Mei Xi, Zhao Zheng, Qiu Zhengfa, Wang Juan, Yu Haihang, Zheng Chengying
Department of Psychiatry, Ningbo Kangning Hospital and Affiliated Mental Health Centre, Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, Ningbo University, Ningbo, Zhejiang, China.
Front Aging Neurosci. 2023 Aug 9;15:1189837. doi: 10.3389/fnagi.2023.1189837. eCollection 2023.
To investigate correlation between cognitive function, age, and sleep disturbances.
This retrospective clinical study enrolled 78 patients with sleep disorders who were divided into three groups: a group of 24 patients with sleep disorders accompanied by cognitive decline (SD-CD); 54 patients with sleep disorders and no cognitive decline (SD-nCD) was divided into two groups, one of 30 patients aged between 60 and 70 years and another of 24 patients aged >70 years. Polysomnography was used to record patients' sleep indicators throughout night; these included total sleep duration, sleep efficiency (SE), sleep latency, sleep structure and percentage of N1, N2, and N3 stages, rapid eye movement (REM) stage, as well as apnea hypopnea index (AHI), and oxygen saturation (OS). Analysis of variance (ANOVA) for continuous variables and chi-square test for categorical variables were used to analyze variables between different groups. Pearson's correlation was used to analyze correlation between sleep parameters and mini-mental state examination (MMSE). Blood samples were used to determine their Aβ, Aβ, Aβ, total tau, phosphorylated tau protein (ptau), ptau, ptau, the inflammatory factor IL-1β, vitamin B12 (VB12), and melatonin levels.
In the SD-CD group, there was a significant decrease in SE and an increase in N1 stage sleep in older patients and a significant increase in AHI, REM stage AHI, and non-REM stage AHI. In patients with SD-nCD, the minimum OS, minimum OS in the REM period, and minimum OS in the non-REM period were significantly reduced. OS was significantly correlated with cognitive level, as evaluated by the MMSE. The addition of sleep parameters can significantly improve the accuracy of dementia diagnosis. Dementia biomarkers of Aβ and tau proteins in blood showed cognition-related differences, while ptau181 was associated with both cognition and age-related differences. Regression models revealed that age was related to higher levels of cognitive decline before (β = -0.43, < 0.001) and after (β = -0.38, < 0.001) adjustment of gender, BMI, and education level. There was a significant mediation effect of relationship between aging and cognitive function by sleep efficiency and N1 stage sleep.
Sleep disorders and low OS are associated with a higher incidence of cognitive decline and dementia.
探讨认知功能、年龄与睡眠障碍之间的相关性。
这项回顾性临床研究纳入了78例睡眠障碍患者，将其分为三组：24例伴有认知功能下降的睡眠障碍患者（SD-CD组）；54例无认知功能下降的睡眠障碍患者（SD-nCD组）被分为两组，一组为30例年龄在60至70岁之间的患者，另一组为24例年龄>70岁的患者。采用多导睡眠图记录患者整夜的睡眠指标；这些指标包括总睡眠时间、睡眠效率（SE）、睡眠潜伏期、睡眠结构以及N1、N2和N3期、快速眼动（REM）期的百分比，以及呼吸暂停低通气指数（AHI）和血氧饱和度（OS）。对连续变量采用方差分析（ANOVA），对分类变量采用卡方检验分析不同组间的变量。采用Pearson相关性分析睡眠参数与简易精神状态检查表（MMSE）之间的相关性。采集血样测定其Aβ、Aβ、Aβ、总tau蛋白、磷酸化tau蛋白（ptau）、ptau、ptau、炎症因子IL-1β、维生素B12（VB12）和褪黑素水平。
在SD-CD组中，老年患者的SE显著降低，N1期睡眠增加，AHI、REM期AHI和非REM期AHI显著增加。在SD-nCD组患者中，最低OS、REM期最低OS和非REM期最低OS显著降低。OS与MMSE评估的认知水平显著相关。增加睡眠参数可显著提高痴呆诊断的准确性。血液中Aβ和tau蛋白的痴呆生物标志物显示出与认知相关的差异，而ptau181与认知和年龄相关差异均有关。回归模型显示，在调整性别、BMI和教育水平之前（β = -0.43，<0.001）和之后（β = -0.38，<0.001），年龄与较高水平的认知功能下降有关。睡眠效率和N1期睡眠在衰老与认知功能之间的关系中存在显著的中介作用。
睡眠障碍和低OS与认知功能下降和痴呆的较高发病率相关。
