Division of Experimental Medicine, McGill University, Montréal, Québec, Canada.
Montréal Neurological Institute-Hospital, McGill University Health Centre, McGill University, Montréal, Québec, Canada.
Sleep Med. 2023 Mar;103:41-50. doi: 10.1016/j.sleep.2023.01.023. Epub 2023 Jan 31.
Sleep disturbances are increasingly recognized as adversely affecting brain health in aging. Our aim was to investigate interrelations between subjective sleep-related symptoms, obesity, cardiometabolic disorders, brain structure and cognitive decline in a population-based aging sample.
Data were extracted from the UK Biobank for anthropometric and demographic information, self-reported sleep behaviours, cardiometabolic measures, structural brain magnetic resonance imaging and cognitive test scores. "Sleep-related symptoms" (SRS) were measured using four questionnaire items: loud snoring, daytime sleepiness, likelihood to nap and difficulty getting up in the morning. Associations were tested using a structural equation model (SEM), adjusted for confounders. Further, multiple regression analysis was used to test for direct relationships between SRS and specific cognitive domains.
Among 36,468 participants with an average age of 63.6 (SD 7.5) years and 46.7% male, we found that SRS were associated with obesity and several pre-existing cardiometabolic disturbances. In turn, cardiometabolic disorders were associated with increased white matter hyperintensities and cortical thinning, which were related to cognitive dysfunction. SRS were also directly related to several structural brain changes and to cognitive dysfunction. Regression analyses showed that SRS were directly associated with slower reaction times, and lower scores in fluid intelligence, working memory and executive function.
Self-reported sleep-related symptoms were associated with cognitive dysfunction directly and through pre-existing cardiometabolic disorders and brain structural alterations. These findings provide evidence that symptoms of sleep disturbances, here defined primarily by hypersomnolence and snoring, are important risk factors or markers for cognitive dysfunction in an aging population.
睡眠障碍越来越被认为会对衰老过程中的大脑健康产生不利影响。我们的目的是在一个基于人群的老龄化样本中研究主观睡眠相关症状、肥胖、心脏代谢紊乱、大脑结构和认知能力下降之间的相互关系。
从英国生物银行提取数据，以获取人体测量和人口统计学信息、自我报告的睡眠行为、心脏代谢测量、结构磁共振成像和认知测试分数。使用四个问卷项目来测量“睡眠相关症状”（SRS）：打鼾、白天嗜睡、午睡倾向和早上起床困难。使用结构方程模型（SEM）进行调整混杂因素后的关联检验。此外，还使用多元回归分析来测试 SRS 与特定认知领域之间的直接关系。
在平均年龄为 63.6 岁（标准差 7.5 岁）、46.7%为男性的 36468 名参与者中，我们发现 SRS 与肥胖和几种现有的心脏代谢紊乱有关。反过来，心脏代谢紊乱与白质高信号增加和皮质变薄有关，这与认知功能障碍有关。SRS 也与几种大脑结构变化和认知功能障碍直接相关。回归分析表明，SRS 与反应时间较慢、流体智力、工作记忆和执行功能的分数较低直接相关。
自我报告的睡眠相关症状与认知功能障碍直接相关，也与现有的心脏代谢紊乱和大脑结构改变有关。这些发现为睡眠障碍症状（这里主要定义为嗜睡和打鼾）是老龄化人群认知功能障碍的重要危险因素或标志物提供了证据。
