【摘要】 目的探讨养老机构老年人日常生活活动能力变化的异质性轨迹,并分析睡眠质量对日常生活活动能力轨迹的预测作用,为制定提高日常生活活动能力的干预措施提供参考。方法采用简易精神状态评价量表(MMSE)、Barthel指数评定表、阿森斯失眠量表对济南市5个区26家养老机构的296名老年人进行基线调查,追踪调查老年人1年内日常生活活动能力的变化,每6个月调查1次,共调查3次。结果 3次分别有296、244、203人完成调查。日常生活活动能力得分依次为78.62±25.90、74.31±27.78及74.11±27.81;对完成2次调查的250人拟合出日常生活活动能力高维持、中下降、低维持3条轨迹;Logistic回归分析示,睡眠质量、简易精神状态评价量表评分、年龄是日常生活活动能力轨迹的预测因素(P<0.05,P<0.01)。结论睡眠质量可以预测养老机构老年人的日常生活活动能力轨迹,老年人睡眠质量越差,日常生活活动能力轨迹越偏向于"低维持"。应为养老机构老年人制定可行的干预措施以改善其睡眠质量,从而提高其日常生活活动能力。更多还原

【Abstract】 Objective To explore the change patterns of activities of daily living(ADL) function over time among institutionalized elderly persons, to analyze the predictive effect of sleep quality on ADL trajectory, and to provide reference for taking intervention measures to improve their ADL function. Methods Residents who had stayed in 26 elder-care institutions in 5 administrative regions of Jinan were surveyed using the Mini-Mental State Examination, Barthel Index and Athens Insomnia Scale at baseline assessment, then they were followed up every 6 months for twice in terms of their ADL function change.Results A total of 296, 244 and 203 participants completed the baseline assessment, 6-month and 12-month follow-up assessments respectively. Their ADL function scored 78.62±25.90 at baseline and 74.31±27.78,74.11±27.81 at follow-up assessments. Three different ADL function trajectories were identified among 250 subjects who completed at least two assessments:high-level maintenance, medium decline and low-level maintenance. Logistic regression analysis showed that sleep quality, MMSE score and age could predict ADL function trajectories(P<0.05,P<0.01).Conclusion Sleep quality can predict ADL function changes in institutionalized elderly persons, demonstrating the poorer sleep quality, the higher likelihood of being in low-level maintenance class. Measures should be taken to improve sleep quality of the institutionalized residents, thus to enhance their ADL function.更多还原