Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China.
Int J Clin Pract. 2021 Jul;75(7):e14225. doi: 10.1111/ijcp.14225. Epub 2021 Apr 27.
In this study, we conducted a cross-sectional analysis of the sleep characteristics in the elderly Chinese people to comprehensively investigate the association between sleep and cognitive function in the elderly people. We aimed to evaluate the most important demographic factors, conventional physiological indices and living habits that may influence sleep.
We surveyed 2901 elderly people (age ≥60 years old) face-to-face from 1 July to 31 December 2017, who were recruited from 17 communities of the Pudong New Area (Shanghai, China) by probability proportional to size. The Pittsburgh sleep quality index (PSQI) scale was used to describe the sleep features of each participant. Cognitive assessment was performed using the mini-mental state examination (MMSE) scale, Montreal cognitive assessment (MoCA) and the clinical dementia rating (CDR) scale. Those factors which potentially influence sleep and consequentially may impact cognition in the elderly people were evaluated, and the correlations of sleep characteristics and cognitive function were explored by the linear regression analysis.
Altogether, there were 1287 (44.4%) people taking part in the investigation. Sleep quality was significantly correlated with MMSE and MoCA total scores. Healthy sleep (especially enough sleep) was correlated with better cognitive functions. Besides recognised relative factors (such as age, sex and living alone), the number of children was found to be a strong risk factor of poor sleep. Anxiety before sleep and light/noise interference significantly damaged sleep while an exercise routine was associated with better sleep. Moderate levels of reading, watching TV and household work were correlated with superior sleep quality.
In conclusion, sleep characteristics correlate with cognitive decline in the elderly people, and they can be influenced by multiple demographic factors and living habits. To improve sleep quality, it may be important to change sleep environment, to be relax, to increase physical exercise and recreational activities moderately.
本研究通过对中国老年人睡眠特征进行横断面分析,全面探讨老年人睡眠与认知功能的关系。我们旨在评估可能影响睡眠的最重要的人口统计学因素、常规生理指标和生活习惯。
我们于 2017 年 7 月 1 日至 12 月 31 日期间,采用概率比例大小抽样法,从上海市浦东新区的 17 个社区中面对面调查了 2901 名老年人(年龄≥60 岁)。使用匹兹堡睡眠质量指数(PSQI)量表描述每位参与者的睡眠特征。使用简易精神状态检查(MMSE)量表、蒙特利尔认知评估(MoCA)量表和临床痴呆评定量表(CDR)量表进行认知评估。评估了那些可能影响老年人睡眠进而影响认知的因素,并通过线性回归分析探讨了睡眠特征与认知功能的相关性。
共有 1287 人(44.4%)参与了调查。睡眠质量与 MMSE 和 MoCA 总分显著相关。健康的睡眠(尤其是充足的睡眠)与更好的认知功能相关。除了公认的相关因素(如年龄、性别和独居)外,孩子的数量被发现是睡眠质量差的一个强烈危险因素。睡前焦虑和光照/噪音干扰显著影响睡眠,而有规律的运动则与更好的睡眠相关。适度的阅读、看电视和家务劳动与较好的睡眠质量相关。
总之,睡眠特征与老年人认知能力下降相关,且受多种人口统计学因素和生活习惯影响。为了改善睡眠质量,改变睡眠环境、放松身心、适度增加体育锻炼和娱乐活动可能很重要。