Fang Jia, Wu Wenwen, Yang Chen, Zhang Ni, Wu Yibo, Zhang Meifen
School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Nursing, International School of Medicine, the Fourth Affiliated Hospital of School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
BMC Geriatr. 2025 Aug 13;25(1):619. doi: 10.1186/s12877-025-06273-1.
Depressive symptoms, sleep disturbances, and frailty significantly affect older adults, representing a substantial public health issue. Although previous studies have demonstrated complex interrelationships among these factors, the underlying causal pathways and optimal intervention targets remain unclear.
The study aimed to elucidate the potential causal pathways linking these factors and identify optimal intervention targets to mitigate their synergistic effects.
A cross-sectional study was conducted in 2022 among 3,924 Chinese adults aged ≥ 60 years. Frailty was assessed using the FRAIL scale; sleep quality via the Brief Pittsburgh Sleep Quality Index; and depressive symptoms with the Patient Health Questionnaire-9. We employed network and Bayesian analyses to examine the interactions among these factors, focusing on identifying core and bridge symptoms and potential causal directions.
Our findings indicate that illness (r=2.30, r=0.01, r=24) has the greatest centrality, while fatigue (r = 0.417) serves as the primary bridge symptom. Network comparison tests showed no significant differences in structure based on gender, age, or residence, suggesting uniformity across groups (p > 0.05). Sleep disturbances emerged as the most influential factor in the network, directly impacting both sleep quality and frailty.
This study uncovers the complex links between depressive symptoms, sleep quality, and frailty in older adults. Illness and fatigue are key symptoms, with sleep disturbances identified as a primary predictor affecting both sleep quality and frailty. Targeting sleep disturbances may alleviate frailty and enhance overall sleep health.
抑郁症状、睡眠障碍和身体虚弱对老年人有显著影响，是一个重大的公共卫生问题。尽管先前的研究已经证明了这些因素之间存在复杂的相互关系，但潜在的因果途径和最佳干预靶点仍不明确。
本研究旨在阐明这些因素之间潜在的因果途径，并确定最佳干预靶点，以减轻它们的协同效应。
2022年对3924名年龄≥60岁的中国成年人进行了一项横断面研究。使用衰弱量表评估身体虚弱；通过匹兹堡睡眠质量指数简表评估睡眠质量；用患者健康问卷-9评估抑郁症状。我们采用网络分析和贝叶斯分析来研究这些因素之间的相互作用，重点是确定核心症状和桥梁症状以及潜在的因果方向。
我们的研究结果表明，疾病（r = 2.30，r = 0.01，r = 24）具有最大的中心性，而疲劳（r = 0.417）是主要的桥梁症状。网络比较测试显示，基于性别、年龄或居住地的结构没有显著差异，表明各组之间具有一致性（p > 0.05）。睡眠障碍是网络中最具影响力的因素，直接影响睡眠质量和身体虚弱。
本研究揭示了老年人抑郁症状、睡眠质量和身体虚弱之间的复杂联系。疾病和疲劳是关键症状，睡眠障碍被确定为影响睡眠质量和身体虚弱的主要预测因素。针对睡眠障碍可能会减轻身体虚弱并改善整体睡眠健康。
