中国四省55岁及以上人群睡眠时长与轻度认知功能障碍的关联性

Association between sleep duration and mild cognitive impairment in people aged 55 and above in 4 provinces of China

目的探索中老年人睡眠时长与轻度认知功能障碍(mild cognitive impairment,MCI)的关联性。方法采用多阶段分层整群随机抽样的方法,于2018年5—8月份抽取河北、浙江、陕西、湖南4个省32个县中5334名55岁及以上居民[男性2362人,女性2972人,年龄(67.43±7.48)岁],通过问卷调查了解基本信息、生活方式、疾病史、睡眠时长等情况,根据蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)筛选是否患有MCI。采用多因素Logistic回归法分析睡眠时长与MCI的关联性。结果16.76%调查对象睡眠时长不到7.0 h,19.10%的睡眠时间在9.0 h及以上,36.24%的中老年人检出MCI。在调整了地区、年龄、性别、文化程度、工作情况、家庭人均月收入、吸烟、饮酒、身体活动、静坐时间、抑郁、高血压、糖尿病、心肌梗死、脑卒中情况后,多因素Logistic回归分析结果显示,与睡眠7.0~7.9 h者相比,睡眠时长为<6.0 h和8.0~8.9 h者患MCI的风险分别为1.417倍(95%CI 1.012~1.984)和1.191倍(95%CI 1.001~1.418),差异均有统计学意义(P<0.05),男性睡眠时长<6 h患MCI的风险是前者的2.083倍(95%CI 1.145~3.789),女性睡眠时长≥9.0 h患MCI的风险是前者的1.741倍(95%CI 1.301~2.331),差异均有统计学意义(P<0.05)。结论较短或较长的睡眠时间是MCI独立相关的重要因素,男性睡眠不足和女性睡眠时间较长均能增加MCI的患病风险。

OBJECTIVE To explore the association between sleep duration and mild cognitive impairment(MCI)in people aged 55 and above in 4 provinces of China.METHODS A stratified multi-stage cluster random sampling method was adopted.From May to August 2018 in 32 survey districts and counties in 4 provinces of Hebei,Zhejiang,Shaanxi,and Hunan,533455-year-old and older persons who met the inclusion criteria were randomly selected.Among them,there were 2362 males and 2972 females,with an average age of(67.43±7.48)years.A questionnaire survey was conducted to collect their basic information,lifestyle,disease history,sleep duration,etc.MCI were screened based on the Montreal cognitive assessment(MoCA).Multivariate Logistic regression was used to analyze the association between sleep duration and MCI.RESULTS 16.76% of them slept for less than 7.0 hours,19.10% of the middle-aged and elderly people slept for 9 hours or more,and 36.24% of them were found to be MCI.After adjusted the area,age,gender,education level,work status,family monthly income per capita,smoking,drinking,physical activity,meditation time,depression,hypertension,diabetes,myocardial infarction and stroke,the result of multivariate Logistic regression analysis shown that,compared with 7.0-7.9 hours of sleep,the risk of MCI among middle-aged and elderly people over 55 years old with<6.0 hours and 8.0-8.9 hours of sleep were 1.417 times(95%CI 1.012-1.984)and 1.191 times(95%CI 1.001-1.418)of the former,respectively,and the differences were statistically significant(P<0.05).The risk of men suffering from MCI for sleep duration<6.0 hours was 2.083 times(95%CI 1.145-3.789)that of the former,and the risk of women suffering from MCI for sleep duration≥9.0 hours was 1.741 times(95%CI 1.301-2.331)that of MCI.The differences are statistically significant(P<0.05).CONCLUSION Shorter or longer sleep time is an important factor independently related to MCI.Insufficient sleep in men and longer sleep time in women can increase the risk of MCI.