中国健康心理学杂志

目的：本研究旨在全面了解老年帕金森病（Parkinson's disease,PD）患者睡眠障碍（Sleep Disorder,SD）的现状，并探讨其对认知功能、心理状态和衰弱与老年PD患者SD之间的关系。方法：选取2023年12月至2024年12月某医院神经内科确诊的老年PD患者190例，将研究对象划分为睡眠障碍组（SD组，n=126）与非睡眠障碍组（NSD组，n=64），分别应用简易精神状态检查量表（MMSE）、汉密尔顿抑郁量表（HAMD）及汉密尔顿焦虑量表（HAMA）和Fried衰弱表型法对患者的焦虑、抑郁以及衰弱情况进行评估。结果：本研究结果显示，老年PD患者中SD的发生率为66.32%。单因素分析结果显示，SD与收入来源、病程、MMSE评分、HAMA评分、HAMD评分、衰弱状况等影响相关，差异具有统计学意义。相关分析结果显示PDSS总分与MMSE总分呈正相关（r=0.647,P<0.05），表明睡眠障碍越严重（PDSS总分越低），认知功能越差（MMSE总分越低）。PDSS总分与HAMA评分、HAMD评分呈负相关（r=-0.581,-0.572;P<0.05），表明睡眠障碍越严重，焦虑和抑郁症状越严重。PDSS总分与病程、衰弱评分呈负相关（r=-0.149,-0.209;P<0.05）），表明病程越长、衰弱评分越高，睡眠障碍越严重。二元logistic回归分析结果显示：MMSE评分、病程、衰弱状态是老年PD患者SD的独立危险因素（P<0.05）。通过ROC曲线评价二元logistic回归模型，发现模型的拟合优度很好，并且模型的AUC为0.986(P<0.05)。结论：老年PD患者的睡眠障碍不仅普遍存在，而且与认知功能、心理状态和衰弱状态密切相关。临床应重视对PD患者睡眠障碍的早期筛查和干预，以改善其认知功能、心理状态和整体健康状况。

Objective:To comprehensively investigate the current status of sleep disorders(SD)in elderly patients with Parkinson's disease(PD);Furthermore,it seeks to explore the associations of SD with cognitive dysfunction,psychological disturbances,and frailty in this population.Methods:A total of 190 elderly Parkinson's disease(PD)patients diagnosed in the Department of Neurology,Zhengzhou Central Hospital Affiliated to Zhengzhou University from December 2022 to December 2024 were enrolled in this study.Participants were divided into two groups based on sleep disorder(SD)diagnosis:The sleep disorder group(SD group,n=126)and non-sleep disorder group(NSD group,n=64).Cognitive function was evaluated using the Mini-Mental State Examination(MMSE),while psychological status was assessed through the Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA).Frailty was measured according to Fried frailty phenotype criteria,which includes five core indicators:unintentional weight loss,self-reported exhaustion,low physical activity,slow gait speed,and weak grip strength.Results:The results indicated a 66.32% prevalence of sleep disorders(SD)among elderly Parkinson's disease(PD)patients.Univariate analysis showed that SD was related to income sources,disease duration,MMSE score,HAMA score,HAMD score,and frailty status,and the differences were statistically significant.Correlation analysis showed that the total score of PDSS was positively correlated with the total score of MMSE(r=0.647,P<0.05),indicating that the more severe the sleep disorder(the lower the total score of PDSS),the worse the cognitive function(the lower the total score of MMSE).The total score of PDSS was negatively correlated with HAMA score and HAMD score(r=-0.581;r=-0.572,P<0.05),indicating that the more severe the sleep disorder,the more severe the anxiety and depression symptoms.PDSS total score demonstrated significant negative correlations with both HAMA and HAMD scores(r=-0.149;r=-0.209,P<0.05),indicating a dose-response relationship between sleep disorder severity and anxiety/depression symptom intensity.The results of binary logistic regression analysis showed that MMSE score,disease duration,and frailty status were independent risk factors for SD in elderly PD patients(P<0.05).The binary logistic regression model was evaluated by ROC curve,and it was found that the model had a good fit and the AUC of the model was 0.986(P<0.05).Conclusion:SD is not only highly prevalent among elderly PD patients but also exhibit significants correlations with cognitive dysfunction,psychological disturbances,and frailty status.Clinicians should prioritize early screening and multimodal interventionsto mitigate SD-related complications,thereby improving cognitive performance,mental well-being,and overall health outcomes in this vulnerable population.