Geriatric Nursing最新文献_第7页

Association of physical activity with depression and suicidal ideation in people with osteoarthritis experiencing moderate to severe pain: A multinational study 在经历中度至重度疼痛的骨关节炎患者中，体育活动与抑郁和自杀意念的关联：一项多国研究

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103908

Joaquín Salazar-Méndez MSc , Rodrigo Núñez-Cortés PhD , Lars Louis Andersen PhD , Rubén López-Bueno PhD , Luis Suso-Martí PhD , Carlos Cruz-Montecinos PhD , Laura López-Bueno PhD , Joaquín Calatayud PhD

Introduction

Previous single-center studies highlighted the association between physical activity and depression in people with osteoarthritis (OA). However, large-scale multinational studies are needed to provide robust evidence. The aim was to determine the association of physical activity with depression and suicidal thoughts in a multinational sample of people with OA with moderate and severe pain.

Methods

We conducted a cross-sectional analysis based on the 9th wave of SHARE, a representative survey in 27 European countries and Israel. Self-reported physical activity (frequency and intensity) was the independent variable. Depression (≥4 points) and suicidal thoughts (yes/no) from the 12-item EURO-D scale were the outcomes. We conducted multivariable logistic regression, controlling for age, sex, geographic region, education, smoking, alcohol consumption, fruit and vegetable consumption, number of comorbidities, body mass index, and verbal fluency.

Results

A total of 7785 participants were included (mean age 72.0 ± 9.5 years). Respondents who engaged in moderate physical activity more than once a week were less likely to be depressed (OR=0.51; 95%CI = 0.45–0.59) and less likely to have suicidal thoughts (OR=0.56; 95%CI = 0.47–0.68) compared to those who hardly ever or never engaged in physical activity. Similarly, responders who engaged in vigorous physical activity were less likely to be depressed (OR=0.69; 95%CI=0.61–0.79) and less likely to have suicidal thoughts (OR=0.67; 95%CI=0.54–0.83).

Conclusions

This study shows that engaging in moderate to vigorous physical activity more than once a week may help reduce high rates of depression and suicidal thoughts in people with osteoarthritis with moderate to severe pain.

先前的单中心研究强调了骨关节炎（OA）患者体力活动与抑郁之间的关系。然而，需要大规模的跨国研究来提供有力的证据。目的是确定体育活动与患有中度和重度疼痛的OA患者的抑郁和自杀念头之间的关系。方法基于在欧洲27个国家和以色列进行的具有代表性的第九波SHARE调查，进行横断面分析。自我报告的体力活动（频率和强度）是自变量。12项EURO-D量表中的抑郁（≥4分）和自杀念头（是/否）是结果。我们进行了多变量logistic回归，控制了年龄、性别、地理区域、教育程度、吸烟、饮酒、水果和蔬菜消费、合并症数量、体重指数和语言流畅性。结果共纳入受试者7785例，平均年龄72.0±9.5岁。与那些很少或从不进行体育锻炼的受访者相比，每周进行一次以上适度体育锻炼的受访者更不容易抑郁（OR=0.51; 95%CI = 0.45-0.59），更不容易产生自杀念头（OR=0.56; 95%CI = 0.47-0.68）。同样，参与剧烈体育活动的应答者更不容易抑郁（OR=0.69; 95%CI= 0.61-0.79），更不容易产生自杀念头（OR=0.67; 95%CI= 0.54-0.83）。结论：这项研究表明，每周进行一次以上的中度到剧烈的体育活动可能有助于降低患有中度到重度疼痛的骨关节炎患者的抑郁和自杀念头的高发生率。

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引用次数: 0

Caregiver outcomes related to sleep disturbances in persons living with cognitive impairment 认知障碍患者睡眠障碍与护理结果的关系

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103869

Miranda V. McPhillips PhD, RN , Erin Donnelly BSN, RN , Fanghong Dong PhD, MA , Darina V. Petrovsky PhD, RN , Justine S. Sefcik PhD, RN , Glenna S. Brewster PhD, RN, FNP-BC , Junxin Li PhD, RN , Nalaka S. Gooneratne MD, MSc , Nancy A. Hodgson PhD, RN, FAAN, FGSA

