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PLoS One. 2013 Nov 25;8(11):e81261. doi: 10.1371/journal.pone.0081261. eCollection 2013.

Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study.

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Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China.



Sleep disorders causes a significant negative effect on mental and physical health, particularly among the elderly. The disease burden and risk factors of poor sleep quality of the elderly need to be verified using a validated form of measurement in urban mainland China.


This study included 1086 community residents aged ≥ 60 years who completed the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleeper was defined by a CPSQI global score of >5. Subjects also accepted the neurological and neuropsychological assessments, including the Mini-Mental State Examination, Center for Epidemiological Studies Depression Scale, and Zung Self-Rating Anxiety Scale (ZSAS). A history of chronic diseases was confirmed by the medical records of each participant.


The prevalence of poor sleep quality in this population was 41.5% (95% confidence interval (CI) = 38.6-44.5%), with a higher rate observed in elderly females (45.8% [95% CI = 41.9-49.7%]) than that in elderly males (35.8% [95% CI = 31.4-40.1%]). The prevalence rate increased with age, from 32.1% (95% CI = 27.8-36.4%) in those aged 60-69 years to 52.5% (95% CI = 45.9-59.1%) in those aged ≥ 80 years (p value for trend<0.001). Multivariate logistic regression analysis indicated that age (OR = 1.03[95% CI = 1.01-1.05], p<0.001), less education duration (OR = 1.04 [95% CI = 1.01-1.08, p = 0.014), living alone (OR = 1.62 [95% CI = 1.02-2.58], p = 0.04), anxiety (ZSAS score: OR = 1.09 [95% CI = 1.05-1.12], p<0.001), number of chronic disease (OR = 1.18 [95% CI = 1.07-1.30], p = 0.14) and arthritis (OR = 1.45[95% CI = 1.05-2.01], p = 0.025) were risk factors of poor sleep quality.


Poor sleep quality is highly prevalent among elderly Chinese residents in urban Shanghai. Growing attention and comprehensive countermeasures involving psycho-social and personal activities might alleviate the sleep problem in the elderly.

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