Liu Yibing, Ji Jingang, Du Wenwen, Cao Qiuye, Su Chang, He Yuna, Wang Huijun, Jia Xiaofang
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Public Nutrition and Health, National Health Commission of the People's Republic of China, Beijing, 100050, China.
BMC Geriatr. 2025 May 29;25(1):386. doi: 10.1186/s12877-025-06044-y.
Successful aging (SA) is a major challenge of population aging. Exploring modifiable factors becomes the focus of promoting SA. We aimed to understand SA status and determine association between sleep and SA in China.
Present study targeted subjects aged ≥ 60 years and those with completed data of demographics, lifestyle, disease history, physical and mental health, and anthropometrics in China Health and Nutrition Survey 2018. Sleep was evaluated using self-reported sleep duration and Bergen insomnia scale. SA was assessed from overall health, mental and cognitive health, activities of daily life, and physical capacity. Multivariate logistic regression models were employed to examine association between sleep and SA and its components. Restricted cubic spline regression models were applied to explore dose-response relationships between insomnia score/sleep duration and SA.
About 41.29% subjects achieved SA. Compared to reference of having no insomnia or having 7-8 h of sleep daily, subjects with insomnia and those with ≥ 9 h of sleep had decreased odds of SA by 53% and 18%, respectively (p < 0.05). Relative to subjects with 7-8 h sleep per day (meaning optimal sleep duration) and without insomnia, those having optimal sleep duration but suffering from insomnia (OR = 0.50, 95%CI:0.39-0.62), improper sleep duration ruling out 7-8 h of sleep but without insomnia (OR = 0.84, 95%CI:0.73-0.97), and both improper sleep duration and insomnia (OR = 0.40, 95%CI:0.32-0.50) displayed lower odds of SA. There were nonlinear dose-response relationships between sleep indicators and SA, that was concave-up for insomnia score while inverted U-shape for sleep duration, where inflection points indicating rapidly decreased SA odds were 2.95 points of insomnia and 8 h sleep duration daily.
Insomnia and longer sleep duration are negative factors for SA in Chinese older adults, and good sleep quality indicated by no insomnia seems more important than sleep duration for SA.
成功老龄化是人口老龄化面临的一项重大挑战。探索可改变的因素成为促进成功老龄化的重点。我们旨在了解中国的成功老龄化状况，并确定睡眠与成功老龄化之间的关联。
本研究以年龄≥60岁且在2018年中国健康与营养调查中拥有完整人口统计学、生活方式、疾病史、身心健康及人体测量学数据的受试者为目标对象。睡眠通过自我报告的睡眠时间和卑尔根失眠量表进行评估。成功老龄化从总体健康、心理和认知健康、日常生活活动及身体能力等方面进行评估。采用多变量逻辑回归模型来检验睡眠与成功老龄化及其组成部分之间的关联。应用受限立方样条回归模型来探索失眠评分/睡眠时间与成功老龄化之间的剂量反应关系。
约41.29%的受试者实现了成功老龄化。与无失眠或每日睡眠7 - 8小时的参照组相比，患有失眠的受试者和睡眠≥9小时的受试者成功老龄化的几率分别降低了53%和18%（p<0.05）。相对于每日睡眠7 - 8小时（即最佳睡眠时间）且无失眠的受试者，拥有最佳睡眠时间但患有失眠的受试者（OR = 0.50，95%CI：0.39 - 0.62）、睡眠时间不当（排除7 - 8小时睡眠）但无失眠的受试者（OR = 0.84，95%CI：0.73 - 0.97）以及睡眠时间不当且患有失眠的受试者（OR = 0.40，95%CI：0.32 - 0.50）成功老龄化的几率较低。睡眠指标与成功老龄化之间存在非线性剂量反应关系，即失眠评分呈向上凹形，而睡眠时间呈倒U形，失眠评分为2.95分和每日睡眠时间为8小时时，拐点表明成功老龄化几率迅速下降。
失眠和较长睡眠时间是中国老年人成功老龄化的负面因素，对于成功老龄化而言，无失眠所表明的良好睡眠质量似乎比睡眠时间更为重要。
