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住院老年轻度痴呆患者的睡眠障碍呼吸及其与认知、情绪和活动能力的关系。

Sleep-Disordered Breathing in Hospitalized Geriatric Patients with Mild Dementia and Its Association with Cognition, Emotion and Mobility.

机构信息

Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.

Department of Nephrology, Geriatric and Internal Medicine, Alfried Krupp Hospital Ruettenscheid-Essen, Alfried-Krupp-Straße 21, 45131 Essen, Germany.

出版信息

Int J Environ Res Public Health. 2019 Mar 9;16(5):863. doi: 10.3390/ijerph16050863.

Abstract

Sleep-disordered breathing (SDB) is an emerging dementia risk factor. Data on the prevalence of SDB in dementia patients and its association with cognitive impairment is so far only based on patients with severe dementia. In 101 geriatric patients mostly with mild dementia recruited on German geriatric wards, SDB was assessed during overnight polygraphy in the patient room with a portable sleep apnea examination device and associations of SDB severity with severity of impairment in cognitive and emotional function as well as mobility were investigated. We also elucidated which factors influence compliance of SDB diagnostics. In 82 of the 101 dementia patients (81.2%), SDB could be assessed. Of those, only 12.2% had an apnea-hypopnea index (AHI) < 5/h demonstrating the absence of SDB. 40.2% exhibited 5/h ≤ AHI < 15/h representing mild SDB, and 47.6% revealed an AHI ≥ 15/h representing moderate/severe SDB. Patients in these three AHI categories did not significant differ from each other in demographical and clinical characteristics. Patients with an AHI ≥ 15/h particularly often presented with heart failure and vitamin D deficiency. We observed a low to moderate association between severity of SDB and severity of dementia. Tolerance of the nasal airflow sensor of at least 6 h was present in less than one third of all patients. The tolerant group exhibited more symptoms of depression and higher physical fitness compared to the non-tolerant group. We observed a high prevalence of SDB also in geriatric patients with mild dementia underlining the importance of SDB screening in the elderly.

摘要

睡眠障碍性呼吸(SDB)是一种新出现的痴呆风险因素。迄今为止,关于痴呆患者中 SDB 的患病率及其与认知障碍的相关性的数据仅基于严重痴呆患者。在德国老年病房招募的 101 名老年患者中,大多数患有轻度痴呆,在患者病房的多导睡眠图检查中使用便携式睡眠呼吸暂停检查仪评估 SDB,并研究 SDB 严重程度与认知和情感功能以及活动能力受损严重程度之间的相关性。我们还阐明了哪些因素会影响 SDB 诊断的依从性。在 101 名痴呆患者中有 82 名(81.2%)可以评估 SDB。其中,只有 12.2%的患者呼吸暂停低通气指数(AHI)<5/h,表明不存在 SDB。40.2%的患者显示 5/h≤AHI<15/h,代表轻度 SDB,47.6%的患者显示 AHI≥15/h,代表中度/重度 SDB。这三个 AHI 类别的患者在人口统计学和临床特征方面没有显著差异。AHI≥15/h 的患者尤其常伴有心力衰竭和维生素 D 缺乏症。我们观察到 SDB 严重程度与痴呆严重程度之间存在低到中度的相关性。所有患者中不到三分之一的患者能够耐受至少 6 小时的鼻气流传感器。耐受组比不耐受组表现出更多的抑郁症状和更高的身体适应性。我们在轻度痴呆的老年患者中也观察到了 SDB 的高患病率,这突显了在老年人中筛查 SDB 的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8fc/6427687/f55fbf14a4c4/ijerph-16-00863-g0A1.jpg

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