| Background:The aging of population is a huge challenge that cannot be ignored for any country in the world,and the cardinal number of China’s population is huge,population aging situation is very severe.People’s body functions decline,and a variety of health problems follow with age,which brings not only physical pain but also heavy economic burden to patients,which seriously affects older adults’living quality.Frailty,as one of the most common health problems in the aged,may lead to a series of adverse clinical outcomes,and has become the leading cause of death among them.Furthermore,frailty is dynamic and its process is reversible,so prevention and timely intervention of the risk factors of frailty is essential to promote the health of old people.Objectives:To understand the status quo and explore the contributing factors of frailty of the community-dwelling older adults in northeastern Chinese urban areas.In addition,to analyze the mediating effect of sleep quality in affecting the frailty of the elderly in the community.And it is expected to offer important clues for further exploring the causes of frailty and provide epidemiological evidence for preventing and formulating proper intervention measures for frailty.Methods:Using community interception sampling method,1866 older people(≥65 years old)in Changchun community were selected as the research objects from July to September 2022.The questionnaire survey method was used to collect data,and centralized investigation was conducted at the survey site provided by the community health service centers.After verifying the age,the informed consent was filled in,and all the respondents were interviewed face-to-face by investigators to complete the questionnaire,which included demographic characteristics and health-related information.Among them,frailty,sleep quality and depression were assessed by FRAIL scale,Pittsburgh Sleep Quality Index(PSQI)and Patient Health Questionnaire-9(PHQ-9),respectively.Besides,Mann-Whitney U test or Kruskal-Wallis H test was adopted for comparing the distribution characteristics and single factor analysis of the status of frailty among the elderly in the community.And multivariate analysis was performed by ordinal logit regression to assess the factors related to frailty of the elderly in the community.Spearman correlation test was used to explore the relevance among depression,sleep quality and frailty.Moreover,process was used to conduct intermediary analysis to understand the extent to which sleep quality can explain the relationship between depression and frailty.Results:1.Among 1866 older adults living in community,77(4.1%)were frail,578(31.0%)were pre-frail.2.Significant differences of frailty were found among different age groups(χ~2=9.480,P=0.024),gender(Z=-2.723,P=0.006),cultural degree(χ~2=14.098,P=0.003),self-rated health(χ~2=266.489,P<0.001),chronic pain(Z=-17.724,P<0.001),number of chronic diseases(χ~2=218.491,P<0.001),exercise habits(Z=-4.864,P<0.001),intake of fruits(χ~2=15.956,P=0.003)and vegetables(χ~2=33.476,P<0.001),sleep quality(Z=-14.071,P<0.001)and status of depression(Z=-16.710,P<0.001).However,the differences of frailty status of the elderly in the community with different nationalities(Z=-1.038,P=0.299),marital status(Z=-1.298,P=0.194),economic levels(χ~2=4.017,P=0.134),living style(Z=-0.580,P=0.562),smoking status(Z=-0.697,P=0.486)and drinking status(Z=-0.237,P=0.812)were not statistically significant.3.The results of ordinal logit regression analysis showed that age(70-74 years old:P<0.001;65-69 years old:P=0.021),self-rated health(general:P=0.006;poor:P<0.001),exercise habits(P<0.001),number of chronic diseases(P<0.001),chronic pain(P<0.001),sleep quality(P=0.001)and status of depression(P<0.001)were contributors to frailty of the community-dwelling elderly.4.The results of intermediary analysis showed that depression partially moderated the relationship between sleep quality and frailty of the older adults in the community and the value of intermediary effect was 0.0336,constituting 61.20%of the total effect.And sleep quality partially moderated the relationship between depression and frailty of the older adults in the community and the value of intermediary effect was 0.0104,constituting 12.48%of the total effect.Conclusion:The detection rate of frailty and pre-frailty of the aged in the community is high,which needs to be paid attention to.Advanced age,lower self-rated health,lack of exercise,depression,poor sleep quality,chronic pain and comorbidities may be associated with the occurrence of frailty of aged people in the community.Additionally,depression has a mediating effect between sleep quality and frailty,meanwhile,sleep quality has a mediating effect between depression and frailty.Attention should be paid to the frailty problem of the aged in the community,and prevention and intervention measures can be targeted to prevent or defer the occurrence of frailty among the elderly living in the community. |
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