The influencing factors of sleep time and its relationship with cognition and depression in middle-aged and elderly people
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摘要:
目的 了解中国中老年人睡眠时间的现况及影响因素，探讨其与认知、抑郁的关系。 方法 数据来自于2015年中国健康与养老追踪调查（China health and retirement longitudinal survey，CHARLS），筛选出符合纳入排除标准的研究对象17 175人，使用χ2检验对抑郁检出率进行比较，使用协方差分析调整年龄探究认知与睡眠时间的关系，使用多元线性逐步回归探究睡眠时间的影响因素。 结果 中老年人短时间睡眠抑郁检出率较高（χ2=461.352，P < 0.001），且正常睡眠时间组的认知水平最高，长时间睡眠组的认知水平最低；多元线性逐步回归显示，睡眠与抑郁相互影响，性别、年龄、居住地、饮酒、健康自评、抑郁是睡眠时间的影响因素（均有P < 0.05）。 结论 中老年人睡眠时间与认知能力、抑郁密切相关，应采取综合性干预措施改善中老年人睡眠质量，从而减缓认知老化速度，减少抑郁发生。 Abstract:Objective To explore the associations of sleep time with cognition and depression in Chinese middle-aged and elderly people. Methods 17 175 subjects were selected according to the inclusion criteria and exclusion criteria from 2015 China health and retirement longitudinal study (Charls). Chi-square test was used to compare the detection rate of depression in different sleep time groups. The relationship between cognition and sleep time was adjusted by covariance analysis. Multiple linear stepwise regression was used to analyze the influencing factors of sleep time. Results The depression were more likely to be detected in short sleep time group (χ2= 461.352, P < 0.001). In view of cognitive level, the normal sleep time group performed the best while the long sleep group performed the worst. The multiple linear stepwise regression showed that gender, age, residence, alcohol drinking, health self-evaluation and depression were influencing factors of the sleep time, and there was interaction between sleep and depression (all P < 0.05). Conclusion The sleep time of middle-aged and elderly people is closely associated with cognitive ability and depression. So comprehensive intervention measures should be taken to improve the sleep quality of these people, which can slow down their cognitive aging and reduce the risk of depression. -
Key words:
- Sleep time /
- Depression /
- Cognition
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表 1 中老年人抑郁的影响因素
Table 1. Influencing factors of depression in middle-aged and old people
变量 人数 抑郁数(n) 抑郁检出率(%) χ2值 P值 性别 364.339 < 0.001 男 8 287 1 932 23.3 女 8 888 3 262 36.7 年龄(岁) 61.319 < 0.001 45~ 7 317 1 983 27.1 60~ 7 546 2 437 32.3 75~ 2 225 748 33.6 >90 87 26 29.9 居住地 222.450 < 0.001 城市 2 765 551 19.9 乡镇 2 668 699 26.2 农村 11 742 3 944 33.6 婚姻状况 178.876 < 0.001 已婚 15 180 4 333 28.5 未婚 98 45 45.9 离异 203 87 42.9 丧偶 1 694 729 43.0 文化程度 312.996 < 0.001 小学及以下 11 126 3 839 34.5 初中 3 826 961 25.1 高中 1 776 333 18.8 大学及以上 447 61 13.6 合计 17 175 5 194 30.2 
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表 2 中老年人不同睡眠时间认知水平比较(x ±s)
Table 2. Comparison of cognitive level of middle-aged and old people in different sleep time (x ±s)
变量 睡眠时间(h) F值 P值 短时间睡眠(n=8 708) 正常时间睡眠(n=6 836) 长时间睡眠(n=1 631) 常识题得分 4.04±1.33 4.21±1.21 3.72±1.49 69.833 < 0.001 记忆力得分 3.92±1.77 4.15±1.79 3.56±1.82 39.997 < 0.001 计算题得分 2.85±1.97 3.05±1.93 2.39±1.96 53.239 < 0.001 画图题得分 0.65±0.48 0.71±0.46 0.55±0.50 48.821 < 0.001 认知测试总分 11.47±4.10 12.13±3.94 10.21±4.31 100.803 < 0.001
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表 3 中老年人睡眠时间影响因素分析赋值表
Table 3. Analysis and assignment of influential factors of sleep time of middle-aged and elderly people
变量 赋值 性别 男=1，女=2 文化程度 小学及以下=1，初中=2，高中=3，大学及以上=4 婚姻状况 已婚=1，未婚=2，离异=3，丧偶=4 居住地 城市=1，乡镇=2，农村=3 吸烟 吸烟=1，戒烟=2，从未吸烟=3 饮酒 饮酒=1，从未饮酒或每月饮酒少于一次=0 健康自评 很好=1，好=2，一般=3，不好=4，很不好=5 慢性病 有=1，无=0
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表 4 中老年人睡眠时间影响因素分析
Table 4. Analysis of influencing factors of sleep time of middle-aged and old people
变量 偏回归系数 标准误 标准化回归系数 t值 P值 性别 -0.207 0.043 -0.055 -4.855 < 0.001 年龄(岁) -0.011 0.002 -0.061 -7.194 < 0.001 居住地 城市 -0.253 0.042 -0.050 -6.071 < 0.001 乡镇 -0.151 0.039 -0.029 -3.820 < 0.001 饮酒情况 -0.112 0.035 -0.027 -3.204 0.001 健康自评 -0.131 0.014 -0.076 -9.641 < 0.001 抑郁评分 -0.071 0.002 -0.233 -28.780 < 0.001
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