Fan Hui-Ying, Sun He-Li, Feng Yuan, Zhang Qinge, Xing Hua-Qing, Huang Qian-Hua, Su Zhaohui, Cheung Teris, Ng Chee H, Xiang Yu-Tao, Wang Gang
International Nursing School, Hainan Medical University, Haikou, Hainan, China.
Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao SAR, China.
Front Aging Neurosci. 2025 Jul 15;17:1579560. doi: 10.3389/fnagi.2025.1579560. eCollection 2025.
Cognitive impairment is a major health concern in older adults with hypertension, and both depression and abnormal sleep duration are recognized as potential contributing factors. This study aimed to explore the nonlinear association of depression and sleep duration with cognitive impairment among older adults with hypertension.
This cross-sectional study was based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey. Depression and cognitive function were measured using the 10-item Center for Epidemiological Studies Short Depression Scale and Mini Mental State Examination, respectively. Univariate, binary logistic regression, and restricted cubic spline regression analyses were used to examine the associations between depression, sleep duration and cognitive impairment.
A total of 3,989 older adults with hypertension were included. The prevalence of depression and cognitive impairment were 28.1% (95%CI = 26.7-29.5%) and 10.1% (95%CI = 9.2-11.1%), respectively. After adjusting for confounding factors, a significant linear association (nonlinear = 0.814) between depression and cognitive impairment risk was found, while a U-shaped nonlinear association was identified between sleep duration and cognitive impairment risk ( = 0.040). Both shorter (<6.6 h) and longer (>7.7 h) sleep duration per day were associated with higher cognitive impairment risk, with an inflection point at 7.3 h. The effect of sleep duration on cognitive impairment risk was more significant for participants with a higher (≥ 6 years) education level.
This study highlights the importance of managing depression and optimizing sleep duration in addressing the risk of cognitive decline in older adults with hypertension.
认知障碍是老年高血压患者的一个主要健康问题，抑郁和睡眠时间异常均被认为是潜在的促成因素。本研究旨在探讨老年高血压患者中抑郁和睡眠时间与认知障碍之间的非线性关联。
本横断面研究基于2017 - 2018年中国健康与养老追踪调查。分别使用10项流行病学研究中心抑郁量表简表和简易精神状态检查表测量抑郁和认知功能。采用单因素分析、二元逻辑回归分析和受限立方样条回归分析来检验抑郁、睡眠时间与认知障碍之间的关联。
共纳入3989名老年高血压患者。抑郁和认知障碍的患病率分别为28.1%（95%CI = 26.7 - 29.5%）和10.1%（95%CI = 9.2 - 11.1%）。在调整混杂因素后，发现抑郁与认知障碍风险之间存在显著的线性关联（非线性 = 0.814），而睡眠时间与认知障碍风险之间存在U型非线性关联（ = 0.040）。每天睡眠时间过短（<6.6小时）和过长（>7.7小时）均与较高的认知障碍风险相关，转折点为7.3小时。睡眠时间对认知障碍风险的影响在教育水平较高（≥6年）的参与者中更为显著。
本研究强调了在应对老年高血压患者认知衰退风险方面管理抑郁和优化睡眠时间的重要性。
