Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA.
Sci Rep. 2022 Jul 8;12(1):11595. doi: 10.1038/s41598-022-15915-y.
Frail older adults are vulnerable to stressors; thus, sleep related cognition impairment might more greatly affect frail than healthy older adults. In the present study, we investigated whether the association between sleep problems and cognition varies with physical frailty status (modified from Fried et al.). Participants 55 years and older who completed a baseline and follow-up questionnaire (median follow-up: 5.5 years), were included in the analysis. Sleep parameters were evaluated in an interview at the baseline. Cognitive decline was defined as a loss of 3 or more points on the Mini-Mental State Examination (MMSE) at follow-up. Associations between sleep problems and cognitive decline were examined using logistic regression and were stratified by baseline physical frailty status, adjusted for potential confounders. A short total sleep duration (< 5 vs. 7-9 h, odds ratio (OR) = 1.88, 95% confidence interval (CI) 1.18-3.00), excessive daytime sleepiness (OR = 1.49, 95% CI 1.04-2.13), low sleep efficiency (< 65% vs. ≥ 85%, OR = 1.62, 95% CI 1.07-2.46), and insomnia complaints (OR = 2.34, 95% CI 1.23-4.43) were associated with MMSE decline in physically robust. The association was stronger for the sleep summary score, which summarized abnormal sleep duration, excessive daytime sleepiness, and insomnia complaints ([Formula: see text] 2 vs. 0, OR = 3.79, 95% CI 2.10-6.85, p < 0.0001). Due to the low prevalence of frailty in this community-dwelling population, the statistical power to detect an association was low. More evidence is needed to clarify the role of sleep in the progression of cognitive decline in frail individuals.
体弱的老年人易受压力影响；因此，与睡眠相关的认知障碍可能会对体弱的老年人产生更大的影响。在本研究中，我们调查了睡眠问题与认知之间的关联是否因身体虚弱状态而不同（改编自 Fried 等人）。分析纳入了完成基线和随访问卷（中位随访时间：5.5 年）且年龄在 55 岁及以上的参与者。在基线访谈中评估睡眠参数。认知衰退定义为随访时 Mini-Mental State Examination（MMSE）得分下降 3 分或以上。使用逻辑回归检查睡眠问题与认知衰退之间的关联，并按基线身体虚弱状态分层，调整潜在混杂因素。总睡眠时间较短（<5 小时与 7-9 小时相比，比值比（OR）=1.88，95%置信区间（CI）1.18-3.00）、白天嗜睡（OR=1.49，95%CI 1.04-2.13）、睡眠效率低（<65%与≥85%相比，OR=1.62，95%CI 1.07-2.46）和失眠投诉（OR=2.34，95%CI 1.23-4.43）与身体强壮者的 MMSE 下降相关。睡眠总结评分的关联更强，该评分总结了异常睡眠时间、白天嗜睡和失眠投诉（[Formula: see text]2 与 0 相比，OR=3.79，95%CI 2.10-6.85，p<0.0001）。由于该社区居住人群中体弱的比例较低，因此检测关联的统计效力较低。需要更多的证据来阐明睡眠在体弱个体认知衰退进展中的作用。
