摘要
[目的]探究睡眠质量和主观认知下降在血瘀质与老年人生命质量间的链式中介作用,为延缓老年人主观认知下降,提高生命质量提供参考。[方法]于2024年1至11月,采用方便抽样法,在北京、山东、湖南、四川、重庆等地对60岁及以上老年人进行现场问卷调查。采用中医体质量表-41条目简短版(CCMQ-41)评价血瘀质偏颇程度、简明健康状况调查问卷(SF-36 v2)评价生命质量、中文版主观认知下降问卷9(SCD-Q9)评价主观认知下降、匹兹堡睡眠质量指数量表(PSQI)评价睡眠质量,运用Pearson相关分析法探究变量间的相关性,使用SPSS 26.0软件的Process3.5插件模型6进行链式中介效应分析。[结果]1)703例老年人样本纳入分析,血瘀质得分为(23.71±15.11)分,睡眠质量(6.20±3.85)分,主观认知下降(4.70±2.43)分,生命质量(80.12±14.52)分。2)相关分析显示,血瘀质得分与睡眠质量(r=0.267,P<0.05),主观认知下降(r=0.458,P<0.05)正向相关,与生命质量负向相关(r=-0.435,P<0.05);睡眠质量得分与主观认知下降正向相关(r=0.281,P<0.05),与生命质量负向相关(r=-0.336,P<0.05);主观认知下降与生命质量负向相关(r=-0.394,P<0.05)。3)中介效应结果表明,血瘀质对老年人生命质量的直接效应显著(效应值为-0.286,95%CI=-0.358~-0.214),占总效应的65.75%(-0.286/-0.435);睡眠质量对老年人生命质量的单独中介效应显著(效应值为-0.054,95%CI=-0.081~-0.031),占总效应的12.41%(-0.054/-0.435);主观认知下降对老年人生命质量的单独中介效应显著(效应值为-0.085,95%CI=-0.117~-0.055),占总效应的19.54%(-0.085/-0.435);睡眠质量和主观认知下降的链式中介效应显著(效应值为-0.010,95%CI=-0.016~-0.005),占总效应的2.30%(-0.010/-0.435)。[结论]血瘀质不仅直接负向影响老年人的生命质量,而且通过睡眠质量和主观认知下降的独立中介和链式中介作用间接影响老年人的生命质量。提示老年人在日常生活中可通过血瘀质调理、睡眠改善及主观认知下降的早期识别与干预,以提升老年人的生命质量。
[Objective]To explore the chain mediating effect of sleep quality and subjective cognitive decline between blood stasis and quality of life in the elderly,so as to provide reference for delaying subjective cognitive decline and improving quality of life in the elderly.[Methods]From January to November 2024,a convenience sampling method was adopted to conduct a questionnaire survey among the elderly aged 60 and above in Beijing,Shandong,Hunan,Sichuan,Chongqing and other places.A total of 703 samples were included for analysis.The degree of blood stasis constitution bias was evaluated using of the 41⁃item Constitution in Chinese Medicine Questionnaire(CCMQ⁃41),the quality of life was assessed by the Short Form 36 Health Survey(SF⁃36 v2),subjective cognitive decline was evaluated by the Chinese version of the Subjective Cognitive Decline Questionnaire 9(SCD⁃Q9),and sleep quality was evaluated by the Pittsburgh Sleep Quality Index(PSQI).Pearson correlation analysis was used to explore the correlations among the variables,and the Process 3.5 plugin model 6 of SPSS 26.0 was used for chain mediation effect analysis.[Results]1)The scores of blood stasis constitution,sleep quality,subjective cognitive decline and quality of life of 703 elderly people were(23.71±15.11)points,(6.20±3.85)points,(4.70±2.43)points and(80.12±14.52)points,respectively.2)Correlation analysis showed that blood stasis constitution was positively correlated with sleep quality score(r=0.267,P<0.05)and subjective cognitive decline(r=0.458,P<0.05),and negatively correlated with quality of life(r=-0.435,P<0.05);sleep quality score was positively correlated with subjective cognitive decline(r=0.281,P<0.05),and negatively correlated with quality of life(r=-0.336,P<0.05);subjective cognitive decline was negatively correlated with quality of life(r=-0.394,P<0.05).3)The results of the mediation effect showed that the direct effect of blood stasis constitution on the quality of life of the elderly was significant(effect value-0.286,95%CI=-0.358 to-0.214),accounting for 65.75%of the total effect(-0.286/-0.435);the independent mediating effect of sleep quality was significant(effect value-0.054,95%CI=-0.081 to-0.031),accounting for 12.41%of the total effect(-0.054/-0.435);the independent mediating effect of subjective cognitive decline was significant(effect value-0.085,95%CI=-0.117 to-0.055),accounting for 19.54%of the total effect(-0.085/-0.435);the chain mediating effect of sleep quality and subjective cognitive decline was significant(effect value-0.010,95%CI=-0.016 to-0.005),accounting for 2.30%of the total effect(-0.010/-0.435).[Conclusion]Blood stasis can not only directly negatively affect the quality of life of the elderly,but also indirectly affect the quality of life of the elderly through the independent mediating and chain mediating effects of sleep quality and subjective cognitive decline.Prompting the elderly to regulate blood stasis constitution,improve sleep,and engage in early identification and intervention of subjective cognitive decline in daily life can enhance their quality of life.
作者
贾佳萌
朱燕波
JIA Jiameng;ZHU Yanbo(School of Management,Beijing University of Chinese Medicine,Beijing 102488,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 102488,China)
出处
《天津中医药》
2026年第3期284-291,共8页
Tianjin Journal of Traditional Chinese Medicine
基金
北京市自然科学基金项目(7222282)
北京中医药大学基本科研业务费揭榜挂帅项目(2022-JYB-JBZR-036)。
关键词
血瘀质
生命质量
主观认知下降
睡眠质量
链式中介效应
blood stasis
quality of life
subjective cognitive decline
sleep quality
chain mediation effect
