Tang Fengyan, Zhu Yuyang, Jayawardena Dasuni, Jin Guoping, Jiang Yanping
School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.
School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
BMC Geriatr. 2025 Jan 22;25(1):52. doi: 10.1186/s12877-024-05644-4.
Racial and ethnic disparities in sleep quality and cognitive health are increasingly recognized, yet little is understood about their associations among Chinese older adults living in the United States. This study aims to examine the relationships between sleep health and cognitive functioning in this population, utilizing data from the Population Study of Chinese Elderly in Chicago (PINE).
This observational study utilized a two-wave panel design as part of the PINE, including 2,228 participants aged 65 years or older who self-identified as Chinese. Participants completed interviews at two time points. Cognitive functioning was assessed using a battery of tests, including the Chinese Mini-Mental State Examination (C_MMSE), the immediate and delayed recall of the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. Sleep quality was assessed using items from the Pittsburgh Sleep Quality Index (PSQI), covering four aspects: subjective sleep quality, sleep latency, sleep efficiency, and sleep duration. Insomnia was assessed using four items from the Women's Health Initiative Insomnia Rating Scale. Mixed-effects regression models were used to assess the effects of sleep parameters on baseline cognitive functioning and cognitive change over time.
Participants had an average age of 77.42 years (± 7.57) at baseline, with about 39% reporting fairly bad or very bad sleep quality. Poorer overall sleep quality (B = -0.01, SE = 0.01, p < .01), and more insomnia symptoms (B = -0.01, SE = 0.00, p < .001) were associated with lower baseline global cognition. However, these associations diminished over time (sleep quality: B = 0.01, SE = 0.00, p < .05; insomnia: B = 0.00, SE = 0.00, p < .05). Among sleep quality subdomains, all except sleep efficiency had significantly negative relationships with baseline global cognition. The associations between sleep parameters and the four cognitive domains were less consistent.
The findings highlight cross-sectional negative relationships between self-reported sleep parameters and cognition, showing distinct associations between various aspects of sleep quality and cognitive domains. Targeted interventions to improve sleep quality may have the potential to enhance cognitive health outcomes.
睡眠质量和认知健康方面的种族和民族差异日益受到关注，但对于居住在美国的中国老年人之间的关联了解甚少。本研究旨在利用芝加哥华人老年人队列研究（PINE）的数据，探讨该人群中睡眠健康与认知功能之间的关系。
本观察性研究采用两波面板设计，作为PINE的一部分，纳入了2228名65岁及以上自我认定为华人的参与者。参与者在两个时间点完成访谈。认知功能通过一系列测试进行评估，包括中文版简易精神状态检查表（C_MMSE）、东波士顿记忆测试的即时和延迟回忆、数字广度倒背评估以及符号数字模式测试。睡眠质量使用匹兹堡睡眠质量指数（PSQI）中的项目进行评估，涵盖四个方面：主观睡眠质量、入睡时间、睡眠效率和睡眠时间。失眠使用妇女健康倡议失眠评定量表中的四个项目进行评估。混合效应回归模型用于评估睡眠参数对基线认知功能和随时间认知变化的影响。
参与者基线时的平均年龄为77.42岁（±7.57），约39%的人报告睡眠质量相当差或非常差。总体睡眠质量较差（B = -0.01，标准误 = 0.01，p <.01）和更多的失眠症状（B = -0.01，标准误 = 0.00，p <.001）与较低的基线整体认知相关。然而，随着时间的推移，这些关联减弱（睡眠质量：B = 0.01，标准误 = 0.00，p <.05；失眠：B = 0.00，标准误 = 0.00），p <.05）。在睡眠质量子领域中，除睡眠效率外，所有方面与基线整体认知均有显著负相关。睡眠参数与四个认知领域之间的关联不太一致。
研究结果突出了自我报告的睡眠参数与认知之间的横断面负相关关系，表明睡眠质量的各个方面与认知领域之间存在明显关联。针对性地改善睡眠质量的干预措施可能有潜力改善认知健康结果。
