Kawai Makoto, Beaudreau Sherry A, Gould Christine E, Hantke Nathan C, Cotto Isabelle, Jordan Josh T, Hirst Rayna B, O'Hara Ruth
Department of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Sierra Pacific Mental Illness Research Education and Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Int J Geriatr Psychiatry. 2016 Oct;31(10):1124-35. doi: 10.1002/gps.4554. Epub 2016 Aug 23.
This investigation sought to determine whether delta activity at sleep onset (DASO) in the sleep electroencephalography of older adults represents normal variation or is associated with clinical pathology. To this end, we examined its longitudinal associations with cognitive and affective function in older adults without dementia.
Participants were 153 community-dwelling older adults without dementia. We evaluated polysomnography (PSG), cognitive performance, and affective function at four time points: baseline, 12, 24, and 36 months. All participants completed PSG and measures of global cognition, delayed verbal memory, information processing speed, attention, inhibition, verbal naming, visuospatial ability, and measures of anxiety and depression. DASO was defined as sequences of rhythmic anterior delta activity on PSG in the transition from awake to sleep during the baseline assessment (Figure ).
At the baseline, 83 women and 70 men, mean age 71.3 ± 0.6 years participated and 19.6% of participants exhibited DASO. Age, years of education, gender, and body mass index did not differ according to DASO status. Linear mixed modeling showed that the presence of DASO was actually associated with lower levels of anxiety and depression. Further, participants with DASO, versus those without DASO, exhibited a trend towards better cognitive performance over time, although none of these associations reached statistical significance.
Whereas DASO was associated with better affective function, no significant association was found between DASO and cognitive change over time. These longitudinal findings support the view that the presence of DASO in healthy older adults represents normal variation rather than pathological aging. Copyright © 2016 John Wiley & Sons, Ltd.
本研究旨在确定老年人睡眠脑电图中睡眠起始时的δ波活动（DASO）是代表正常变异还是与临床病理相关。为此，我们在无痴呆的老年人中研究了其与认知和情感功能的纵向关联。
参与者为153名居住在社区的无痴呆老年人。我们在四个时间点评估了多导睡眠图（PSG）、认知表现和情感功能：基线、12个月、24个月和36个月。所有参与者均完成了PSG以及整体认知、延迟言语记忆、信息处理速度、注意力、抑制力、言语命名、视觉空间能力的测量，以及焦虑和抑郁的测量。DASO被定义为在基线评估期间从清醒到睡眠过渡时PSG上有节律的前部δ波活动序列（图）。
基线时，83名女性和70名男性参与研究，平均年龄71.3±0.6岁，19.6%的参与者表现出DASO。根据DASO状态，年龄、受教育年限、性别和体重指数无差异。线性混合模型显示，DASO的存在实际上与较低水平的焦虑和抑郁相关。此外，与没有DASO的参与者相比，有DASO的参与者随着时间推移表现出认知表现更好的趋势，尽管这些关联均未达到统计学显著性。
虽然DASO与更好的情感功能相关，但未发现DASO与随时间的认知变化之间存在显著关联。这些纵向研究结果支持以下观点：健康老年人中DASO的存在代表正常变异而非病理性衰老。版权所有©2016约翰威立父子有限公司。
