Abstract: Background　According to body disease-related theories，TCM-based constitution is closely associated with the initiation，progression，and outcome of diseases，suggesting that TCM-based constitution may play an important role in the development of frailty in the elderly，but there are no relevant studies.Objective　To investigate the effects of sleep quality，body constitution，and their interactions on frailty in the elderly.Methods　In December 2019，by use of random stratified sampling，six communities and 10 administrative villages in Jinan City，China were selected，from which a cluster sample of eligible 1 130 elderly individuals were enrolled，and were invited to attend a questionnaire survey using the General Demographic Questionnaire（developed by our research team），Constitution in Chinese Medicine Questionnaire（CCMQ），Pittsburgh Sleep Quality Index（PSQI）and the Chinese version of Tilburg Frailty Indicator（TFI）.Multivariate Logistic regression analysis was performed to investigate the strength of association of frailty with sleep quality，TCM-based constitution，as well as the interaction between sleep quality and TCM-based constitution.Results　In all，1 091 cases（96.5%） who returned responsive questionnaires were included for final analysis.Among the respondents，186 （17.0%） had sleep disorders and other 905 （83.0%） did not；448 （41.1%） had balanced TCM-based constitution while 643 （58.9%） had unbalanced；373 （34.2%） were frail and 718 （65.8%） were non-frail.Multivariate Logistic regression analysis showed that the presence of sleep disorders〔OR=2.718，95%CI（1.891，3.905）〕and unbalanced TCM-based constitution〔OR=4.782，95%CI（3.410，6.704）〕were factors associated with frailty in the elderly（P<0.05）.Multivariate Logistic regression model-based additive interaction analysis demonstrated that the risk of frailty in elderly individuals with sleep disorders and unbalanced TCM-based constitution was 12.960 times higher than in those without sleep disorders and with balanced TCM-based constitution〔95%CI（8.207，20.465）〕，RERI=6.101〔95%CI（0.579，11.623）〕，AP=0.471〔95%CI（0.181，0.761）〕，S=2.041〔95%CI（1.092，3.817）〕，indicating that sleep quality and TCM-based constitution had additive interaction on frailty.Conclusion　Sleep disorders and unbalanced TCM-based constitution were risk factors for frailty in the elderly，and they also had an additive interactive effect on frailty.

Key words: Frailty, Elderly, Chinese medicine constitution, Sleep quality, Root cause analysis

摘要： 背景　体病相关理论认为，中医体质与疾病的发生、发展和预后关系密切，而由此推断，其在老年人衰弱的发生中可能扮演着重要角色，但目前尚未见相关研究。目的　探讨睡眠质量与中医体质类型及其交互作用对老年人发生衰弱的影响。方法　采用分层整群抽样法，于2019年12月从济南市随机选取6个社区、10个行政村的1 130例老年人为调查对象。采用调查问卷〔一般资料调查表、中医体质量表（CCMQ）、匹兹堡睡眠质量指数量表（PSQI）、中文版Tilburg衰弱量表〕进行问卷调查。采用多因素Logistic回归分析探究睡眠质量及中医体质类型与老年人发生衰弱的关联强度和交互作用。结果　共发放调查问卷1 130份，回收有效问卷1 091份，有效回收率为96.5%。1 091例老年人中无睡眠障碍905例（83.0%），存在睡眠障碍186例（17.0%）；中医体质：平和质448例（41.1%），偏颇体质643例（58.9%）；衰弱373例（34.2%），非衰弱718例（65.8%）。多因素Logistic回归分析结果显示，存在睡眠障碍〔OR=2.718，95%CI（1.891，3.905）〕、偏颇体质〔OR=4.782，95%CI（3.410，6.704）〕是老年人发生衰弱的影响因素（P<0.05）。基于多因素Logistic回归分析的相加交互作用分析结果显示，存在睡眠障碍且为偏颇体质的老年人发生衰弱的风险为无睡眠障碍且为平和质老年人的12.960倍〔95%CI（8.207，20.465）〕，超额危险度（RERI）=6.101〔95%CI（0.579，11.623）〕，归因比（AP）=0.471〔95%CI（0.181，0.761）〕，交互作用指数（S）=2.041〔95%CI（1.092，3.817）〕，睡眠质量与中医体质类型对老年人发生衰弱具有相加交互作用。结论　存在睡眠障碍与偏颇体质是老年人发生衰弱的危险因素，且睡眠质量与中医体质类型对老年人发生衰弱具有相加交互作用。

关键词: 衰弱, 老年人, 中医体质, 睡眠质量, 影响因素分析