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老年人脑小血管病患者淡漠与静息活动节律非参数变量的关系。

The relationship between apathy and nonparametric variables of rest activity rhythm in older adults with cerebral small vessel disease.

机构信息

Department of Neurology, The Seventh-Medical Center of PLA General Hospital, Beijing, China.

Department of Neurology, NO 984 Hospital of PLA, Beijing, China.

出版信息

Chronobiol Int. 2023 Dec 2;40(12):1574-1581. doi: 10.1080/07420528.2023.2282467. Epub 2023 Dec 5.

Abstract

The goal of the current study was to demonstrate if the rest-activity rhythm (RAR) was altered in apathetic older adults with cerebral small vessel disease (CSVD) and find out the relationship between apathy/depression severity and RAR features in CSVD patients. This is a cross-sectional observational investigation including 53 CSVD cases (54.74% men), aged 70.70 ± 6.18 years old. The participants were assessed by neuropsychiatric inventory (NPI) subscale of apathy (NPI-apathy) and depression (NPI-depression) in succession, according to updated diagnostic criteria for apathy (DCA). Each subject wore an actigraph device (ActiGraph GT3X) in their nondominant hand for 7 days to collect raw data. Using a non-parametric methodological analysis, this study determined RAR variables such as interdaily stability (IS), intraday variability (IV) and relative amplitude (RA). Patients in the apathy-positive group had a higher Fazekas score than those in the apathy-negative group. IS, but not IV, RA, or objective sleep variables, differed between elderly patients with varying degrees of CSVD burden. Furthermore, apathy severity was statistically correlated with RA after adjusting for age, gender and education level, whereas depression severity was not associated with RAR variables. Finally, we discovered that the severity of apathy had no significant relationship with the severity of depression. All these findings indicated that the RAR altered in apathetic older adults with CSVD, and apathy was associated with decreased RAR amplitude.

摘要

本研究旨在探讨有无淡漠症状的脑小血管病 (CSVD) 老年患者的静息-活动节律 (RAR) 是否发生改变,并找出 CSVD 患者淡漠/抑郁严重程度与 RAR 特征之间的关系。这是一项横断面观察性研究,共纳入 53 例 CSVD 患者(54.74%为男性),年龄 70.70±6.18 岁。根据最新的淡漠诊断标准(DCA),采用神经精神病学问卷(NPI)中的淡漠(NPI-apathy)和抑郁(NPI-depression)亚量表对患者进行连续评估。每位受试者在非优势手上佩戴活动记录仪(ActiGraph GT3X),连续佩戴 7 天以收集原始数据。本研究采用非参数方法分析,确定 RAR 变量,如日间不稳定性(IS)、日内变异性(IV)和相对振幅(RA)。在淡漠阳性组中,患者的 Fazekas 评分高于淡漠阴性组。IS,但不是 IV、RA 或客观睡眠变量,在不同 CSVD 负荷的老年患者之间存在差异。此外,在调整年龄、性别和教育程度后,淡漠严重程度与 RA 呈统计学相关,而抑郁严重程度与 RAR 变量无关。最后,我们发现淡漠严重程度与抑郁严重程度之间没有显著关系。所有这些发现表明,CSVD 伴淡漠的老年患者 RAR 发生改变,且淡漠与 RAR 振幅降低有关。

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