Sleep disturbances in persons living with cognitive impairment (PLWCI) may impose a great burden on caregivers. We examined the association between sleep (objective sleep quality and quantity; subjective sleep impairment, quality, and daytime sleepiness) in PLWCI and caregiver depression, mastery, and burden via secondary analysis of Healthy Patterns baseline data (n = 209). Objective sleep variables included total sleep time and sleep efficiency derived from PLWCI using 3 nights of actigraphy. Subjective sleep measures included PROMIS Sleep Related Impairment, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale, filled out by the caregiver describing the PLWCI sleep. Caregiver measures included Center for Epidemiological Studies Depression Scale, Caregiver Mastery Scale and Zarit Burden Interview. PLWCI were primarily female (66.5%) and Black (64%), with a mean age of 73.6 ± 8.6. Caregivers were mainly female (81%) and family caregivers (67%), with a mean age of 56.6 ± 14.7. After controlling for PLWCI cognition, age, and gender, poorer PLWCI sleep quality was significantly associated with more caregiver depression (β = 0.387, p = 0.029); worse PLWCI sleep impairment was associated with worse mastery (β = 0.104, p = 0.004). Poor PLWCI sleep quality was associated with lower caregiver mastery; the effect was larger for females than males. PLWCI being less sleepy during the day (β = 0.104, p = 0.055) and having worse sleep impairment (β =-0.163, p = 0.039) were both associated with more caregiver burden. There is a critical need to address the effects of PLWCI sleep disruption on caregivers in dementia care services.

认知障碍患者的睡眠障碍可能给护理人员带来巨大负担。我们通过对健康模式基线数据（n = 209）的二次分析，研究了PLWCI患者的睡眠（客观睡眠质量和数量；主观睡眠障碍、质量和白天嗜睡）与照顾者抑郁、掌握和负担之间的关系。目的睡眠变量包括总睡眠时间和睡眠效率，由PLWCI使用3晚活动记录仪得出。主观睡眠测量包括PROMIS睡眠相关障碍、匹兹堡睡眠质量指数和Epworth嗜睡量表，由护理人员填写，描述PLWCI睡眠。照顾者测量包括流行病学研究中心抑郁量表、照顾者掌握量表和Zarit负担访谈。PLWCI患者以女性（66.5%）和黑人（64%）为主，平均年龄73.6±8.6岁。照顾者以女性（81%）和家庭照顾者（67%）为主，平均年龄56.6±14.7岁。在控制PLWCI认知、年龄和性别后，PLWCI睡眠质量较差与照顾者抑郁程度显著相关（β = 0.387, p = 0.029）；PLWCI睡眠障碍越严重，掌握程度越差（β = 0.104, p = 0.004）。PLWCI睡眠质量差与较低的照顾者掌握程度有关；对女性的影响比男性更大。PLWCI白天较少困倦（β = 0.104, p = 0.055）和睡眠障碍更严重（β =-0.163, p = 0.039）均与更多的照顾者负担相关。迫切需要解决PLWCI睡眠中断对痴呆症护理服务中的护理人员的影响。

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引用次数: 0

Construction of a home care quality evaluation index system for disabled elderly based on “internet + nursing services” 基于“互联网+护理服务”的残疾老年人居家护理质量评价指标体系构建

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103838

Hanyu Ma BSc, Weiming Gao BSc, Jian Tang

Objective

To develop a standardized quality evaluation index system for home-based care for disabled older adults within the context of “Internet + Nursing Services” in China.

Methods

Based on the three-dimensional quality model, a preliminary indicator framework was developed through policy review and literature analysis. Two rounds of Delphi surveys with 15 experts were conducted to refine the indicators, and the Analytic Hierarchy Process (AHP) was applied to determine weights.

