中国临床医学2025，Vol.32Issue(1)：58-64,7.DOI:10.12025/j.issn.1008-6358.2025.20241373
上海社区老年人认知功能和睡眠质量现状及影响因素分析
Analysis of the current status and influencing factors of cognitive function and sleep quality of elderly people in Shanghai community
摘要
Abstract
Objective To analyze the cognitive function and sleep quality of the elderly in Shanghai community,and explore the related influencing factors.Methods A stratified cluster random sampling method was used to select 8 community health centers in Shanghai for a questionnaire survey,including 3 677 elderly individuals who completed the"Comprehensive Health Status Survey of Elderly Residents in Shanghai"from September 2023 to November 2023.Basic information of the elderly was collected,including age,gender,education level,smoking,drinking,mahjong playing behavior,and exercise habits.The Pittsburgh sleep quality index(PSQI)was used to assess the sleep quality of the elderly,subjective cognitive decline(SCD)self-assessment questionnaire and Mini-Mental State Examination(MMSE)were used to evaluate cognitive function,while the Hamilton Anxiety Scale(HAMA)and patient health questionnaire-9(PHQ-9)were used to assess anxiety and depression levels,and the mini nutritional assessment(MNA)was used to evaluate nutritional status.According to the MMSE scores,the elderly were divided into three groups:no cognitive impairment(MMSE≥27),mild cognitive impairment(MMSE 21-26),and moderate to severe cognitive impairment(MMSE≤20).The general data,lifestyle habits,and scale scores of the three groups were compared.Ordered logistic regression was used to analyze the influencing factors of sleep quality.Results There were statistically significant differences in age,gender,waist circumference,body mass index(BMI),education level,pet ownership,smoking,drinking,mahjong playing behavior,exercise habits,and scale scores among the three groups(P＜0.05).Logistic regression analysis showed that age,waist circumference,gender,drinking habits,mahjong playing behavior,and chronic comorbidities are influencing factors for the PSQI grading in the elderly(P＜0.05).The MMSE score(OR=1.037,P=0.001),SCD score(OR=1.123,P＜0.001),HAMA score(OR=1.183,P＜0.001),PHQ-9 score(OR=1.249,P＜0.001)are positive influencing factors for PSQI grading,while the MNA score is a negative influencing factor(OR=0.960,P=0.037).Conclusions Advanced age,female gender,low education level,no pet ownership,no mahjong playing behavior,no exercise habits,and poor sleep quality are risk factors for cognitive impairment in the elderly.Advanced age,female gender,no mahjong playing behavior and poor nutritional status are influencing factors for poor sleep quality in the elderly,and severe comorbidities,anxiety,depression,and subjective decline in cognitive function all affect sleep quality.关键词
老年人/睡眠质量/认知功能/匹兹堡睡眠质量指数量表/流行状况Key words
elderly/sleep quality/cognitive function/Pittsburgh sleep quality index/epidemiology分类
临床医学引用本文复制引用
张颜莉,王萌,王雪纯,黄姗姗,任姣錡,周厚广..上海社区老年人认知功能和睡眠质量现状及影响因素分析[J].中国临床医学,2025,32(1):58-64,7.基金项目
国家重点研发计划"政府间国际科技创新合作"重点专项(2021YFE0111800),上海市临床重点学科建设"腾飞计划-强主体"项目(shslczdzk02802).Supported by the National Key R&D Plan"Intergovernmental International Science and Technology Innovation Cooperation"Key Special Project(2021YFE0111800),and Shanghai Municipal Key Clinical Specialty Project(shslczdzk02802). （2021YFE0111800）
