Study On The Correlation Between Sleep And Fall Among The Elderly In Tai’an City

Background:With the rapid development of China’s economy and the improvement of people’s living standards,the average life expectancy continues to increase,China has entered an aging society.Human aging inevitably brings many negative effects,such as the decline of various functions of the body,including the decrease of bone mineral density and the weakening of reaction ability,making the elderly more vulnerable to falls.The fall of the elderly will be accompanied by serious consequences,including affecting physical and mental health,causing life restriction,increasing family and social burden,and even death.Short sleep duration and taking hypnotic medicines will affect the daily function of the body,thus becoming a risk factor for falls.Compared with young people,the elderly have more common sleep problems.Therefore,it is of great significance to focus on the elderly who are prone to sleep problems and explore the relationship between sleep and falls.Objectives:To understand the sleep status among the elderly in Tai’an City,and analyze the risk factors of sleep.To understand the current situation of falls among the elderly in Tai’an City and analyze the risk factors of falls.To explore the relationship between sleep quality and falls.Propose corresponding policy recommendations to reduce the incidence of falls in the elderly and provide intervention strategies for the elderly at high risk of falls.Methods:The data used in this study comes from the general project of National Natural Science Foundation of China "Optimizing Design and Strategy of Family Doctor Contract Service from the Perspective of Behavioral Economics:An Empirical Study on Urban-Rural Supply and Demand"(71974118).The survey adopted the multi-stage random cluster sampling method.Firstly,in six districts(counties)of Tai’an City,Shandong Province,three or four streets(towns)were randomly selected from each district(county)by using the Probability Proportionate to Population Size Sampling method.Secondly,8 villages or communities were randomly selected from each town or street.Finally,50 households were randomly selected from each sample village(community).The respondents were over 15 years old,and the elderly over 60 years old were selected in this study.The self-designed question,Mini-Mental State Examination(MMSE)and Pittsburgh Sleep Quality Index(PSQI)were used to collect data.EpiData software was used for database establishment and data entry.SPSS 24.0 was used for preliminary data analysis and Stata 14.0 was used to draw restricted cube lines.Then,multiple linear regression and multiple logistic regression were used to analyze the risk factors of sleep and fall.First,Student’s t-tests,ANO VA and chi-square tests were selected to complete the univariate analysis.Then,multiple linear regression and multiple logistic regression were used to analyze the risk factors of sleep and fall.Multiple logistic regression was used to explore the relationship between sleep and falls.The dose-response relationship between sleep quality and falls was demonstrated by using restrictive cubic splines.Results:The study included 3864 participants over the age of 60.The average PSQI score of the elderly was(5.66 ± 4.49).Univariate analysis showed that age,gender,marital status,educational level,self-rated economic status,smoking status,drinking status,habit of eating more fruits and vegetables,exercise status,habit of drinking tea,whether suffering from hypertension,diabetes,hearing,vision,cognitive status and loneliness were significant factors associated with sleep(P<0.05).The significant variables in univariate analysis were included in multivariate analysis.Multivariate analysis showed that the elderly with female,no spouse,poor self-rated economic status,no habit of eating more fruits and vegetables,no habit of drinking tea,poor self-rated health status,hypertension,poor eyesight,poor cognitive status and loneliness had higher PSQI scores and were more likely to have sleep problems(P<0.05).The prevalence of falls among the elderly in Shandong Province was 6.26%.Univariate analysis showed that the factors related to falls were age,marital status,educational level,self-rated economic status,habit of eating more fruits and vegetables,self-rated health status,whether suffering from hypertension,diabetes,hearing,vision,cognitive status and loneliness(P<0.05).The significant variables in univariate analysis were included in multivariate analysis.Multivariate analysis showed that the elderly were older(P<0.05),had poor self-rated economic status(P=0.016),had poor self-rated health status(P=0.001),and felt lonely(P=0.001)were more likely to fall.The correlation between sleep quality and fall was statistically significant(P=0.001),and the correlation between sleep disorder and fall was statistically significant(P=0.021).The tolerance values of collinear diagnosis were less than 1,greater than 0.1;the VIF values were less than 10,which indicates that there was no collinear in the model,and the model was good of stability.The dose-response relationship between PSQI score and fall showed that with the increase of PSQI score,the odds ratio of fall increased and the risk of fall increased(P<0.05).There was a nonlinear correlation between sleep quality and falls(P<0.05).Conclusions:There was a significant association between sleep and falls.Moreover,loneliness plays a mediating role in the relationship between sleep and falls.In order to reduce the prevalence of falls in the elderly and protect their health,following measures should be taken:(1)Improve the sleep quality of the elderly and regular health education on sleep topics should be carried out for the elderly to improve their awareness of the health hazards caused by sleep problems;(2)Prevent the occurrence of falls in the elderly,strengthen the elderly’s awareness of falls prevention,and focus on the prevention of high-risk elderly people(3)Improve the health service system and increase the investment in health services for the elderly.