Institute for Neurosciences of Montpellier INM, Montpellier University, INSERM, Montpellier, France.
RUSH Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac186.
given the complex relationship between sleep and neurodegenerative processes, it is important to examine whether changes in sleep patterns occur prior or close to dementia onset.
to examine the relationship between sleep parameters and dementia incidence and, to characterize trajectories of sleep patterns before dementia diagnosis.
a 14-year longitudinal study including a nested case-control study.
the French Three-City Study.
overall, 1,749 cognitively healthy participants (≥65 years) for the longitudinal study and, 182 incident dementia cases and 719 controls matched by sex, age and educational level for the case-control study.
dementia cases were assessed at each visit and self-reported sleep parameters at baseline, 2, 8, 10, 12 and 14 years. Cox models were used to estimate the risk of dementia associated with baseline sleep parameters (sleep duration, time in bed (TIB), sleep timing, sleepiness and insomnia). Latent-process mixed models were performed to compare sleep trajectories according to the case-control status.
long baseline nighttime and 24-h sleep durations (≥9 h) as well as being persistent or becoming long sleepers during follow-up were associated with dementia incidence. Trajectories of sleep durations and TIB showed faster increases in cases compared with controls up to 12 years before dementia. The mean differences [95%CI] for 24-h sleep duration between cases and controls were: 0.27 h [0.01;0.52], 0.34 [0.09;0.58] and 0.67 [0.44;0.90] at -12, -8 and -2 years, respectively. Bedtime trajectories showed an earlier bedtime in cases up to -8 years.
long sleep duration and earlier bedtime may impact dementia incidence.
鉴于睡眠与神经退行性过程之间的复杂关系，重要的是要检查睡眠模式的变化是否发生在痴呆症发病之前或接近发病之时。
研究睡眠参数与痴呆症发病的关系，并描述痴呆症诊断前的睡眠模式轨迹。
一项为期 14 年的纵向研究，包括嵌套病例对照研究。
法国三城研究。
共有 1749 名认知健康的参与者（≥65 岁）参加了纵向研究，182 例新发痴呆病例和 719 名按性别、年龄和教育程度匹配的对照病例参加了病例对照研究。
在每次就诊时评估痴呆病例，并在基线、2、8、10、12 和 14 年时报告睡眠参数。使用 Cox 模型估计基线睡眠参数（睡眠时间、卧床时间（TIB）、睡眠时间、嗜睡和失眠）与痴呆风险的相关性。进行潜在过程混合模型比较病例对照状态下的睡眠轨迹。
基线夜间和 24 小时睡眠时间较长（≥9 小时）以及随访期间持续或成为长睡眠者与痴呆症发病有关。与对照组相比，病例的睡眠持续时间和 TIB 轨迹在痴呆症发生前 12 年就显示出更快的增长。病例与对照组之间 24 小时睡眠时间的平均差异 [95%CI] 分别为：-12 年时为 0.27 小时 [0.01；0.52]，-8 年时为 0.34 小时 [0.09；0.58]，-2 年时为 0.67 小时 [0.44；0.90]。睡眠时间轨迹显示病例的入睡时间较早，最早可至 -8 年。
较长的睡眠时间和较早的就寝时间可能会影响痴呆症的发病。
