Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden.
Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK.
BMC Med. 2020 Dec 7;18(1):382. doi: 10.1186/s12916-020-01846-w.
Sleep disturbances are prevalent among older adults and are associated with various individual diseases. The aim of this study was to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults.
Data were gathered from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study of subjects aged 60+ (N = 3363). The study included a subsample (n = 1189) without multimorbidity at baseline (< 2 chronic diseases). Baseline sleep disturbances were derived from the Comprehensive Psychiatric Rating Scale and categorized as none, mild, and moderate-severe. The number of chronic conditions throughout the 9-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic disease accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. We repeated the analyses including only cardiovascular, neuropsychiatric, or musculoskeletal diseases as the outcome.
Moderate-severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year = 0.142, p = 0.008), regardless of potential confounders. Significant positive associations were also found between moderate-severe sleep disturbances and neuropsychiatric (ß/year = 0.041, p = 0.016) and musculoskeletal (ß/year = 0.038, p = 0.025) disease accumulation, but not with cardiovascular diseases. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded.
The finding that sleep disturbances are associated with faster chronic disease accumulation points towards the importance of early detection and treatment of sleep disturbances as a possible strategy to reduce chronic multimorbidity among older adults.
睡眠障碍在老年人中很常见，与各种个体疾病有关。本研究旨在调查睡眠障碍是否与老年人多种疾病发展速度有关。
数据来自瑞典 Kungsholmen 老龄化和护理全国研究（SNAC-K），这是一项针对 60 岁以上人群的正在进行的基于人群的研究（N=3363）。该研究包括一个基线时无多种疾病（<2 种慢性疾病）的亚样本（n=1189）。基线睡眠障碍由综合精神病评定量表得出，并分为无、轻度和中重度。9 年随访期间的慢性疾病数量通过临床检查获得。使用线性混合模型研究睡眠障碍与慢性疾病积累速度之间的关系，调整性别、年龄、教育、身体活动、吸烟、饮酒、抑郁、疼痛和精神药物使用等因素。我们重复了仅包括心血管、神经精神或肌肉骨骼疾病作为结果的分析。
中重度睡眠障碍与慢性疾病积累速度较快有关（ß/年=0.142，p=0.008），与潜在混杂因素无关。中重度睡眠障碍与神经精神疾病（ß/年=0.041，p=0.016）和肌肉骨骼疾病（ß/年=0.038，p=0.025）的积累也存在显著正相关，但与心血管疾病无关。当排除基线时有痴呆、认知障碍或抑郁的参与者时，结果仍然稳定。
睡眠障碍与慢性疾病积累速度较快有关，这表明早期发现和治疗睡眠障碍可能是减少老年人慢性多种疾病的一种策略。
