中国西部多民族中老年人群睡眠质量与认知障碍的关联：一项多中心横断面研究

The association between sleep quality and cognitive impairment among a multi-ethnic population of middle-aged and older adults in Western China: a multi-center cross-sectional study.

作者信息

Hu Yuexia, Xia Xin, Li Huixian, Xie Yuqing, Tian Xin, Li Yun, Yue Jirong, Dong Birong, Wang Yanyan

机构信息

Healthcare Innovation Research Laboratory, West China School of Nursing & National Clinical Research Center for Geriatrics, Science and Technology Department, West China Hospital, Sichuan University, Chengdu, China.

National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Public Health. 2025 Apr 17;13:1500027. doi: 10.3389/fpubh.2025.1500027. eCollection 2025.

DOI:10.3389/fpubh.2025.1500027

PMID:40313499

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12043481/

Abstract

OBJECTIVE

This study aims to investigate the relationship between sleep quality and cognitive impairment in middle-aged and older adults living in Western China.

METHODS

Baseline data from the West China Health and Aging Trend (WCHAT) study were utilized, with enrollment of participants aged 50 years or older. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), where a PSQI score > 5 indicated poor sleep quality. The cognitive status was evaluated using the 10-item Short Portable Mental Status Questionnaire (SPMSQ). Multinomial logistic regression was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

A total of 6,728 middle-aged and older adults dwelling in western China (age = 62.39 ± 8.925 years, 2,520 males and 4,208 females) were included in the analysis. The prevalence of mild cognitive impairment was 11.0%, with 4.3% having moderate to severe cognitive impairment. Poor sleep quality was found in 47.7% of participants. After adjusting for age, gender, education, marital status, and chronic disease, poor sleep quality (OR = 1.29, 95% CI: 1.1-1.52, = 0.002) was associated with a higher risk of mild cognitive impairment. Among specific sleep dimensions, there is a significant association between high daytime dysfunction and mild cognitive impairment (adjusted OR = 1.96, 95% CI: 1.45-2.62) as well as moderate to severe cognitive impairment (adjusted OR = 3.15, 95% CI: 2.09-4.73) in the middle-aged and older adults residing in multi-ethnic areas of western China. Besides, a sleep duration of 6-7 h was associated with a reduced risk of mild cognitive impairment (OR = 0.80, 95% CI: 0.65-0.98) and moderate to severe cognitive impairment (OR = 0.71, 95% CI: 0.51-0.99). Stratified analysis showed that poor sleep quality-particularly daytime dysfunction-was significantly associated with moderate to severe cognitive impairment in Han (OR = 4.14, 95%CI: 1.65-10.23), Tibetan (OR = 3.45, 95% CI: 1.42-8.1), and Yi (OR = 4.04, 95%CI: 1.46-10.97) participants, but not in Uyghur and Qiang groups.

CONCLUSION

Sleep quality is significantly associated with cognitive impairment among middle-aged and older adults in Western China, particularly concerning the components of daytime dysfunction.

摘要

目的

本研究旨在调查中国西部中老年人群睡眠质量与认知障碍之间的关系。

方法

利用中国西部健康与老龄化趋势（WCHAT）研究的基线数据，纳入年龄在50岁及以上的参与者。使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，PSQI得分>5表明睡眠质量差。使用10项简易便携式精神状态问卷（SPMSQ）评估认知状态。应用多项逻辑回归来估计比值比（OR）和95%置信区间（CI）。

结果

共有6728名居住在中国西部的中老年人（年龄=62.39±8.925岁，男性2520名，女性4208名）纳入分析。轻度认知障碍的患病率为11.0%，中度至重度认知障碍的患病率为4.3%。47.7%的参与者存在睡眠质量差的情况。在调整年龄、性别、教育程度、婚姻状况和慢性病因素后，睡眠质量差（OR=1.29，95%CI：1.1-1.52，P=0.002）与轻度认知障碍风险较高相关。在特定睡眠维度中，在中国西部多民族地区的中老年人中，日间功能障碍程度高与轻度认知障碍（调整后OR=1.96，95%CI：1.45-2.62）以及中度至重度认知障碍（调整后OR=3.15，95%CI：2.09-4.73）之间存在显著关联。此外，6-7小时的睡眠时间与轻度认知障碍（OR=0.80，95%CI：0.65-0.98）和中度至重度认知障碍（OR=0.71，95%CI：0.51-0.99）风险降低相关。分层分析表明，睡眠质量差——尤其是日间功能障碍——与汉族（OR=4.14，95%CI：1.65-10.23）、藏族（OR=3.45，95%CI：1.42-8.1）和彝族（OR=4.04，95%CI：1.46-10.97）参与者的中度至重度认知障碍显著相关，但在维吾尔族和羌族人群中未发现此关联。