A Ten-Year Comparative Study On Sleep Quality And Life Quality Of People Aged 60 And Over In Shandong Province

Objective:Since 1984,Shandong Province has conducted a provincial epidemiological survey of mental disorders every 10 years.The methods,procedures,and diagnostic criteria for the two epidemiological surveys of mental disorders in 2004 and 2015 were the same.This study analyzed the trends,characteristics,and distribution of sleep quality and quality of life among people aged 60 and over in Shandong Province during the two surveys,to explore the current situation and trends of sleep quality and quality of life among the elderly population in Shandong Province over the past decade.Provide scientific decision-making basis for the government to formulate relevant mental health policies,improve the sleep quality and quality of life of the elderly population in Shandong Province,and provide technical support for further improving the research program on sleep quality and quality of life of the elderly population in the fifth epidemiological survey of mental disorders in Shandong Province.Fully exploring the value of continuous epidemiological survey big data in Shandong Province is of great significance for further dynamic observation of the changes in the mental health level of the elderly population in Shandong Province during the rapid aging stage of China’s social population.Methods:This study consists of two parts.In 2004,a multistage stratified cluster sampling method was used to randomly select 23984 people from 20 neighborhood committees and 60 administrative villages in 5 districts,15 counties,10 streets,and 30 townships in 5 prefecture-level cities in Shandong Province.According to age>60,those with dementia,severe deafness,and incomplete information were excluded,and 4451 elderly people aged 60 and above were eventually included.In 2015,Shandong Province conducted a multistage stratified cluster sampling of 34 streets and 62 townships in 49 counties(cities,districts)in 16 cities across the province.A total of 102 village(neighborhood)committees were sampled,and 28534 people were randomly selected,based on age ≥60 years old.Those with dementia,severe deafness,and incomplete information were excluded,and 10894 elderly people aged 60 and above were eventually included.The above population was investigated with a general situation questionnaire,the Pittsburgh Sleep Quality Index Scale,and the Simple Quality of Life Scale.Results:1.The adjusted incidence of poor sleep was 22.5%(95%CI:21.7%～23.3%)lower in 2015 than in 2004,24.8%(95%CI:23.5%～26.0%,P<0.01);the actual mean sleep time was longer in 2015(7.39±1.88h)than in 2004,the actual mean sleep time(7.22±1.77h,P<0.001);the total PSQI score in 2015 was 4.74±3.96 lower than that of 2004 4.97±4.18(P=0.002),and among the factors,the 201 5 sleep latency factor,sleep duration factor,and sleep efficiency factor scores were lower than those in 2004(P<0.05),and the scores of subjective sleep quality factor,sleep disorder factor,and daytime dysfunction factor were higher in 2015 than those in 2004(P<0.05,P<0.01);binary logistic stepwise regression analysis in 2015 showed that women,rural areas,people living alone,higher age,lower years of study,jobless unemployed,the higher the likelihood of poor sleep in the elderly population(P<0.05,P<0.01).The Nomogram prediction model in 2015 showed the prevalence of poor sleep in the elderly population with different characteristics(C-index=0.636).2.7855(72.1%)with high QLQ scores and 3039(27.9%)with low QLQ scores in 2015,compared with 2683(60.3%)with high QLQ scores and 1768(39.7%)with low QLQ scores in 2004;all 6 entries and total score scores in QLQ were higher in 2015 than in 2004(P<0.001),and the same characteristics population with higher QLQ total score scores in 2015 than in 2004(P<0.001);binary logistic stepwise regression analysis in 2015 showed that the quality of life was higher in urban areas,lower age.higher years of education,medical source of commercial insurance,married/remarried,working people,and retired/sick retired people in Shandong Province ≥60 years old and above.3.The total quality of life score and all dimensions were higher in older adults with good sleep than in those with poor sleep(P<0.001).Sleep quality was negatively correlated with quality-of-life scores(r=-0.476,P<0.001),where the entry with the highest degree of correlation with the quality of life was subjective sleep quality(r=0.447,P<0.001).In the gender-adjusted model,women reduced the effect of sleep quality on quality of life(β=-0.2095,P<0.001).In addition,the moderating effect of gender was also significant in the older group who slept well(β=-0.2916,P=0.004).but this moderating effect was not significant in the group who slept poorly(β=-0.3538,P=0.058).Conclusion:1.The prevalence of poor sleep among the elderly in Shandong Province is lower than the domestic and international average.In 201 5.the sleep quality of people aged 60 and above in Shandong Province improved significantly compared to 2004,but the prevalence of poor sleep among high-risk groups such as women and rural areas is still high.In addition,the elderly population in 2015 suffered more nighttime sleep disorders and daytime dysfunction than in 2004.2.The quality of life of the elderly population in Shandong Province is generally good,and the quality of life in 2015 has also significantly improved compared to 2004.Over the past 10 years,the relevant factors affecting the quality of life of people aged 60 and above in Shandong Province have also changed,and attention should be focused on multiple factors such as region,age,education,marriage,medical source,and occupation.3.In 2015,among the elderly population,the better the quality of sleep,the higher the quality of life,this relationship is more significant among the male elderly population.When implementing relevant public health policies,programs to improve sleep quality can be adopted to improve the quality of life of elderly people.