Results

The effective response rate for both survey rounds was 100%. The expert authority coefficients were 0.87 and 0.89, and Kendall’s W coordination coefficient increased from 0.169 to 0.191 (P < 0.01), indicating strong consensus. The final system comprises 3 first-level, 12 s-level, and 46 third-level indicators.

Conclusion

The established index system provides a scientifically grounded and quantifiable tool for evaluating the quality of “Internet + Nursing Services,” supporting its standardized and sustainable development in China.

目的建立“互联网+护理”背景下中国残疾老年人居家护理标准化质量评价指标体系。方法基于三维质量模型，通过政策回顾和文献分析，构建初步指标框架。通过15名专家参与的两轮德尔菲调查来完善指标，并采用层次分析法（AHP）确定权重。结果两轮调查的有效回复率均为100%。专家权威系数分别为0.87和0.89，Kendall的W协调系数从0.169增加到0.191 (P < 0.01)，表明一致性较强。最终系统包括3个一级指标、12个s级指标和46个三级指标。结论建立的指标体系为“互联网+护理服务”质量评价提供了科学、可量化的工具，为“互联网+护理服务”在中国的规范化、可持续发展提供了支撑。

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引用次数: 0

Functional experience and safety perceptions in smart refrigerator adoption among older adults: A technology acceptance model for supporting independent living 老年人采用智能冰箱的功能体验和安全感知：支持独立生活的技术接受模型

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103903

Yongchuan Li PhD , Lun Sun MS , Bowen Zhang MS , Cuiping Jiang PhD , Salwa Hanim Abdul-Rashid PhD , Yao Wu MS

Smart appliances technologies promise enhanced independence for older users, yet adoption rates remain paradoxically low. This study investigates how functional experience—users’ cumulative perceptions from interacting with product features—shapes technology acceptance among older populations. We developed an extended Technology Acceptance Model incorporating functional experience as a multidimensional construct and tested it through structural equation modeling with 206 older smart refrigerator users (aged 65–84). Results reveal that functional experience demonstrates differential impacts across acceptance dimensions, with perceived safety showing the strongest relationship (β = 0.501, p < 0.001), followed by perceived enjoyment (β = 0.384, p < 0.001), perceived usefulness (β = 0.331, p < 0.001), and perceived ease of use (β = 0.309, p < 0.001). Unexpectedly, functional experience showed no significant relationship with perceived universality (β = 0.161, p = 0.07). Mediation analysis revealed that safety and usefulness perceptions serve as primary cognitive channels linking functional experience to behavioral intention. Multi-group analyses indicated substantial heterogeneity within the older population, with experience level emerging as the strongest moderator of acceptance relationships. These findings challenge conventional technology acceptance assumptions by establishing a hierarchy where safety and enjoyment considerations supersede traditional usefulness and ease-of-use metrics. We propose a two-tier design framework prioritizing safety-centric features and enjoyment enhancement. The research advances theory by conceptualizing functional experience as a higher-order construct and provides evidence-based guidelines for age-appropriate smart appliances design. For geriatric nursing practice, these findings provide an evidence-based framework for technology assessment and recommendation, supporting medication management, nutritional monitoring, and care coordination while respecting older adults’ autonomy and safety priorities.

智能家电技术有望提高老年用户的独立性，但采用率仍然很低。这项研究调查了功能体验——用户通过与产品特性互动而累积的感知——如何影响老年人对技术的接受程度。我们开发了一个扩展的技术接受模型，将功能体验作为一个多维结构，并通过结构方程建模对206名老年智能冰箱用户（65-84岁）进行了测试。结果显示，功能体验在不同的接受维度上表现出不同的影响，其中感知安全性表现出最强的关系（β = 0.501, p < 0.001），其次是感知享受（β = 0.384, p < 0.001），感知有用性（β = 0.331, p < 0.001）和感知易用性（β = 0.309, p < 0.001）。出乎意料的是，功能体验与感知普遍性没有显著关系（β = 0.161, p = 0.07）。中介分析表明，安全性和有用性知觉是连接功能体验与行为意向的主要认知渠道。多组分析表明，在老年人群中存在实质性的异质性，经验水平成为接受关系的最强调节因子。这些发现挑战了传统的技术接受假设，建立了一个层次结构，其中安全性和享受性的考虑取代了传统的有用性和易用性指标。我们提出了一个两层设计框架，优先考虑以安全为中心的功能和享受增强。该研究通过将功能体验概念化为高阶结构来推进理论，并为适合年龄的智能家电设计提供循证指导。对于老年护理实践，这些发现为技术评估和推荐提供了一个基于证据的框架，支持药物管理、营养监测和护理协调，同时尊重老年人的自主权和安全优先事项。

