老年医学与保健2026，Vol.32Issue(4)：499-504,6.DOI:10.3969/j.issn.1008-8296.2026.04.005
老年失眠与抑郁、焦虑共病诊疗专家共识
Expert consensus on the diagnosis and treatment of comorbid insomnia,depression,and anxiety in older adults
摘要
Abstract
Insomnia,depression,and anxiety commonly coexist and interact in older adults,influenced by cognitive decline,physical illness,polypharmacy,and psychosocial factors.Treating a single symptom may lead to missed diagnoses,poor outcomes,and medication-related harms.Their coexistence is also associated with increased dementia risk,and sleep or mood changes may signal early neurodegeneration.This consensus addresses adults aged≥60 years and recommends a clinical pathway of three-dimensional assessment of sleep,mood,and cognition;comorbidity diagnosis;coordinated treatment;and dynamic follow-up.Key priorities are identifying onset patterns,shared causes,treatment targets,and risks associated with combined therapy,particularly sedation,falls,and cognitive impairment.Traditional Chinese medicine may be used adjunctively after standardized diagnostic and safety assessments.Patients meeting criteria for pre-dementia psychological and behavioral disorders should undergo etiological evaluation for cognitive impairment.This consensus complements,but does not replace,disease-specific guidelines.关键词
老年人/失眠障碍/抑郁障碍/焦虑障碍/共病/综合评估与干预Key words
older adults/insomnia disorder/depressive disorder/anxiety disorder/comorbidity/comprehensive assessment and intervention引用本文复制引用
上海市医师协会老年医学科医师分会,国家重点研发计划主动健康和人口老龄化科技应对重点专项专家组,李霞,保志军..老年失眠与抑郁、焦虑共病诊疗专家共识[J].老年医学与保健,2026,32(4):499-504,6.基金项目
国家重点研发计划(2023YFC3603200) （2023YFC3603200）
