分析了FESTA研究中老年人参与者的数据，分别使用匹兹堡睡眠质量指数（PSQI）和活动记录仪评估主观和客观睡眠指标。使用日本版心血管健康研究（J-CHS）和基本检查表（KCL）确定虚弱状态。通过多因素逻辑回归分析研究其关系。分析了537名老年人（中位年龄 = 76岁；177名男性和360名女性）的数据。除年龄、抑郁和饮食多样性评分外，当使用J-CHS时，PSQI评分和睡眠开始后的觉醒次数与非强健性显著相关（OR 1.086，95%CI 1.017 - 1.159，P = 0.014；OR 0.964，95%CI 0.934 - 0.994，P = 0.019）。当使用KCL时，非强健性与PSQI评分显著相关（OR 1.100，95%CI 1.028 - 1.178，P = 0.006），同时还与年龄、性别、合并症数量和抑郁有关。在PSQI的七个项目中，非强健性与因困倦导致的白天功能障碍显著相关。非强健性与客观睡眠指标之间的关联因虚弱评估方法而异，而无论用于虚弱状态和年龄的诊断工具如何，非强健性与主观睡眠质量均显著相关。因此，主观睡眠质量对于预防和/或管理老年人的虚弱可能更可靠。