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引用次数: 0

Dementia care insights: An item response theory approach to behavioral and psychological symptoms of dementia in long-term care 痴呆症护理的见解：项目反应理论的方法对行为和心理症状的痴呆症在长期护理。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103837

Asuna Arai PhD , Takashi Ozaki MD , Khaltar Amartuvshin MD, PhD , Yuriko Katsumata PhD

This study aimed to characterize behavioral and psychological symptoms of dementia (BPSD) based on latent trait scores using item response theory and to provide insights into dementia care. We performed a questionnaire-based assessment for residents with dementia in long-term care facilities. A two-parameter logistic model was applied for 12 BPSD symptoms. Agitation/aggression and irritability/lability appeared even in people with lower latent trait scores of BPSD (i.e., lower predisposition to BPSD). A generalized linear regression model with stabilized inverse probability of treatment weights showed that the latent trait scores were associated with impairment levels of cognitive function. Those with greater impairment in cognitive function were more likely to have higher latent trait scores, indicating that they were more likely to exhibit BPSD. The characteristics of BPSD represented by the latent traits would help forecast BPSD risk timing to facilitate appropriate management of BPSD.

本研究旨在运用项目反应理论，以潜在特质评分为基础，对痴呆患者的行为和心理症状进行表征，为痴呆患者的护理提供依据。我们对长期护理机构的痴呆症患者进行了基于问卷的评估。采用双参数logistic模型对12种BPSD症状进行分析。即使在BPSD潜在特征得分较低的人群中（即较低的BPSD易感），也会出现躁动/攻击和易怒/不稳定。一个具有稳定的处理权逆概率的广义线性回归模型表明，潜在特质得分与认知功能损害水平相关。那些认知功能受损更严重的人更有可能有更高的潜在特征得分，这表明他们更有可能表现出BPSD。以潜在特征为代表的BPSD特征有助于预测BPSD的风险时间，以便于对BPSD进行适当的管理。

引用次数: 0

Impact of multimodal training on nursing staff’s competencies in dementia mealtime support: A mixed-methods pilot study 多模式培训对护理人员痴呆症用餐时间支持能力的影响：一项混合方法的试点研究

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-22 DOI: 10.1016/j.gerinurse.2026.103905

Hui-Chen (Rita) Chang PhD, RN , Hansen (Cindy) Tang RN , Yu (Carrie) Cheng MN , Lei (Tina) Sun BN , Ivy Wong BN , Wenpeng You PhD, RN

Aims

This study assessed the effectiveness of a structured training program in improving nursing staff’s knowledge, skills, and attitudes toward assisting older people with dementia during mealtimes.

Design

A mixed-methods design integrating quantitative and qualitative approaches was used.

Methods

Conducted in a Sydney residential aged care facility, 24 nursing staff participated in face-to-face training involving education booklets, role-playing, and case studies. Pre/post-training assessments included questionnaires, Objective Structured Clinical Examination (OSCE), and semi-structured interviews.

Results

Knowledge scores significantly improved post-training (pre-M = 13.83, post-M = 16.54, p < .01). Although attitude changes were not statistically significant (p > .05), participants reported a marked reduction in perceived difficulty when assisting residents (pre-M = 5.85, post-M = 3.75, p < .01). Frequency of using assistance skills slightly decreased (pre-M = 2.75, post-M = 2.25, p < .05), indicating that assisting with eating became smoother or less challenging. Thematic analysis identified four areas of improvement: environmental adjustments, emotional support, early health issue detection, and personalized strategies.

