Johar Hamimatunnisa, Kawan Rasmila, Emeny Rebecca Thwing, Ladwig Karl-Heinz
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany.
Department of Medical Informatics, Biometry and Epidemiology, Ludwig- Maximilian- Universität München, Germany.
Sleep. 2016 Jan 1;39(1):217-26. doi: 10.5665/sleep.5352.
To investigate the association between sleep-related characteristics and cognitive change over 3 years of follow up in an aged population.
Sleep characteristics and covariates were assessed at baseline in a standardized interview and clinical examination of the population-based KORA Age Study (n = 740, mean age = 75 years). Cognitive score (determined by telephone interview for cognitive status, TICS-m) was recorded at baseline and 3 years later.
At baseline, 82.83% (n = 613) of participants had normal cognitive status, 13.51% (n = 100) were classified with mild cognitive impairment (MCI), and 3.64% (n = 27) with probable dementia. The effect of three distinct patterns of poor sleep (difficulties initiating [DIS] or maintaining sleep [DMS], daytime sleepiness [DS] or sleep duration) were considered on a change in cognitive score with adjustments for potential confounders in generalized linear regression models. Cognitive decline was more pronounced in individuals with DMS compared to those with no DMS (β = 1.33, 95% CI = 0.41-2.24, P < 0.001). However, the predictive power of DMS was only significant in individuals with normal cognition and not impaired subjects at baseline. Prolonged sleep duration increased the risk for cognitive decline in cognitively impaired elderly (β = 1.86, 95% CI = 0.15-3.57, P = 0.03). Other sleep characteristics (DIS and DS) were not significantly associated with cognitive decline.
DMS and long sleep duration were associated with cognitive decline in normal and cognitively impaired elderly, respectively. The identification of impaired sleep quality may offer intervention strategies to deter cognitive decline in the elderly with normal cognitive function.
探讨老年人群3年随访期间睡眠相关特征与认知变化之间的关联。
在基于人群的KORA年龄研究（n = 740，平均年龄 = 75岁）的标准化访谈和临床检查中，于基线时评估睡眠特征和协变量。在基线时和3年后记录认知得分（通过认知状态电话访谈确定，TICS - m）。
基线时，82.83%（n = 613）的参与者认知状态正常，13.51%（n = 100）被归类为轻度认知障碍（MCI），3.64%（n = 27）可能患有痴呆症。在广义线性回归模型中，考虑了三种不同的睡眠不佳模式（入睡困难[DIS]或维持睡眠困难[DMS]、日间嗜睡[DS]或睡眠时间）对认知得分变化的影响，并对潜在混杂因素进行了调整。与无DMS的个体相比，有DMS的个体认知衰退更为明显（β = 1.33，95% CI = 0.41 - 2.24，P < 0.001）。然而，DMS的预测能力仅在基线时认知正常而非受损的个体中显著。睡眠时间延长增加了认知受损老年人认知衰退的风险（β = 1.86，95% CI = 0.15 - 3.57，P = 0.03）。其他睡眠特征（DIS和DS）与认知衰退无显著关联。
DMS和睡眠时间长分别与认知正常和认知受损老年人的认知衰退相关。识别睡眠质量受损可能为阻止认知功能正常的老年人认知衰退提供干预策略。
