老年人睡眠效率变异性与认知能力的关系：横断面加速度计研究。
Association Between Sleep Efficiency Variability and Cognition Among Older Adults: Cross-Sectional Accelerometer Study.
机构信息
School of Data Science, City University of Hong Kong, Hong Kong, China (Hong Kong).
Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
出版信息
JMIR Aging. 2024 Apr 4;7:e54353. doi: 10.2196/54353.
BACKGROUND
Sleep efficiency is often used as a measure of sleep quality. Getting sufficiently high-quality sleep has been associated with better cognitive function among older adults; however, the relationship between day-to-day sleep quality variability and cognition has not been well-established.
OBJECTIVE
We aimed to determine the relationship between day-to-day sleep efficiency variability and cognitive function among older adults, using accelerometer data and 3 cognitive tests.
METHODS
We included older adults aged >65 years with at least 5 days of accelerometer wear time from the National Health and Nutrition Examination Survey (NHANES) who completed the Digit Symbol Substitution Test (DSST), the Consortium to Establish a Registry for Alzheimer's Disease Word-Learning subtest (CERAD-WL), and the Animal Fluency Test (AFT). Sleep efficiency was derived using a data-driven machine learning algorithm. We examined associations between sleep efficiency variability and scores on each cognitive test adjusted for age, sex, education, household income, marital status, depressive symptoms, diabetes, smoking habits, alcohol consumption, arthritis, heart disease, prior heart attack, prior stroke, activities of daily living, and instrumental activities of daily living. Associations between average sleep efficiency and each cognitive test score were further examined for comparison purposes.
RESULTS
A total of 1074 older adults from the NHANES were included in this study. Older adults with low average sleep efficiency exhibited higher levels of sleep efficiency variability (Pearson r=-0.63). After adjusting for confounding factors, greater average sleep efficiency was associated with higher scores on the DSST (per 10% increase, β=2.25, 95% CI 0.61 to 3.90) and AFT (per 10% increase, β=.91, 95% CI 0.27 to 1.56). Greater sleep efficiency variability was univariably associated with worse cognitive function based on the DSST (per 10% increase, β=-3.34, 95% CI -5.33 to -1.34), CERAD-WL (per 10% increase, β=-1.00, 95% CI -1.79 to -0.21), and AFT (per 10% increase, β=-1.02, 95% CI -1.68 to -0.36). In fully adjusted models, greater sleep efficiency variability remained associated with lower DSST (per 10% increase, β=-2.01, 95% CI -3.62 to -0.40) and AFT (per 10% increase, β=-.84, 95% CI -1.47 to -0.21) scores but not CERAD-WL (per 10% increase, β=-.65, 95% CI -1.39 to 0.08) scores.
CONCLUSIONS
Targeting consistency in sleep quality may be useful for interventions seeking to preserve cognitive function among older adults.
背景
睡眠效率常被用作衡量睡眠质量的指标。老年人获得高质量的睡眠与认知功能的提高有关；然而，每日睡眠质量变化与认知之间的关系尚未得到很好的证实。
目的
我们旨在通过加速度计数据和 3 项认知测试，确定老年人每日睡眠效率变化与认知功能之间的关系。
方法
我们纳入了来自国家健康和营养检查调查（NHANES）的年龄>65 岁、佩戴加速度计至少 5 天且完成数字符号替代测试（DSST）、阿尔茨海默病合作研究记忆词汇学习子测试（CERAD-WL）和动物流畅性测试（AFT）的老年人。使用数据驱动的机器学习算法得出睡眠效率。我们调整了年龄、性别、教育程度、家庭收入、婚姻状况、抑郁症状、糖尿病、吸烟习惯、饮酒量、关节炎、心脏病、既往心脏病发作、既往中风、日常生活活动和工具性日常生活活动后，考察了睡眠效率变化与每个认知测试分数之间的关联。为了比较，进一步检查了平均睡眠效率与每个认知测试分数之间的关联。
结果
本研究共纳入了来自 NHANES 的 1074 名老年人。平均睡眠效率较低的老年人表现出更高水平的睡眠效率变化（Pearson r=-0.63）。调整混杂因素后，平均睡眠效率越高，DSST 得分越高（每增加 10%，β=2.25，95%CI 0.61 至 3.90），AFT 得分越高（每增加 10%，β=0.91，95%CI 0.27 至 1.56）。睡眠效率变化较大与 DSST（每增加 10%，β=-3.34，95%CI -5.33 至 -1.34）、CERAD-WL（每增加 10%，β=-1.00，95%CI -1.79 至 -0.21）和 AFT（每增加 10%，β=-1.02，95%CI -1.68 至 -0.36）认知功能较差相关。在完全调整的模型中，睡眠效率变化与 DSST（每增加 10%，β=-2.01，95%CI -3.62 至 -0.40）和 AFT（每增加 10%，β=-0.84，95%CI -1.47 至 -0.21）得分降低相关，但与 CERAD-WL（每增加 10%，β=-0.65，95%CI -1.39 至 0.08）得分无关。
结论
针对睡眠质量的一致性进行干预可能有助于提高老年人的认知功能。
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