认知功能正常老人睡眠与认知功能变化1年随访研究

One year follow-up study of sleep duration and cognitive function changes in the elderly with normal cognitive function

目的·分析睡眠时间对认知功能正常老人的认知功能变化的影响。方法·以572 例认知功能正常老人(NC 组)、224 例遗忘型轻度认知功能损害(amnestic mild cognitive impairment,aMCI)患者(aMCI 组)和48 例阿尔茨海默病(Alzheimer's disease,AD)患者(AD 组)为研究对象,采用统一编制的调查表采集人口学信息、日常生活信息等一般资料。在基线期分别比较各组不同阶段睡眠时间与认知功能的相关性。对NC 组进行1 年随访,确认其认知功能的变化,分析睡眠时间与认知功能变化的相关性。结果· NC 组青年期的睡眠时间与简易精神状态检查量表(Mini-Mental State Examination,MMSE)分值(r=0.114,P=0.006)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)分值(r=0.116,P=0.006)呈正相关,NC 组老年期的睡眠时间与MMSE 分值(r=0.124,P=0.004)呈正相关。NC 组1 年随访获得有效数据282 例;将其中诊断为aMCI 的29 例患者和诊断为AD 的6 例患者归入进展组(NC-P 组),将其中仍诊断为正常老人的224 例对象和诊断为成功老人的5 例对象归入稳定组(NC-S 组)。NC-P 组的平均年龄(P=0.000)、女性占比(P=0.003)和罹患心脏疾病比例(P=0.001)均高于NC-S 组,而NC-P 组的受教育年数(P=0.000)、老年期睡眠时间(P=0.001)和有吸烟史比例(P=0.040)低于NC-S 组,差异均有统计学意义。Logistics 多因素回归分析显示,老年期睡眠时间减少(P=0.001)和罹患心脏疾病(P=0.003)是正常老人在1 年内出现认知功能损害的主要危险因素。结论·认知功能正常老人的认知功能水平与睡眠时间呈正相关,老年期睡眠时间减少是aMCI 发病的危险因素。

Objective · To analyze the effect of sleep duration on cognitive function of the elderly with normal cognitive function. Methods · A total of 572 elderly people with normal cognitive function (NC group), 224 patients with amnestic mild cognitive impairment (aMCI) and 48 patients with Alzheimer's disease (AD) were selected as the subjects. A unified questionnaire was used to collect their general data including demographic information, daily life information and so on. At the baseline stage, the correlation between sleep duration and cognitive function of NC group, aMCI group and AD group were compared, respectively. The elderly in NC group were followed up for one year to confirm the change of their cognitive function and analyze the correlation between sleep duration and cognitive function. Results · In NC group, the sleep duration in adolescence was positively correlated with Mini-Mental State Examination (MMSE) score (r=0.114, P=0.006) and Montreal Cognitive Assessment (MoCA) score (r=0.116, P=0.006), while the sleep duration in old age was positively correlated with MMSE score (r=0.124, P=0.004). For 572 elderly people with normal cognition, 282 cases of one year follow-up data were available. Twenty-nine patients diagnosed as aMCI and 6 patients diagnosed as AD were classified into progressive (NC-P) group, while 224 normal elderly subjects and 5 successful elderly subjects were classified into stable (NC-S) group. The average age (P=0.000), female percentage (P=0.003) and heart disease rate (P=0.001) in NC-P group were higher than those in NC-S group, while the number of years of education (P=0.000), sleep duration in old age (P=0.001) and the smoking history rate (P=0.040) in NC-P group were lower than those in NC-S group, and the differences were statistically significant. Logistic multivariate regression analysis showed that decreased sleep duration (P=0.001) and heart disease (P=0.003) were the main risk factors for cognitive impairment in normal elderly people within one year. Conclusion · There is a positive correlation between cognitive function level and sleep duration in the elderly with normal cognition. Reduced sleep duration in the elderly is a risk factor for aMCI.