Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Sleep Res. 2014 Feb;23(1):69-76. doi: 10.1111/jsr.12086. Epub 2013 Sep 2.
Using a sample of 2925 stroke-free participants drawn from a national population-based study, we examined cross-sectional associations of obstructive sleep apnea (OSA) risk with cognition and quality of life and whether these vary with age, while controlling for demographics and comorbidities. Included participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were aged 47-93 years. OSA risk was categorized as high or low based on responses to the Berlin Sleep Questionnaire. Cognitive function was assessed with standardized fluency and recall measures. Depressive symptoms were assessed with the four-item Center for Epidemiologic Studies Depression Scale. Health-related quality of life (HRQoL) was assessed with the Medical Outcomes Study Short Form-12 (SF-12). Multivariate analyses of covariance (mancova) statistics were applied separately to the cognitive and quality of life dependent variables while accounting for potential confounders (demographics, comorbidities). In fully adjusted models, those at high risk for OSA had significantly lower cognitive scores (Wilks' lambda = 0.996, F3,2786 = 3.31, P < 0.05) and lower quality of life [depressive symptoms and HRQoL] (Wilks' lambda = 0.989, F3,2786 = 10.02, P < 0.0001). However, some of the associations were age-dependent. Differences in cognition and quality of life between those at high and low obstructive sleep apnea risk were most pronounced during middle age, with attenuated effects after age 70 years.
我们使用了一项来自全国人群基础研究的 2925 名无中风参与者的样本，研究了阻塞性睡眠呼吸暂停（OSA）风险与认知和生活质量的横断面关联，以及在控制人口统计学和合并症的情况下，这些关联是否因年龄而异。纳入的参与者来自地理和种族差异中风原因（REGARDS）研究，年龄在 47-93 岁之间。根据柏林睡眠问卷的回答，将 OSA 风险分为高或低。认知功能通过标准化流畅性和回忆测试进行评估。抑郁症状采用四项流行病学研究抑郁量表评估。健康相关生活质量（HRQoL）采用医疗结局研究短表-12（SF-12）评估。在考虑潜在混杂因素（人口统计学、合并症）的情况下，分别对认知和生活质量因变量进行多元协方差分析（manova）统计。在完全调整的模型中，OSA 风险高的患者认知评分显著降低（Wilks' lambda = 0.996，F3,2786 = 3.31，P < 0.05），生活质量[抑郁症状和 HRQoL]降低（Wilks' lambda = 0.989，F3,2786 = 10.02，P < 0.0001）。然而，其中一些关联是年龄依赖性的。在中年时，高和低阻塞性睡眠呼吸暂停风险组之间的认知和生活质量差异最为明显，70 岁以后的影响减弱。
