睡眠与认知功能的关系:心理弹性和抑郁倾向的中介作用

Relationship between sleep and cognitive function:The mediatin grole of psychological resilience and depressive tendency

目的:探究中老年人的睡眠对认知功能的影响及心理弹性和抑郁倾向在中老年人睡眠与认知功能之间的中介效应。方法:运用匹兹堡睡眠质量指数(PSQI)、心理弹性量表(CD-RISC)、简版抑郁量表(GDS-15)、蒙特利尔认知评估量表(MoCA)对624位来自福州社区的中老年人进行面访调查,采用相关性分析、PROCESS宏程序进行中介效应检验。结果:中老年人的睡眠质量指数得分为5.38±2.975分,心理弹性得分为66.07±18.235分,抑郁倾向得分为2.68±2.003分,认知功能得分为20.96±4.497分。睡眠质量指数与抑郁倾向呈正相关(r=0.268,P<0.01),与心理弹性和认知功能呈负相关(r=-0.182,-0.175;P<0.01);心理弹性与抑郁倾向呈负相关(r=-0.245,P<0.01),与认知功能呈正相关(r=0.253,P<0.01);抑郁倾向与认知功能呈负相关(r=-0.192,P<0.01)。中老年人的睡眠可直接影响认知功能(β=-0.152,P<0.01),也可以通过心理弹性(β=-0.049,CI=-0.081~-0.026)和抑郁倾向(β=-0.035,CI=-0.012~-0.002)的单中介及心理弹性与抑郁倾向的链式中介(β=-0.005,CI=-0.070~-0.012)介导中老年人的认知功能。结论:睡眠质量好的中老年人有较高的心理弹性水平,可减少抑郁倾向的发生,从而对认知功能起到保护作用。

Objective:To explore the impact of sleep in middle-aged and elderly people on cognitive function and the mediating role of psychological resilience and depressive tendency between them.Methods:A total of 624middle-aged and elderly people from the Fuzhou community interview survey were tested with Pittsburgh Sleep Quality Index(PSQI),Connor-Davidson resilience scale(CD-RISC),Geriatric Depression Scale(GDS)and Montreal Cognitive Assessment(MoCA).Correlation analysis and PROCESS macro program were used to test the mediation effect.Results:The scores of middle-aged and elderly people sleep quality index,psychological resilience,depressive tendency and cognitive function were 5.38±2.975,66.07±18.235,2.68±2.003,and 20.96±4.497respectively.Sleep quality index was positively correlated with depressive tendency(r=0.268,P<0.01),and negatively correlated with psychological resilience and cognitive function(r=-0.182,-0.175;P<0.01).Psychological resilience was negatively correlated with depressive tendency(r=-0.245,P<0.01),and positively correlated with cognitive function(r=0.253,P<0.01).Depressive tendency was negatively correlated with cognitive function(r=-0.192,P<0.01).The sleep of middle-aged and elderly people could directly affect cognitive function(β=-0.152,P<0.01),and indirectly through psychological resilience(β=-0.049,CI=-0.081~-0.026)and depressive tendency(β=-0.035,CI=-0.012~-0.002)and the chain mediation of psychological resilience and depressive tendency(β=-0.005,CI=-0.070~-0.012).Conclusion:Middle-aged and elderly people with good sleep quality have a higher level of psychological resilience and reduce the incidence of depression,which finally protects the cognitive function.