College of Marxism, Jiaxing University, Jiaxing, China.
Department of Psychology and Behavioral Sciences, Zhejiang University, NO. 866 Yuhangtang Road, Zijingang Campus of Zhejiang University, Hangzhou, Zhejiang, China.
Sci Rep. 2024 Sep 11;14(1):21242. doi: 10.1038/s41598-024-72159-8.
Although it is generally recognized that sleep quality, depressive symptoms, and cognitive functions are related respectively, the main ambiguity comes from difficulties in determining their cause-effect relationships. The present study aimed to explore the longitudinal causation relationships among sleep quality, depressive symptoms, and cognitive functions in older people with mild cognitive impairment (MCI). A total of 134 patients from 24 communities in Ningbo City, Zhejiang Province, China with MCI were interviewed at baseline, while 124 of them were re-interviewed 2 months later, and 122 were re-interviewed 4 months later. The Patient Health Questionnaire-9, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment Scale were assessed in the interview. Cross-lagged models were tested to disentangle the relationships among sleep quality, depressive symptoms, and cognitive functions using structural equation modeling with latent variables on the four-mouth longitudinal data. The correlation coefficients between sleep quality and depressive symptoms were significant showing the stability across time points of assessment, while the correlation coefficient of cognitive function was not significant (r = 0.159, p > 0.05). The results of index of model fit indicated that the cross-lagged model was acceptable (CFI = 0.934, TLI = 0.899, RMSEA = 0.075, χ/df = 1.684). The results of cross-lagged model analysis supported the complete mediating role of depressive symptoms in the association between sleep quality and cognitive functions, where worse sleep quality may lead to more severe depressive symptoms, which in turn leads to more severe cognitive decline. In Conclusion, sleep quality is significantly correlated with cognitive functions in patients with mild cognitive impairment, which association is fully mediated by depressive symptoms. Approaches addressing sleep quality and depressive symptoms are recommended and hold promise for the management of mild cognitive impairment.
虽然人们普遍认为睡眠质量、抑郁症状和认知功能分别相关，但主要的模糊之处在于难以确定它们的因果关系。本研究旨在探讨老年人轻度认知障碍（MCI）中睡眠质量、抑郁症状和认知功能之间的纵向因果关系。共有 134 名来自中国浙江省宁波市 24 个社区的 MCI 患者在基线时接受了访谈，其中 124 名在 2 个月后接受了重访，122 名在 4 个月后接受了重访。在访谈中评估了患者健康问卷-9、匹兹堡睡眠质量指数和蒙特利尔认知评估量表。使用结构方程模型和潜在变量对四个月的纵向数据进行交叉滞后模型测试，以厘清睡眠质量、抑郁症状和认知功能之间的关系。睡眠质量与抑郁症状之间的相关系数具有显著性，表明评估时间点之间的稳定性，而认知功能的相关系数不显著（r=0.159，p>0.05）。模型拟合指数的结果表明，交叉滞后模型是可接受的（CFI=0.934，TLI=0.899，RMSEA=0.075，χ/df=1.684）。交叉滞后模型分析的结果支持抑郁症状在睡眠质量与认知功能之间的关联中完全起中介作用，即较差的睡眠质量可能导致更严重的抑郁症状，进而导致更严重的认知能力下降。总之，在轻度认知障碍患者中，睡眠质量与认知功能显著相关，这种关联完全由抑郁症状介导。建议采用针对睡眠质量和抑郁症状的方法，为轻度认知障碍的管理提供了新的思路。
