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在美国,研究了 5 年内老年人的睡眠不足和睡眠障碍及其对痴呆症和全因死亡率的影响。

Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States.

机构信息

Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA.

Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA.

出版信息

Aging (Albany NY). 2021 Feb 11;13(3):3254-3268. doi: 10.18632/aging.202591.

Abstract

BACKGROUND

Sleep disturbance and deficiency are common among older adults and have been linked with dementia and all-cause mortality. Using nationally representative data, we examine the relationship between sleep disturbance and deficiency and their risk for incident dementia and all-cause mortality among older adults.

METHODS

The National Health and Aging Trends Study (NHATS) is a nationally-representative longitudinal study of Medicare beneficiaries in the US age 65 and older. Surveys that assessed sleep disturbance and duration were administered at baseline. We examined the relationship between sleep disturbance and deficiency and incident dementia and all-cause mortality over the following 5 years using Cox proportional hazards modeling, controlling for confounders.

RESULTS

Among the sample (n = 2,812), very short sleep duration (≤5 hours: HR = 2.04, 95% CI: 1.26 - 3.33) and sleep latency (>30 minutes: HR = 1.45, 95% CI: 1.03 - 2.03) were associated with incident dementia in adjusted Cox models. Difficulty maintaining alertness ("Some Days": HR = 1.49, 95% CI: 1.13 - 1.94 and "Most/Every Day": HR = 1.65, 95% CI: 1.17 - 2.32), napping ("Some days": HR = 1.38, 95% CI: 1.03 - 1.85; "Most/Every Day": HR = 1.73, 95% CI: 1.29 - 2.32), sleep quality ("Poor/Very Poor": HR = 1.75, 95% CI: 1.17 - 2.61), and very short sleep duration (≤5 hours: HR = 2.38, 95% CI: 1.44 - 3.92) were associated with all-cause mortality in adjusted Cox models.

CONCLUSIONS

Addressing sleep disturbance and deficiency may have a positive impact on risk for incident dementia and all-cause mortality among older adults.

摘要

背景

睡眠障碍和不足在老年人中很常见,与痴呆症和全因死亡率有关。使用全国代表性数据,我们研究了睡眠障碍和不足与老年人发生痴呆症和全因死亡率的关系。

方法

国家健康老龄化趋势研究(NHATS)是一项对美国 65 岁及以上的医疗保险受益人的全国代表性纵向研究。在基线时进行了评估睡眠障碍和持续时间的调查。我们使用 Cox 比例风险模型,在控制混杂因素的情况下,在接下来的 5 年内检查睡眠障碍和不足与新发痴呆症和全因死亡率之间的关系。

结果

在样本(n=2812)中,睡眠持续时间非常短(≤5 小时:HR=2.04,95%CI:1.26-3.33)和入睡潜伏期(>30 分钟:HR=1.45,95%CI:1.03-2.03)与调整后的 Cox 模型中的新发痴呆症相关。难以保持警觉(“有些日子”:HR=1.49,95%CI:1.13-1.94 和“大多数/每天”:HR=1.65,95%CI:1.17-2.32)、小睡(“有些日子”:HR=1.38,95%CI:1.03-1.85;“大多数/每天”:HR=1.73,95%CI:1.29-2.32)、睡眠质量(“差/非常差”:HR=1.75,95%CI:1.17-2.61)和睡眠持续时间非常短(≤5 小时:HR=2.38,95%CI:1.44-3.92)与调整后的 Cox 模型中的全因死亡率相关。

结论

解决睡眠障碍和不足问题可能对老年人新发痴呆症和全因死亡率的风险产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7e9/7906211/dc71e84d9950/aging-13-202591-g001.jpg

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