Department of Health Science, Kansai Medical University, Hirakata, Japan.
Health Science Center, Kansai Medical University Hospital, Hirakata, Japan.
J Cardiol. 2019 Jun;73(6):530-535. doi: 10.1016/j.jjcc.2018.12.015. Epub 2019 Jan 2.
Because of the advanced age of patients with cardiovascular disease (CVD), prevention of sleep disorder and dementia is a priority for cardiac rehabilitation (CR) during their long-term care. This study aimed to investigate the association of physical activity with sleep quality and cognitive function in elderly patients with CVD in the CR maintenance phase.
We conducted a multicenter study through the Clinical Exercise Physiology Association Japan network, which included 102 elderly patients (mean age, 74±7.4 years) with CVD undergoing phase III CR at 6 institutions. Physical activity was assessed using a triaxial accelerometer for 7 consecutive days and was classified as locomotive and household activities. Physical fitness was assessed via 6-min walking distance (6MD), hand grip power, 10-m walking speed, one leg standing time with eyes open, and 10 times sit-to-stand tests. Sleep quality and cognitive function were evaluated using the Pittsburgh sleep quality index (PSQI) and mini-mental state examination (MMSE) scores, respectively.
The patients performed 5506.8±3743.6 steps/day and scored 5.8±3.5 points in the PSQI and 28.4±1.7 points in the MMSE. Sleep latency and MMSE scores correlated with locomotive activity, but not with household activity. Locomotive activity and 6MD were independent predictors of sleep latency and MMSE score, respectively. When patients with heart failure were excluded, the relationship between sleep latency and locomotive activity was preserved, but the relationship between exercise tolerance and cognitive function disappeared.
Locomotive activity and exercise tolerance are associated with sleep latency and cognitive function in elderly patients with CVD continuing phase III CR. However, in this study, the relationship between exercise tolerance and cognitive function was offset by the presence of heart failure.
由于心血管疾病 (CVD) 患者年龄较大，因此在长期护理期间，预防睡眠障碍和痴呆症是心脏康复 (CR) 的重点。本研究旨在调查在 CR 维持阶段，体力活动与老年 CVD 患者的睡眠质量和认知功能之间的关系。
我们通过日本临床运动生理学协会网络进行了一项多中心研究，该研究纳入了 6 个机构中 102 名正在接受 III 期 CR 的老年 CVD 患者（平均年龄 74±7.4 岁）。使用三轴加速度计连续 7 天评估体力活动，并将其分为移动活动和家务活动。通过 6 分钟步行距离（6MD）、手握力、10 米步行速度、睁眼单腿站立时间和 10 次坐立站起测试评估身体机能。使用匹兹堡睡眠质量指数（PSQI）和简易精神状态检查（MMSE）评分分别评估睡眠质量和认知功能。
患者每天完成 5506.8±3743.6 步，PSQI 评分为 5.8±3.5 分，MMSE 评分为 28.4±1.7 分。睡眠潜伏期和 MMSE 评分与移动活动相关，但与家务活动无关。移动活动和 6MD 是睡眠潜伏期和 MMSE 评分的独立预测因子。排除心力衰竭患者后，睡眠潜伏期与移动活动之间的关系仍然存在，但运动耐量与认知功能之间的关系消失了。
在继续进行 III 期 CR 的老年 CVD 患者中，移动活动和运动耐量与睡眠潜伏期和认知功能相关。然而，在本研究中，运动耐量与认知功能之间的关系因心力衰竭的存在而被抵消。
