实用老年医学

实用老年医学 ›› 2026, Vol. 40 ›› Issue (1): 38-42.doi: 10.3969/j.issn.1003-9198.2026.01.008

• 临床研究 • 上一篇    下一篇

医养结合机构高龄老人睡眠质量与衰弱的相关性研究

柏赟, 王琦, 杨莲倩子, 朱金雨, 张园园   

  1. 210029 江苏省南京市,南京中医药大学附属医院护理部
  • 收稿日期:2025-06-09 发布日期:2026-01-16
  • 通讯作者: 张园园,Email:540314441@qq.com
  • 基金资助:
    江苏省中医护理骨干人才高级研修项目(苏中医科教〔2022〕18号);江苏省中医院院级课题(Y23011);江苏省中医院研究者发起的临床研究(yjz202430);国家中医优势专科建设单位项目(国中医药医政函90号)

Association of sleep quality with frailty among adults aged 80 years and older in an integrated medical and long-term care institution

BO Yun, WANG Qi, YANG Lianqianzi, ZHU Jinyu, ZHANG Yuanyuan   

  1. Department of Nursing, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 210029, China
  • Received:2025-06-09 Published:2026-01-16
  • Contact: ZHANG Yuanyuan, Email: 540314441@qq.com

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摘要： 目的 探讨医养结合机构高龄老人睡眠质量与衰弱的关系,为预防及改善衰弱提供依据。 方法 采用便利抽样法于2024年1—4月对江苏省中医院钟山疗养院130例高龄老人(≥80岁)进行调查,采用匹兹堡睡眠质量指数(PSQI)、智能手环评估主、客观睡眠质量,采用FRAIL衰弱量表评估衰弱状况。采用多因素logistic回归分析高龄老人衰弱状况与睡眠的相关性。 结果 本研究高龄老人睡眠障碍发生率为56.9%(74例),衰弱发生率为40.8%(53例)。74例存在睡眠障碍的高龄病人中,衰弱39例(52.7%)。单因素分析显示,与非衰弱高龄老人相比,衰弱高龄老人表现出更短的夜间睡眠时间、更长的浅睡时间和更频繁的日间零星小睡次数(P<0.05)。多因素logistic回归分析结果显示:存在睡眠问题(PSQI≥5分)(OR=1.392,95%CI:1.151～1.680)、睡眠总时长(OR=2.431,95%CI:1.202～4.911)、浅睡眠时间(OR=1.123,95%CI:1.013～1.252)、日间零星小睡次数(OR=1.680,95%CI:1.050～2.671)是高龄老人衰弱的危险因素;夜间睡眠时间(OR=0.359,95%CI:0.178～0.731)是保护因素(P<0.05)。 结论 医养结合机构高龄老人的衰弱与睡眠质量差、睡眠结构失衡及昼夜节律碎片化密切相关,呈现“低质量-碎片化”特征,制订有针对性的干预策略可通过改善睡眠质量降低衰弱的发生风险。

关键词: 医养结合机构, 高龄老人, 睡眠质量, 衰弱

Abstract: Objective To examine the association between sleep quality and frailty among the oldest old (≥80 years) residing in integrated medical and long-term care institution, and to inform frailty prevention and management. Methods In a cross-sectional study conducted in Jiangsu Province Zhongshan Sanatorium from January to April 2024, 130 residents aged ≥80 years were surveyed using convenience sampling. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index (PSQI) and objectively via a wrist-worn smart band, which captured various sleep parameters.Frailty was screened using the FRAIL Scale. Multivariable logistic regression was applied to evaluate associations between sleep-related variables and frailty. Results The prevalence rates of sleep disturbance and frailty were 56.9%(74/130) and 40.8%(53/130), respectively.Among 74 participants with sleep disturbances, 39 individuals presented with frailty. Univariate analysis demonstrated that frailty group exhibited shorter nocturnal sleep duration, increased light sleep duration, and a higher frequency of daytime napping compared to non-frail group (P<0.05).Multivariable logistic regression analysis revealed that higher PSQI score (PSQI≥5) (OR=1.392, 95%CI: 1.151-1.680), longer total sleep time (OR=2.431, 95%CI: 1.202-4.911), longer light sleep duration (OR=1.123, 95%CI: 1.013-1.252), and greater number of daytime naps (OR=1.680, 95%CI:1.050-2.671) were independent risk factors for frailty. Conversely, longer nighttime sleep duration (OR=0.359, 95%CI: 0.178-0.731) was a protective factor. Conclusions Frailty among oldest old in integrated medical and long-term care institution is closely associated with poor sleep quality, impaired sleep structure and fragmented circadian rhythms, exhibiting characteristics of poor quality and fragmentation. Targeted intervention strategies need to be developed to improve sleep quality in order to mitigate the risk of frailty.

Key words: integrated medical and long-term care facility, advanced aged, sleep quality, frailty

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