【摘要】 目的 探讨睡眠质量在老年共病患者肌少症和衰弱间的中介效应。方法 采用一般资料调查表、Fried衰弱表型、肌少症筛查问卷、匹兹堡睡眠质量指数对2024年10月至2025年4月广西医科大学第一附属医院心血管内科收治的260例老年共病患者进行调查。采用SPSS 26.0进行描述性分析和Spearman相关分析，使用Process宏程序进行中介效应检验并采用Bootstrap法检验中介效应的显著性。结果 共发放问卷260份，回收有效问卷253份，有效回收率为97.3%。老年共病患者衰弱发生率较高（44.27%），老年共病患者肌少症、睡眠质量指数、衰弱呈两两正相关（r_s>0,P<0.05）。肌少症不仅可直接预测老年共病患者的衰弱水平，还可通过睡眠质量的中介路径间接影响衰弱，中介效应占总效应的23.11%。结论 睡眠质量在老年共病患者肌少症和衰弱间起部分中介作用，提示临床护理人员可将睡眠管理纳入衰弱干预策略，作为可调控的关键靶点，加强老年共病患者睡眠质量问题的预防和综合干预，从而延缓衰弱的发生与进展。更多还原

【Abstract】 Objective To explore the mediating effect of sleep quality on sarcopenia and frailty in elderly patients with multimorbidity. Methods A total of 260 elderly patients with multimorbidity in the Department of Geriatrics Cardiology Division, the First Affiliated Hospital of Guangxi Medical University from October 2024 to April 2025 were investigated using a general information questionnaire, fried frailty phenotype, sarcopenia screening questionnaire, and Pittsburgh sleep quality index. Descriptive analysis and Spearman correlation analysis were conducted using SPSS 26.0. The Process macro program was used to test the mediating effect, and the Bootstrap method was used to test the significance of the mediating effect. Results A total of 260 questionnaires were distributed, and 253 valid questionnaires were retrieved, the effective recovery rate was 97.3%. The incidence of frailty in elderly patients with comorbidity was high(44.27%). There was a positive correlation between sarcopenia, sleep quality index and frailty in elderly patients with comorbidity(r_s>0,P<0.05). Sarcopenia not only directly predicts the level of frailty in elderly patients with comorbidities, but also indirectly affects frailty through the mediating path of sleep quality, with the mediating effect accounting for 23.11% of the total effect. Conclusion Sleep quality plays a partial mediating role between sarcopenia and frailty in elderly patients with comorbidities. This suggests that clinical caregivers can incorporate sleep management into the frailty intervention strategy as a controllable key target, to enhance the prevention and comprehensive intervention of sleep quality issues in elderly patients with comorbidities, thereby delaying the occurrence and progression of frailty.更多还原