Miao Yudong, Li Xinran, Shen Zhanlei, Zhu Dongfang, Bai Junwen, Zhang Jingbao, Ren Ruizhe, Guo Dan, Tarimo Clifford Silver, Cui Jinxin, Zhen Mingyue, Zhang Jiajia, Song Yalin
School of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China.
Sci Rep. 2025 Jan 22;15(1):2829. doi: 10.1038/s41598-025-85163-3.
Previous research on lifestyle has primarily focused on individual lifestyle factors, often overlooking the broader influence of social determinants. This study aimed to examine factors associated with healthy lifestyle scores (HLS) among older adults with diabetes, emphasizing modifiable behaviors within the framework of the socioecological model (SEM). A cross-sectional survey was conducted from July 1 to August 31, 2023, in Jia County, Henan Province, utilizing a whole-cluster sampling method. Influencing factors were categorized into five levels based on the socioecological model (SEM). We used Generalized linear models to examine the associations between these factors and HLS, while adjusting for potential confounders. The study included 5,451 eligible participants. The proportion of participants with healthy sleep habits was notably low (14.71%). Higher HLS were positively associated with being female, better cognitive competence, greater social engagement, and unemployment. In contrast, lower HLS were significantly associated with the presence of complications, depression, higher income, and residing farther from major roads. This study identified the key modifiable factors influencing HLS among older adults with diabetes. Disrupted sleep patterns emerged as a significant concern warranting targeted intervention. Medical insurance directly affects the accessibility and economic burden of medical resources. The government should further optimize medical insurance policies to facilitate patients in adopting healthier lifestyles choices.
以往关于生活方式的研究主要集中在个体生活方式因素上，常常忽视社会决定因素的更广泛影响。本研究旨在探讨糖尿病老年患者健康生活方式得分（HLS）的相关因素，强调社会生态模型（SEM）框架内的可改变行为。2023年7月1日至8月31日，在河南省佳县采用整群抽样方法进行了一项横断面调查。根据社会生态模型（SEM），将影响因素分为五个层次。我们使用广义线性模型来检验这些因素与HLS之间的关联，同时对潜在混杂因素进行调整。该研究纳入了5451名符合条件的参与者。有健康睡眠习惯的参与者比例显著较低（14.71%）。较高的HLS与女性、较好的认知能力、更多的社交参与和失业呈正相关。相比之下，较低的HLS与并发症的存在、抑郁、较高的收入以及居住在离主要道路较远的地方显著相关。本研究确定了影响糖尿病老年患者HLS的关键可改变因素。睡眠模式紊乱成为一个值得进行针对性干预的重大问题。医疗保险直接影响医疗资源的可及性和经济负担。政府应进一步优化医疗保险政策，以促进患者选择更健康的生活方式。
