Department of Psychiatry, University of Crete, University Hospital of Heraklion, Heraklion, Crete, Greece.
Institute of Computer Science, Foundation of Research and Technology, Heraklion, Crete, Greece.
J Sleep Res. 2019 Dec;28(6):e12864. doi: 10.1111/jsr.12864. Epub 2019 Apr 21.
The prevalence of mild cognitive impairment (MCI) increases among elderly people and is associated with a high risk of dementia. Identifying factors that may contribute to the progress of MCI to dementia is critical. The objective of this study was to examine the association of objective sleep with cognitive performance in MCI patients. A subsample of 271 participants with a diagnosis of probable Alzheimer's disease (AD; N = 50) or mild cognitive impairment (MCI; N = 121) and 100 persons who were not cognitively impaired (NI) were recruited from a large population-based cohort in the island of Crete, Greece (3140 older adults aged >60 years). All participants underwent extensive neuropsychiatric/neuropsychological evaluation and a 3-day 24-hr actigraphy. Objective sleep variables and their association with neuropsychological performance were examined across the three groups, controlling for demographics, body mass index, depression, sleep apnea symptoms and psychotropic medications. Patients with AD had significantly longer 24-hr total sleep time (TST) compared to the MCI and NI groups. Long 24-hr TST was associated with reduced performance on tasks that placed significant demands on attention and processing speed in the MCI group and the AD group. Elderly patients with MCI have similar objective sleep duration to normal controls, whereas AD patients sleep longer. Long sleep duration in patients with multidomain subtypes of MCI is associated with critical non-memory cognitive domains. It appears that within the MCI group those that sleep longer have more severe cognitive impairment.
轻度认知障碍 (MCI) 在老年人中的患病率增加，并且与痴呆的高风险相关。确定可能导致 MCI 向痴呆进展的因素至关重要。本研究旨在探讨客观睡眠与 MCI 患者认知表现的关系。从希腊克里特岛一个大型基于人群的队列中招募了一个亚组，包括 271 名被诊断为可能的阿尔茨海默病 (AD; N = 50) 或轻度认知障碍 (MCI; N = 121) 和 100 名认知未受损的人 (NI)。所有参与者都接受了广泛的神经精神病学/神经心理学评估和为期 3 天的 24 小时活动记录仪监测。在控制人口统计学、体重指数、抑郁、睡眠呼吸暂停症状和精神药物的情况下，检查了三组参与者的客观睡眠变量及其与神经心理学表现的关系。与 MCI 和 NI 组相比，AD 患者的 24 小时总睡眠时间 (TST) 明显更长。在 MCI 组和 AD 组中，长 24 小时 TST 与对注意力和处理速度要求较高的任务表现下降有关。MCI 老年患者的客观睡眠时间与正常对照组相似，而 AD 患者睡眠时间更长。MCI 多领域亚型患者的长睡眠时间与关键的非记忆认知领域有关。似乎在 MCI 组中，睡眠时间较长的患者认知障碍更严重。
