Division of Pulmonary and Critical Care Medicine, Department of Medicine (DVL), Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Neurology (MNW), Johns Hopkins University School of Medicine, Baltimore, MD.
Am J Geriatr Psychiatry. 2019 Dec;27(12):1386-1396. doi: 10.1016/j.jagp.2019.07.001. Epub 2019 Jul 4.
Excessive and insufficient sleep have been associated with cognitive dysfunction in older adults in U.S. and non-U.S.
However, the U.S. studies were not in nationally representative samples. The authors investigated the association between sleep duration and cognitive performance in a nationally representative sample of U.S. older adults.
The authors studied 1,496 survey participants aged 60 years or older from the National Health and Nutrition Examination Survey 2013-2014 dataset.
Our primary predictor was weekday (or workday) nighttime sleep duration, categorized as 2-4, 5, 6, 7 (reference), 8, 9, and 10 hours or more. The authors studied five cognitive outcomes: Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL) immediate recall, CERAD-WL delayed recall, Animal Fluency Test (AFT), Digital Symbol Substitution Test (DSST), and subjective cognitive problems (SCP).
After adjusting for age, sex, race, education, depressive symptoms, and sedative-hypnotic use, sleep duration of 10 hours or more was significantly associated with lower scores on CERAD-WL immediate recall, CERAD-WL delayed recall, AFT, and DSST, and greater odds of SCP; sleep duration of 8 hours or more was associated with lower CERAD-WL delayed recall scores: 8, 9, and 10 hours or more. After adjustment, there were no significant associations of shorter sleep duration with cognition.
In U.S. adults aged 60 years or older, long nighttime weekday or workday sleep duration is associated with poorer verbal memory, semantic fluency, working memory, and processing speed in addition to greater odds of self-reported cognitive problems. Long sleep duration may be a marker of fragmented sleep or neurodegeneration in U.S. older adults.
在美国和非美国的老年人中，过多和过少的睡眠都与认知功能障碍有关。
然而，美国的研究样本并非具有全国代表性。作者研究了具有全国代表性的美国老年人样本中，睡眠持续时间与认知表现之间的关系。
作者研究了来自 2013-2014 年全国健康和营养调查的 1496 名年龄在 60 岁或以上的调查参与者。
我们的主要预测指标是工作日（或工作日）夜间睡眠时间，分为 2-4、5、6、7 小时（参考）、8、9 和 10 小时或更多。作者研究了五种认知结果：阿尔茨海默病协会注册研究单词学习（CERAD-WL）即时回忆、CERAD-WL 延迟回忆、动物流畅性测试（AFT）、数字符号替代测试（DSST）和主观认知问题（SCP）。
在调整年龄、性别、种族、教育、抑郁症状和镇静催眠药物使用后，睡眠时间为 10 小时或更长时间与 CERAD-WL 即时回忆、CERAD-WL 延迟回忆、AFT 和 DSST 得分较低以及 SCP 的可能性增加显著相关；睡眠时间为 8 小时或更长时间与 CERAD-WL 延迟回忆得分较低相关：8、9 和 10 小时或更长时间。调整后，较短的睡眠时间与认知功能没有显著关联。
在美国 60 岁或以上的成年人中，夜间工作日或工作日的长时间睡眠与言语记忆、语义流畅性、工作记忆和处理速度较差以及自我报告的认知问题的可能性增加有关。在美国老年人中，长时间的睡眠可能是睡眠碎片化或神经退行性变的标志。
