The Irish Longitudinal Study on Ageing, Trinity College Dublin, University of Dublin, Dublin, Ireland.
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.
Int J Geriatr Psychiatry. 2021 May;36(5):731-742. doi: 10.1002/gps.5473. Epub 2020 Nov 22.
Cognitive impairment is prevalent in older ages. Associations with sleep are well established; however, ambiguity remains in which sleep characteristics contribute to this impairment. We examined cross-sectional associations between both self-reported and actigraphy-based sleep and cognitive performance across a number of domains in community-dwelling older adults.
1520 participants aged 50 and older with self-reported and actigraphy-based total sleep time (TST) (≤5, 6, 7-8, 9 and ≥10 h) and self-reported sleep problems were analysed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), verbal fluency, immediate and delayed recall memory, colour trails tests, and choice reaction tests (CRT). Associations between sleep and cognition were modelled using linear and negative binomial regression.
Negative associations were found between ≥10 h of self-reported TST and MoCA error rate (incidence rate ratio [IRR] = 1.42; 95% confidence interval [CI] = 1.18, 1.71; p < 0.001); verbal fluency (beta [B] = -2.32 words; 95% CI = -4.00, -0.65; p < 0.01); and delayed recall (B = -0.91 words; 95% CI = -1.58, -0.25; p < 0.05) compared to 7-8 h. Significant associations with actigraphy-based TST were limited to MoCA error rate in ≤5 h (IRR = 1.22; 95% CI = 1.02, 1.45; p < 0.05) compared to 7-8 h. Higher numbers of sleep problems were associated with slower performance in CRT cognitive response time (IRR = 1.02; 95% CI = 1.00, 104; p < 0.05) and total response time (IRR = 1.02; 95% CI = 1.00, 1.04; p < 0.05).
Self-reported long sleep duration was consistently associated with worse cognitive performance across multiple domains. Marginal associations between cognition and both actigraphy-based sleep and self-reported sleep problems were also apparent. These results further affirm poor sleep as a risk factor for cognitive impairment.
认知障碍在老年人中很常见。睡眠与认知障碍之间存在关联已得到充分证实；然而，哪种睡眠特征会导致认知障碍仍然存在不确定性。我们研究了社区居住的老年人中，基于自我报告和活动记录仪的睡眠与多项认知领域表现之间的横断面关联。
对 1520 名年龄在 50 岁及以上、有自我报告和基于活动记录仪的总睡眠时间（TST）（≤5、6、7-8、9 和≥10 小时）和自我报告睡眠问题的参与者进行了分析。使用简易精神状态检查（MMSE）、蒙特利尔认知评估（MoCA）、词语流畅性、即刻和延迟回忆记忆、色线测试和选择反应测试（CRT）评估认知功能。使用线性和负二项式回归模型来分析睡眠与认知之间的关联。
与 7-8 小时相比，自我报告的 TST≥10 小时与 MoCA 错误率（发病率比 [IRR] = 1.42；95%置信区间 [CI] = 1.18，1.71；p < 0.001）；词语流畅性（B = -2.32 个单词；95%CI = -4.00，-0.65；p < 0.01）；以及延迟回忆（B = -0.91 个单词；95%CI = -1.58，-0.25；p < 0.05）存在负相关。与基于活动记录仪的 TST 相关的显著关联仅限于≤5 小时的 MoCA 错误率（IRR = 1.22；95%CI = 1.02，1.45；p < 0.05）与 7-8 小时相比。更多的睡眠问题与 CRT 认知反应时间（IRR = 1.02；95%CI = 1.00，104；p < 0.05）和总反应时间（IRR = 1.02；95%CI = 1.00，1.04；p < 0.05）的较慢表现相关。
自我报告的长时间睡眠与多项认知领域的较差认知表现始终相关。基于活动记录仪的睡眠和自我报告的睡眠问题与认知之间也存在边际关联。这些结果进一步证实了睡眠质量差是认知障碍的一个风险因素。