Conclusion

Structured training effectively enhances staff knowledge and skills in dementia mealtime care. Ongoing support may be needed to sustain skill application. Emphasis on environment, emotion, and collaboration is key to improving care quality.

目的：本研究评估了一个结构化培训项目在提高护理人员的知识、技能和态度方面的有效性，以帮助患有痴呆症的老年人在用餐时间。设计采用定量与定性相结合的混合方法设计。方法在悉尼一家养老院，24名护理人员参加了面对面的培训，包括教育小册子、角色扮演和案例研究。培训前/培训后评估包括问卷调查、客观结构化临床检查（OSCE）和半结构化访谈。结果培训后知识得分显著提高（前m = 13.83，后m = 16.54, p < 0.01）。虽然态度的改变在统计上并不显著（p > 0.05），但参与者报告在帮助住院医生时感知到的困难显著减少（m前= 5.85，m后= 3.75,p < 0.01）。使用辅助技能的频率略有下降（前m = 2.75，后m = 2.25, p < 0.05），表明辅助进食变得更顺畅或更不具挑战性。专题分析确定了四个改进领域：环境调整、情感支持、早期健康问题发现和个性化战略。结论有组织的培训能有效提高员工在痴呆餐时护理方面的知识和技能。可能需要持续的支持来维持技能应用。强调环境、情感和协作是提高护理质量的关键。

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引用次数: 0

Intracranial compliance is influenced by sex in older adults 老年人颅内顺应性受性别影响。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103805

Gabriel Novaes Miranda MD , Alinne Alves Oliveira PhD , Paulo Sérgio Almeida MD , Júlia Quaresma PT , Filipe Lírio Malta MD , Mateus Argôlo PT , Rafael Pereira PhD

The intracranial arterial pulse wave could be recorded by measuring skull deformation behavior, called noninvasive intracranial compliance (NICC). Its measurement is particularly beneficial for older adults due to the aging-associated vascular stiffening. However, data are scarce regarding NICC in older adults and potential differences between older men and women. This observational and transversal study aimed to investigate NICC data from community-dwelling older adults, comparing NICC values by sex. One hundred and eighty-seven participants (111 women) underwent a 10-minute NICC recording. Measurements included time to peak and the P2/P1 ratio. Anthropometric data, medical history related to diabetes mellitus (DM) and hypertension, and medication usage were recorded. Between-sex comparisons were performed through a linear mixed model. Results indicated a high P2/P1 ratio (1.24 ± 0.25). Older women demonstrated a significantly higher P2/P1 ratio than older men. These findings highlight the relevance of ambulatory monitoring of aging-associated vascular stiffening, especially among older women.

颅内动脉脉搏波可以通过测量颅骨变形行为来记录，称为无创颅内顺应性（NICC）。由于与年龄相关的血管硬化，其测量对老年人特别有益。然而，关于老年人NICC和老年男性和女性之间潜在差异的数据很少。这项观察性和横向研究旨在调查社区居住老年人的NICC数据，比较不同性别的NICC值。187名参与者（111名女性）接受了10分钟的NICC记录。测量包括达到峰值的时间和P2/P1比率。记录患者的人体测量数据、糖尿病和高血压相关病史及用药情况。性别间比较通过线性混合模型进行。结果显示P2/P1比值较高（1.24±0.25）。老年女性的P2/P1比值明显高于老年男性。这些发现强调了动态监测衰老相关血管硬化的相关性，特别是在老年妇女中。

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引用次数: 0

Individuality in delivering older people’s home care and services: An integrative review 提供老年人家庭护理和服务中的个性：一项综合综述。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103833

