Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania.
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):520-527. doi: 10.1093/gerona/glaa120.
Excessive daytime sleepiness is associated with chronic disorders of aging and mortality. Because longitudinal data are limited on the development of sleep disturbances and cognitive changes in older adults, we investigated the demographic, clinical, and cognitive predictors of self-reported daytime sleepiness over a period of 10 years.
We jointly modeled latent trajectories over time of sleepiness, cognitive domains, and informative attrition and then fit models to identify cognitive trajectories and baseline characteristics that predicted the trajectories of sleepiness.
Three latent trajectory groups were identified: emerging sleepiness, persistent sleepiness, and consistently low daytime sleepiness accounting for attrition in all groups. Compared with low sleepiness, emerging sleepiness was significantly associated with declining attention and subjective memory complaints; persistent sleepiness was associated with lower baseline scores in all cognitive domains, declining language trajectory, and more subjective memory complaints.
These findings suggest that persistent sleepiness and emerging daytime sleepiness are associated with cognitive decline and multiple morbidities, albeit more subtly in emerging daytime sleepiness. Furthermore, these data suggest that change in the cognitive domain of attention and subjective memory complaints may be early indicators of future sleep disturbance.
日间嗜睡与衰老和死亡的慢性疾病有关。由于关于老年人睡眠障碍和认知变化的纵向数据有限，我们研究了在 10 年期间自我报告日间嗜睡的人口统计学、临床和认知预测因素。
我们联合建模了随时间变化的嗜睡、认知领域和信息性失访的潜在轨迹，然后拟合模型以确定认知轨迹和基线特征，这些特征预测了嗜睡轨迹。
确定了三个潜在的轨迹组：出现的嗜睡、持续的嗜睡和持续的低日间嗜睡，这些组的所有人群都存在失访。与低嗜睡相比，出现的嗜睡与注意力下降和主观记忆主诉显著相关；持续的嗜睡与所有认知领域的基线得分较低、语言轨迹下降以及更多的主观记忆主诉相关。
这些发现表明，持续的嗜睡和出现的日间嗜睡与认知能力下降和多种疾病有关，尽管在出现的日间嗜睡中更为微妙。此外，这些数据表明，注意力和主观记忆主诉的认知领域的变化可能是未来睡眠障碍的早期指标。
