Yang Pei-Lin, Chaytor Naomi S, Burr Robert L, Kapur Vishesh K, McCurry Susan M, Vitiello Michael V, Hough Catherine L, Parsons Elizabeth C
School of Nursing, 106177National Defense Medical Center, Taipei, Taiwan.
Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, 6760Washington State University, Spokane, WA, USA.
Biol Res Nurs. 2023 Jan;25(1):5-13. doi: 10.1177/10998004221109925. Epub 2022 Jun 27.
: Survivors of acute respiratory failure (ARF) experience long-term cognitive impairment and circadian rhythm disturbance after hospital discharge. Although prior studies in aging and neurodegenerative diseases indicate actigraphy-estimated rest-activity circadian rhythm disturbances are risk factors for cognitive impairment, it is unclear if this applies to ARF survivors. This study explored the relationships of actigraphy-estimated rest-activity circadian rhythms with cognitive functioning in ARF survivors at 3 months after discharge. : 13 ARF survivors (mean age 51 years and 69% males) completed actigraphy and sleep diaries for 9 days, followed by at-home neuropsychological assessment. Principal component factor analysis created global cognition and circadian rhythm variables, and these first components were used to examine the global relationships between circadian rhythm and cognitive measure scores. : Global circadian function was associated with global cognition function in ARF survivors ( = .70, = .024) after adjusting for age, education, and premorbid cognition. Also, greater fragmented rest-activity circadian rhythm (estimated by intradaily variability, = .85, = .002), and weaker circadian strength (estimated by amplitude, = .66, = .039; relative strength, = .70, = .024; 24-h lag serial autocorrelation, = .67, = .035), were associated with global cognition and individual cognitive tests. : These results suggest circadian rhythm disturbance is associated with poorer global cognition in ARF survivors. Future prospective research with larger samples is needed to confirm these results and increase understanding of the relationship between disrupted circadian rhythms and cognitive impairment among ARF survivors.
急性呼吸衰竭（ARF）幸存者在出院后会经历长期的认知障碍和昼夜节律紊乱。尽管先前关于衰老和神经退行性疾病的研究表明，通过活动记录仪估计的静息 - 活动昼夜节律紊乱是认知障碍的危险因素，但尚不清楚这是否适用于ARF幸存者。本研究探讨了出院3个月时，通过活动记录仪估计的ARF幸存者静息 - 活动昼夜节律与认知功能之间的关系。13名ARF幸存者（平均年龄51岁，69%为男性）完成了为期9天的活动记录仪监测和睡眠日记，随后进行了家庭神经心理学评估。主成分因子分析创建了整体认知和昼夜节律变量，这些第一成分用于检验昼夜节律与认知测量分数之间的整体关系。在调整年龄、教育程度和病前认知后，ARF幸存者的整体昼夜节律功能与整体认知功能相关（r = 0.70，p = 0.024）。此外，更碎片化的静息 - 活动昼夜节律（通过日内变异性估计，r = 0.85，p = 0.002），以及较弱的昼夜节律强度（通过振幅估计，r = 0.66，p = 0.039；相对强度，r = 0.70，p = 0.024；24小时滞后序列自相关，r = 0.67，p = 0.035），与整体认知和个体认知测试相关。这些结果表明，昼夜节律紊乱与ARF幸存者较差的整体认知相关。未来需要更大样本的前瞻性研究来证实这些结果，并增进对ARF幸存者昼夜节律紊乱与认知障碍之间关系的理解。
