Research Institute, California Pacific Medical Center, San Francisco, California, USA.
J Am Geriatr Soc. 2011 Dec;59(12):2217-25. doi: 10.1111/j.1532-5415.2011.03731.x. Epub 2011 Nov 7.
To examine the association between sleep architecture, sleep-disordered breathing, and cognition in older men.
Population-based cross-sectional study.
Six clinical sites in the United States.
Two thousand nine hundred nine community-dwelling men aged 67 and older who were not selected on the basis of sleep problems or cognitive impairment.
Predictors were measured using in-home polysomnography: sleep architecture, nocturnal hypoxemia (any sleep time with arterial oxygen saturation <80%), apnea-hypopnea index (AHI), and arousal index. Cognitive outcomes were measured using the modified Mini-Mental State Examination (3MS), Trail-Making Test Part B (TMT-B), and the Digit Vigilance Test (DVT).
Analyses adjusted for age, race, education, body mass index, lifestyle, comorbidities, and medication use showed that participants who spent less percentage of time in rapid eye movement (REM) sleep had lower levels of cognition; participants in the lowest quartile (<14.8%) took an average of 5.9 seconds longer on the TMT-B and 20.1 seconds longer on the DVT than those in the highest quartile (≥23.7%). Similarly, greater percentage of time spent in Stage 1 sleep was related to poorer cognitive function. Participants in the highest quartile of Stage 1 sleep (≥8.6%) had worse cognitive scores on average than those in the lowest quartile (<4.0%). Those with nocturnal hypoxemia took an average of 22.3 seconds longer to complete the DVT than those without, but no associations were found with 3MS or the TMT-B.
Spending less percentage of time in REM sleep and greater percentage of time in Stage 1 sleep and having higher levels of nocturnal hypoxemia were associated with poorer cognition in older men. Further studies are needed to clarify the direction of these associations and to explore potential mechanisms.
研究老年男性的睡眠结构、睡眠呼吸障碍与认知之间的关系。
基于人群的横断面研究。
美国六个临床地点。
2909 名年龄在 67 岁及以上、非基于睡眠问题或认知障碍选择的社区居住男性。
使用家庭多导睡眠图测量预测因子：睡眠结构、夜间低氧血症（任何动脉血氧饱和度<80%的睡眠时间）、呼吸暂停低通气指数（AHI）和觉醒指数。使用改良的简易精神状态检查（3MS）、连线测试 B（TMT-B）和数字警觉测试（DVT）测量认知结果。
调整年龄、种族、教育程度、体重指数、生活方式、合并症和用药情况后分析显示，快速眼动（REM）睡眠中时间百分比较低的参与者认知水平较低；处于最低四分位数（<14.8%）的参与者完成 TMT-B 的平均用时比处于最高四分位数（≥23.7%）的参与者长 5.9 秒，完成 DVT 的平均用时长 20.1 秒。同样，第一阶段睡眠时间百分比越高与认知功能越差相关。处于第一阶段睡眠最高四分位数（≥8.6%）的参与者的认知评分平均比处于最低四分位数（<4.0%）的参与者差。有夜间低氧血症的参与者完成 DVT 的平均用时比没有夜间低氧血症的参与者长 22.3 秒，但与 3MS 或 TMT-B 无关。
REM 睡眠中时间百分比较低、第一阶段睡眠中时间百分比较高以及夜间低氧血症水平较高与老年男性认知功能较差有关。需要进一步的研究来阐明这些关联的方向，并探索潜在的机制。