Jonna Puustinen MHSc , Riitta Turjamaa PhD , Mari Kangasniemi PhD

Individuality is an ethical value and a focus in achieving quality outcomes for both older people and professionals through person-centred care. This integrative review aimed to identify and synthesise previous research on individuality in delivering older people’s home care and services. We conducted systematic searches in CINAHL, PubMed, SocIndex, and Web of Science databases on empirical studies published in English (1/2012 – 2/2024). Out of 1596 records, 23 studies were included in the review. Based on this review, individuality is a prerequisite for older people to pursue a meaningful life and receive tailored care at home. It relies on older people expressing individuality, voicing self-determination in their care, and the structures of home care and services prioritising individuality. Further research is needed into how individuality can be supported and delivered in home care and services, and how delivery can be evaluated and developed to respect the individuality of older people.

个性是一种道德价值，是通过以人为本的护理为老年人和专业人士实现高质量结果的重点。本综合综述旨在识别和综合以往关于提供老年人家庭护理和服务中的个性的研究。我们系统检索了CINAHL、PubMed、SocIndex和Web of Science数据库中发表的英文实证研究（2012年1月- 2024年2月）。在1596项记录中，有23项研究纳入了综述。基于这一综述，个性是老年人追求有意义的生活和接受量身定制的家庭护理的先决条件。它依赖于老年人表达个性，在他们的护理中表达自决，以及优先考虑个性的家庭护理和服务结构。需要进一步研究如何在家庭护理和服务中支持和提供个性，以及如何评估和发展服务以尊重老年人的个性。

引用次数: 0

Mechanisms of insulin resistance in elderly sarcopenia patients and their bidirectional relationship 老年肌肉减少症患者胰岛素抵抗的机制及其双向关系

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103907

Haiyan Du M.M., Yuqing Qu M.M., Zhouyang Huai M.M., Shumin Wang M.M.

引用次数: 0

The impact of mind-body and aerobic exercises on subjective and objective sleep quality in middle-aged and older adults: A systematic review and meta-analysis of randomized controlled trials 身心和有氧运动对中老年人主观和客观睡眠质量的影响：随机对照试验的系统回顾和荟萃分析。

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing

Pub Date : 2026-01-21 DOI: 10.1016/j.gerinurse.2026.103867

Zhixin Fan PhD , Zhibo Wang PhD , Yunlong Li PhD, Xueying Chen PhD, Yifan Zhang PhD

Objective

To evaluate the effects of mind-body and aerobic exercises on subjective and objective sleep quality in middle-aged and older adults.

Methods

A systematic search was conducted in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases.

Results

Twenty-eight studies were included. Compared to the control group, mind-body (P < 0.00001) and aerobic exercises (P = 0.0001) significantly improved subjective sleep quality in middle-aged and older adults. For objective sleep quality, both mind-body and aerobic exercises significantly increased total sleep time (P = 0.004) and reduced wake time after sleep onset (P < 0.00001). However, improvements in sleep efficiency (P = 0.06) and reductions in sleep onset latency (P = 0.19) were not statistically significant.

Conclusions

Mind-body and aerobic exercises have shown to improve sleep quality in middle-aged and older adults, particularly in increase total sleep time, decreasing nighttime wakefulness, and improving subjective sleep quality.

目的：探讨身心运动和有氧运动对中老年人主观和客观睡眠质量的影响。方法：系统检索PubMed、Web of Science、Embase、Cochrane图书馆、中国国家知识基础设施和万方数据库。结果：纳入28项研究。与对照组相比，心身运动（P < 0.00001）和有氧运动（P = 0.0001）显著改善了中老年人主观睡眠质量。在客观睡眠质量方面，身心运动和有氧运动均显著增加了总睡眠时间（P = 0.004），并显著减少了入睡后的醒来时间（P < 0.00001）。然而，睡眠效率的改善（P = 0.06）和睡眠发作潜伏期的减少（P = 0.19）没有统计学意义。结论：身心和有氧运动已被证明可以改善中老年人的睡眠质量，特别是在增加总睡眠时间、减少夜间清醒和改善主观睡眠质量方面。

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引用次数: 0