Zheng Wei, Sun Yan, Liu Xianling, Lu Miao, Xu Di
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Sci Rep. 2025 Apr 15;15(1):12958. doi: 10.1038/s41598-025-97130-z.
The relationship between sleep duration and frailty remains unclear, particularly regarding their bidirectional nature and temporal dynamics in the Chinese population. This study aimed to investigate the cross-sectional association, developmental trajectories, and interactions between sleep duration and frailty in Chinese middle-aged and older adults. Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 12,942 participants for cross-sectional analysis and 11,192 participants for the longitudinal trajectory study. Latent growth models and cross-lagged panel models were utilized to explore the temporal effects of sleep duration on frailty and vice versa. Participants' mean age was 59.29 ± 9.48 years, comprising 47.73% men and 52.27% women. Cross-sectional analysis revealed that, compared with participants with normal sleep duration (6-8 h), both Q1 (≤ 5 h, OR = 1.99, 95% CI 1.64-2.41, P < 0.001) and Q4 (> 8 h, OR = 1.50, 95% CI 1.12-2.02, P = 0.01) showed increased risks of frailty. The parallel latent growth model demonstrated that the initial level of sleep duration significantly negatively predicted the initial level of frailty (β = - 0.34, P < 0.001), while the rate of change in sleep duration negatively predicted the rate of change in frailty (β = - 0.61, P < 0.001). Conversely, the initial level of frailty significantly negatively predicted the initial level of sleep duration (β = - 0.36, P < 0.001), and the rate of change in frailty negatively predicted the rate of change in sleep duration (β = - 0.71, P < 0.001). Cross-lagged analysis indicated a bidirectional causal association between sleep duration and frailty, with the negative predictive effect of frailty on sleep duration being relatively stable, while sleep duration had a short-term effect on frailty. Our study revealed a U-shaped correlation between sleep duration and frailty risk in cross-sectional analysis and established a bidirectional relationship through longitudinal investigation. These findings underscore the importance of balanced sleep patterns and early screening for both conditions in middle-aged and older adults.
睡眠时长与衰弱之间的关系仍不明确，尤其是在中国人群中它们的双向性质和时间动态方面。本研究旨在调查中国中老年人睡眠时长与衰弱之间的横断面关联、发展轨迹及相互作用。数据来自中国健康与养老追踪调查（CHARLS），其中12,942名参与者用于横断面分析，11,192名参与者用于纵向轨迹研究。采用潜在增长模型和交叉滞后面板模型来探究睡眠时长对衰弱的时间效应，反之亦然。参与者的平均年龄为59.29±9.48岁，男性占47.73%，女性占52.27%。横断面分析显示，与睡眠时长正常（6 - 8小时）的参与者相比，Q1组（≤5小时，OR = 1.99，95%CI 1.64 - 2.41，P < 0.001）和Q4组（>8小时，OR = 1.50，95%CI 1.12 - 2.02，P = 0.01）的衰弱风险均增加。平行潜在增长模型表明，睡眠时长的初始水平显著负向预测衰弱的初始水平（β = -0.34，P < 0.001），而睡眠时长的变化率负向预测衰弱的变化率（β = -0.61，P < 0.001）。相反，衰弱的初始水平显著负向预测睡眠时长的初始水平（β = -0.36，P < 0.001），且衰弱的变化率负向预测睡眠时长的变化率（β = -0.71，P < 0.001）。交叉滞后分析表明睡眠时长与衰弱之间存在双向因果关联，衰弱对睡眠时长的负向预测效应相对稳定，而睡眠时长对衰弱有短期效应。我们的研究在横断面分析中揭示了睡眠时长与衰弱风险之间的U型相关性，并通过纵向调查建立了双向关系。这些发现强调了平衡睡眠模式以及对中老年人这两种情况进行早期筛查的重要性。
