Huang Jing, Tang Aoyi, Li Qianrui, Chen Fei, Ye Suni, Song Linyang, Qiu Peiyuan
Department of Epidemiology and Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, 17 section 3 south Renmin Road, Chengdu, 610041, China.
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
BMC Geriatr. 2025 Sep 24;25(1):694. doi: 10.1186/s12877-025-06381-y.
Sleep disorders, depression, and anxiety are emerging as significant public health concerns among the aging population worldwide, and they are highly interrelated with each other. We aim to identify key symptoms and shed light on a deeper understanding of the intricate connections between symptoms of sleep disorders, depression and anxiety.
This study used multistage sampling to select 18 residential areas in Jinjiang District, Chengdu City, Sichuan Province, China from December 2017 to April 2018. A total of 434 urban community-dwelling older adults aged 60 or above were recruited. The item scores of the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure the participants' symptoms of sleep disorders, depression and anxiety, respectively. The statistical analysis employed network analyses as the primary methodology.
Within the realm of depressive symptoms, "Suicidality" showed the strongest link with "Worthlessness" (weight = 0.23). In terms of cross-disorders connections, "Disturbed sleep" in depression displayed a close relationship with "Sleep latency" in sleep disorders (weight = 0.32). However, no strong connection was observed between anxiety and sleep disorders. Furthermore, the symptoms "Fatigue" and "Sleep difficulties " had the highest strength centrality (z > = 1).
The central symptoms and their intricate connections in the network play an importance role in gaining the underlying pathological mechanisms, as well as potential interventions for comorbidity in community older adults.
睡眠障碍、抑郁症和焦虑症正成为全球老年人口中重大的公共卫生问题，且它们之间高度相互关联。我们旨在识别关键症状，并更深入地了解睡眠障碍、抑郁症和焦虑症症状之间的复杂联系。
本研究采用多阶段抽样方法，于2017年12月至2018年4月在中国四川省成都市锦江区选取了18个居民区。共招募了434名60岁及以上的城市社区老年人。匹兹堡睡眠质量指数（PSQI）、患者健康问卷-9（PHQ-9）和广泛性焦虑障碍量表-7（GAD-7）的项目得分分别用于测量参与者的睡眠障碍、抑郁和焦虑症状。统计分析采用网络分析作为主要方法。
在抑郁症状领域，“自杀观念”与“无价值感”的联系最为紧密（权重=0.23）。在跨障碍联系方面，抑郁症中的“睡眠障碍”与睡眠障碍中的“入睡潜伏期”关系密切（权重=0.32）。然而，未观察到焦虑症与睡眠障碍之间有强烈联系。此外，“疲劳”和“睡眠困难”症状具有最高的强度中心性（z≥1）。
网络中的核心症状及其复杂联系在了解社区老年人潜在病理机制以及共病的潜在干预方面发挥着重要作用。
