Gan Jinghuan, Liu Shuai, Wang Fei, Shi Zhihong, Lü Yang, Niu Jianping, Meng Xinling, Cai Pan, Wang Xiao-Dan, Chen Zhichao, Gang Baozhi, Ji Yong
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China.
Front Hum Neurosci. 2022 Sep 14;16:976753. doi: 10.3389/fnhum.2022.976753. eCollection 2022.
Few studies are available on the prevalence and sleep-related factors of dementia with Lewy bodies (DLB) in Chinese older adults, aiming to explore the associations between sleep characteristics and DLB. A cross-sectional study with 7,528 individuals aged ≥65 years in 106 communities in Northern China was conducted from April 2019 to January 2020. Questionaries (including demographic characteristics, comorbidities, lifestyles, and sleep characteristics) were administered, and neuropsychological assessments and physical examination were conducted in phase I; screening for probable DLB was done in phase II. Logistic regressions were used to assess associations. A total of 919 (12.2%, 919/7,528) participants had dementia, and 101 (1.3%, 101/7,528) participants were diagnosed with DLB. The prevalence of dementia and DLB were slightly higher or equal in women, increased with age, and roughly decreased with nighttime sleep duration. Of the 101 participants, all of them (100.0%) had cognitive impairment, 46 (44.54%) displayed fluctuating cognition, 72 (71.29%) of them showed visual hallucination, 22 (21.78%) individuals reported RBD, and 27.71% showed Parkinsonism. Sleeping for <5 h (adjusted OR = 1.795, 95%CI: 1.055-3.054, < 0.05) or having hypersomnolence (adjusted OR = 31.213, 95% CI: 17.618-55.301, < 0.001) were significantly associated with the occurrence of DLB. Sleep duration of <5 h or >8 h had combined diagnostic value for DLB (AUC = 0.783, 95%CI: 0.734-0.831, < 0.001). The current prevalence of DLB is 1.3% in Northern China. Short or long nighttime sleep duration is independently associated with the occurrence of dementia and DLB.
关于中国老年人群中路易体痴呆(DLB)的患病率及睡眠相关因素的研究较少,本研究旨在探讨睡眠特征与DLB之间的关联。2019年4月至2020年1月,在中国北方106个社区对7528名年龄≥65岁的个体进行了一项横断面研究。进行问卷调查(包括人口统计学特征、合并症、生活方式和睡眠特征),并在第一阶段进行神经心理学评估和体格检查;在第二阶段进行可能的DLB筛查。采用逻辑回归评估关联。共有919名(12.2%,919/7528)参与者患有痴呆症,101名(1.3%,101/7528)参与者被诊断为DLB。痴呆症和DLB的患病率在女性中略高或相当,随年龄增长而增加,大致随夜间睡眠时间减少。在这101名参与者中,所有人(100.0%)都有认知障碍,46名(44.54%)表现出认知波动,72名(71.29%)有视幻觉,22名(21.78%)报告有快速眼动睡眠行为障碍,27.71%有帕金森综合征。睡眠时间<5小时(调整后OR = 1.795,95%CI:1.055 - 3.054,P<0.05)或嗜睡(调整后OR = 31.213,95%CI:17.618 - 55.301,P<0.001)与DLB的发生显著相关。睡眠时间<5小时或>8小时对DLB具有联合诊断价值(AUC = 0.783,95%CI:0.734 - 0.831,P<0.001)。中国北方目前DLB的患病率为1.3%。夜间睡眠时间过短或过长与痴呆症和DLB的发生独立相关。