School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Camperdown, NSW, Australia.
School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia; CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.
J Affect Disord. 2024 Mar 1;348:35-43. doi: 10.1016/j.jad.2023.12.032. Epub 2023 Dec 18.
While depression is intrinsically and bidirectionally linked with both sleep disturbance and cognition, the inter-relationships between sleep, cognition, and brain integrity in older people with depression, especially those with late-onset depression are undefined.
One hundred and seventy-two older adults (mean age 64.3 ± 6.9 years, Depression: n = 66, Control: n = 106) attending a memory clinic underwent a neuropsychological battery of declarative memory, executive function tasks, cerebral magnetic resonance imaging and overnight polysomnography with quantitative electroencephalography.
The time spent in slow-wave sleep (SWS) and rapid eye movement (REM) sleep, slow-wave activity, sleep spindles, hippocampal volume and prefrontal cortex thickness did not differ between depression and control and depression onset groups. However, sleep onset latency (p = 0.005) and REM onset latency (p = 0.02) were later in the Depression group compared to controls. Less SWS was associated with poorer memory (r = 0.31, p = 0.023) in the depression group, and less SWS was related to better memory in the control group (r = -0.20, p = 0.043; Fishers r-to-z = -3.19).
Longitudinal studies are needed to determine if changes in sleep in those with depressive symptoms predict cognitive decline and illness trajectory.
Older participants with depressive symptoms had delayed sleep initiation, suggestive of delayed sleep phase. The association between SWS and memory suggests SWS may be a useful target for cognitive intervention in older adults with depression symptoms. Reduced hippocampal volumes did not mediate this relationship, indicating a broader distributed neural network may underpin these associations.
尽管抑郁与睡眠障碍和认知都存在内在联系，且双向关联，但老年人中抑郁与睡眠、认知和大脑完整性的相互关系仍未明确，尤其是在迟发性抑郁患者中。
172 名老年患者（平均年龄 64.3±6.9 岁，抑郁组：n=66，对照组：n=106）参加了记忆诊所，接受了一系列认知测试、大脑磁共振成像和整晚多导睡眠图及定量脑电图检查。
慢波睡眠（SWS）和快速眼动（REM）睡眠、慢波活动、睡眠纺锤波、海马体体积和前额叶皮层厚度在抑郁和对照组及抑郁发作组之间没有差异。然而，与对照组相比，抑郁组的睡眠潜伏期（p=0.005）和 REM 潜伏期（p=0.02）更长。在抑郁组中，SWS 减少与记忆下降相关（r=0.31，p=0.023），而在对照组中，SWS 减少与记忆改善相关（r=-0.20，p=0.043；Fisher r-to-z=-3.19）。
需要进行纵向研究，以确定有抑郁症状者的睡眠变化是否可预测认知下降和疾病轨迹。
有抑郁症状的老年患者睡眠起始延迟，提示睡眠时相延迟。SWS 与记忆之间的关联表明，SWS 可能是老年抑郁症状患者认知干预的一个有用靶点。海马体体积减少并未介导这种关系，这表明更广泛的分布式神经网络可能是这些关联的基础。
