The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom.
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France.
J Affect Disord. 2021 Aug 1;291:57-64. doi: 10.1016/j.jad.2021.04.076. Epub 2021 May 2.
Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association.
Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations.
The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association.
Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail.
焦虑可能是轻度认知障碍（MCI）的一个风险因素，但关于这种关联的证据有限，特别是来自中低收入国家（LMIC）的证据。因此，我们调查了居住在六个 LMIC（中国、加纳、印度、墨西哥、俄罗斯、南非）的老年人中焦虑与 MCI 之间的关联，以及睡眠问题在这种关联中的中介作用。
分析了世界卫生组织全球老龄化和成人健康研究（SAGE）的横断面、基于社区、具有全国代表性的数据。MCI 的定义基于美国国家老龄化研究所-阿尔茨海默病协会的标准。采用多变量逻辑回归分析、荟萃分析和中介分析来评估关联。
最终样本包括 32715 名年龄≥50 岁且功能能力完好的个体[平均（标准差）年龄 62.1（15.6）岁；48.3%为男性]。各国的分析结果显示，焦虑与所有国家的 MCI 之间存在正相关（OR 1.35-14.33）。基于随机效应荟萃分析的汇总估计值为 OR=2.27（95%CI=1.35-3.83）。睡眠问题解释了这种关联的 41.1%。
在 LMIC 中，患有焦虑症的老年人发生 MCI 的可能性更高。未来的研究应检验在 LMIC 中，预防焦虑或解决 MCI 患者的焦虑是否可以降低痴呆发病的风险，同时应详细研究睡眠问题在这种关联中的作用。
