Department of General Internal Medicine, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Gerontology. 2010;56(1):41-50. doi: 10.1159/000264654. Epub 2009 Dec 3.
Perturbed sleep might contribute to cardiovascular disease by accelerating atherosclerosis. Sleep is poor in Alzheimer caregivers who are also a group at increased cardiovascular risk.
To test the hypothesis that impaired sleep relates to elevated levels of biomarkers of atherosclerosis in community-dwelling elderly and that this association would possibly be stronger in caregivers than in non-caregiving controls.
We studied 97 Alzheimer caregivers and 48 non-caregiving controls (mean age 71 +/- 8 years, 72% women) who underwent wrist actigraphy at their homes. Measures of objective sleep were averaged across 3 consecutive nights. The Pittsburgh Sleep Quality Index was administered by an interviewer to rate subjective sleep quality. Morning fasting blood samples were collected to determine measures of inflammation, coagulation and endothelial dysfunction.
There were independent associations between decreased subjective sleep quality and increased levels of fibrin D-dimer (p = 0.022, DeltaR(2) = 0.029) and von Willebrand factor antigen (p = 0.029, DeltaR(2) = 0.034) in all participants. Percent sleep (p = 0.025) and subjective sleep quality (p = 0.017) were lower in caregivers than in controls. In caregivers, the correlation between decreased percent sleep and elevated levels of interleukin-6 (p = 0.042, DeltaR(2) = 0.039) and C-reactive protein (p < 0.10, DeltaR(2) = 0.027) was significantly stronger than in controls.
Perceived impairment in sleep related to increased coagulation activity and endothelial dysfunction in all participants, whereas objectively impaired sleep related to inflammation activity in caregivers. The findings provide one explanation for the increased cardiovascular risk in elderly poor sleepers and dementia caregivers in particular.
睡眠紊乱可能通过加速动脉粥样硬化而导致心血管疾病。在阿尔茨海默病护理者中，睡眠质量较差，而他们也是心血管疾病风险增加的人群。
验证假说，即睡眠紊乱与社区居住的老年人中动脉粥样硬化生物标志物水平升高有关，并且在护理者中这种关联可能比在非护理者对照中更强。
我们研究了 97 名阿尔茨海默病护理者和 48 名非护理者对照（平均年龄 71 +/- 8 岁，72%为女性），他们在家中进行了手腕活动记录。通过访谈者对匹兹堡睡眠质量指数进行评分，以评估主观睡眠质量。采集清晨空腹血样以确定炎症、凝血和内皮功能障碍的指标。
在所有参与者中，主观睡眠质量下降与纤维蛋白 D-二聚体水平升高（p = 0.022，DeltaR(2) = 0.029）和血管性血友病因子抗原（p = 0.029，DeltaR(2) = 0.034）独立相关。与对照组相比，护理者的睡眠百分比（p = 0.025）和主观睡眠质量（p = 0.017）更低。在护理者中，睡眠时间减少与白细胞介素-6 水平升高（p = 0.042，DeltaR(2) = 0.039）和 C 反应蛋白（p < 0.10，DeltaR(2) = 0.027）之间的相关性明显强于对照组。
在所有参与者中，感知到的睡眠障碍与凝血活性和内皮功能障碍增加有关，而在护理者中，客观的睡眠障碍与炎症活性有关。这些发现为老年睡眠不佳者，特别是痴呆症护理者心血管疾病风险增加提供了一种解释。
