老年人夜间睡眠时间与认知功能的关系

Association between nocturnal sleep duration and cognitive function among the elderly

目的 评估60岁及以上老年人夜间睡眠时间与认知功能的关系。方法 本研究为横断面分析,选取2013—2014年美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库中60岁及以上老年人的资料,收集人口学特征和基础病史等变量。数据库中研究对象的夜间睡眠时间以问卷的方式采集,将6~8h夜间睡眠时间设定为正常睡眠时间,<6h分类为短睡眠时间,>8h分类为长睡眠时间。数字符号转换测验(Digit Symbol Substitution Test,DSST)用于患者认知功能的评价,本研究将DSST评分的最小四分位数确定为认知功能减退。使用二分类Logistic回归分析探究夜间睡眠时间与认知功能减退的关系。结果 本研究最终纳入1 588例研究对象,女性827例(52.1%),男性761例(47.9%),平均年龄(69.6±6.7)岁。875例(55.1%)报告睡眠时间为6~8h,527例(33.2%)睡眠时间<6h,186例(11.7%)睡眠时间>8h。在校正相关因素后,短睡眠时间和长睡眠时间均与认知功能减退的风险增加相关,OR分别为2.03 (95%CI:1.57~2.62)和2.24 (95%CI:1.01~5.00)。多因素Logistic回归分析结果显示,高龄、女性、种族、低教育水平、低家庭年收入、饮酒、吸烟、抑郁、高血压、高脂血症、冠状动脉粥样硬化性心脏病、心肌梗死和卒中均为认知功能减退的影响因素。限制性立方样条图结果显示,老年人夜间睡眠时间与认知功能减退的关系呈近似U型曲线关系。结论 老年人夜间睡眠时间过短或过长均与认知功能减退有关,建议进行必要的干预,并定期对此类人群进行认知筛查。

Objective To assess the relationship between nocturnal sleep duration and cognitive function among the elderly aged 60 and above.Methods The National Health and Nutrition Examination Survey(NHANES)of the elderly aged 60 and above from 2013 to 2014 were selected.Data on demographic characteristics,and medical history were collected.Nocturnal sleep duration was ascertained by the questionnaire.We set the normal reference value of sleep duration at 6~8 hours,and sleep duration<6 hours as short sleep and sleep duration as>8 h as long sleep.Digit Symbol Substitution Test(DSST)was used to assess the participants'cognitive function,and the lowest quartile of the score to indicate cognitive decline.Binary logistic regression analyses were used to assess the relationship between nocturnal sleep duration and cognitive function.Results A total of 1588 participants were enrolled,827(52.1%)of whom were female and 761(47.9%)were male,with an average age of(69.6±6.7)years.875 cases(55.1%)reported that the sleep duration was 6-8 hours,527 cases(33.2%)were less than 6 hours,and 186 cases(11.7%)were more than 8 hours.In the model fully adjusted risk factors,both short and long sleep duration were associated with the increased risk of cognitive decline,with OR values of 2.03(95%CI:1.57-2.62)and 2.24(95%CI:1.01-5.00),respectively.Multivariate logistic regression analysis showed that elderly,female,race,low education level,low annual household income,alcohol,smoke,hypertension,hyperlipidemia,coronary heart disease,myocardial infarction,and stroke were relevant risk factors for cognitive decline.The restricted cubic spline graph showed that sleep duration has a U-shaped relationship with cognitive function among the elderly.Conclusions Among the elderly,short and long nocturnal sleep duration both have an increased risk for cognitive decline.Necessary interventions and regular cognitive screening of this population are recommended.