Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
School of Global Public Health, New York University, New York, NY, USA.
Sleep Med. 2021 Mar;79:183-189. doi: 10.1016/j.sleep.2020.11.004. Epub 2020 Nov 11.
Sleep difficulties are common among older adults, and clinical management of sleep difficulties commonly includes sleep medication (pharmacological and non-pharmacological). Our research examines sleep medication use and incident dementia over 8 years using nationally representative data from older adults ages 65 years and older in the United States.
We used data collected from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of Medicare beneficiaries. Routine sleep medication use (pharmacological and non-pharmacological) was defined as use "most nights" or "every night." Participants were screened for dementia with validated instruments that assessed memory, orientation, and executive function. We conduct prospective analyses to examine the relationship between routine sleep medication use and incident dementia using Cox proportional hazards modeling and estimated survival curves. Analyses controlled for age, sex, marital status, education, and chronic conditions.
Among respondents at baseline (n = 6373), most participants (21%) were age 70-74 years of age. Participants were 59% female and the sample comprised non-Hispanic White (71%). At baseline, 15% of our study sample reported using sleep medication routinely, which is representative of 4.6 million older adults in the US. Covariate adjusted proportional hazard models revealed that routinely using sleep medication was associated with incident dementia (HR = 1.30, 95%CI: 1.10 to 1.53, p < 0.01).
Our study observed, in a nationally representative study of older adults in the US across 8 years of data that 15% of older adults report routinely using sleep medication, yet routine use of sleeping medication was associated with incident dementia across the follow-up interval. Future research may examine behavioral approaches to improving sleep among older adults.
睡眠困难在老年人中很常见，睡眠困难的临床管理通常包括使用睡眠药物（包括药物和非药物治疗）。我们的研究使用来自美国 65 岁及以上老年人的全国代表性数据，在 8 年的时间里，研究了睡眠药物的使用与痴呆症的发病情况。
我们使用了国家健康老龄化趋势研究（NHATS）的数据，这是一项针对医疗保险受益人的全国代表性纵向研究。常规使用睡眠药物（药物和非药物治疗）被定义为“大多数晚上”或“每天晚上”使用。使用经过验证的评估记忆、定向和执行功能的工具对参与者进行痴呆筛查。我们使用 Cox 比例风险模型和估计的生存曲线进行前瞻性分析，以检查常规使用睡眠药物与痴呆症发病之间的关系。分析控制了年龄、性别、婚姻状况、教育程度和慢性疾病等因素。
在基线时（n=6373），大多数参与者（21%）年龄在 70-74 岁之间。参与者中 59%为女性，样本由非西班牙裔白人（71%）组成。在基线时，我们研究样本中有 15%的人常规使用睡眠药物，这代表了美国 460 万老年人。调整协变量的比例风险模型显示，常规使用睡眠药物与痴呆症发病有关（HR=1.30，95%CI：1.10 至 1.53，p<0.01）。
我们的研究观察到，在美国一项针对全国代表性的老年人的研究中，有 15%的老年人报告常规使用睡眠药物，但在整个随访期间，常规使用睡眠药物与痴呆症发病有关。未来的研究可能会研究改善老年人睡眠的行为方法。
