Race Differences in the Association Between Sleep Medication Use and Risk of Dementia.
Race Differences in the Association Between Sleep Medication Use and Risk of Dementia.
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DOI：
10.3233/jad-221006
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Yaffe K
中科院分区：
文献类型：
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作者：
Leng Y;Stone KL;Yaffe K
睡眠药物对老年人认知的影响是有争议的，可能取决于睡眠质量，而且可能因种族而异。确定15年来睡眠药物使用与痴呆症事件之间的纵向联系，并探索这种联系是否独立于夜间睡眠干扰，以及是否因种族而不同。我们检查了3068名社区居住的老年人(年龄74.1±2.9岁，41.7%是黑人，51.5%是女性)，没有痴呆。安眠药的使用被记录了三次，通过询问“你是否服用安眠药或其他药物来帮助你入睡？”响应选项：“从不(0)”、“很少(≤1/月)”、“有时(2-4/月)”、“经常(5-15/月)”或“几乎总是(16-30/月)”。使用住院记录、痴呆症药物处方或临床上全球认知显著下降来定义偶发痴呆症。据报道，138名白人(7.71%)和34名黑人(2.66%)“经常或几乎总是”服用安眠药。白人服用所有处方催眠药的可能性几乎是前者的两倍。617名参与者在随访期间患上了痴呆症。在调整了所有协变量后，报告每月服用≥5次安眠药的参与者比每月服用≤1次的参与者更有可能患上痴呆症，而且这种关联只在白人中观察到(HR=1.79，1.21-2.66)，而没有观察到黑人(HR=0.84，0.38-1.83)；交互作用的p=0.048。对夜间睡眠的进一步调整并没有明显改变结果。在使用安眠药的累积频率上，这种关联是相似的，并在引入3年的时间滞后后仍然存在。在白人老年人中，频繁使用安眠药与痴呆症风险增加有关。需要进一步的研究来确定潜在的机制。
The effect of sleep medications on cognition in older adults is controversial, possibly dependent upon sleep quality, and may differ by race. To determine the longitudinal association between sleep medication use and incident dementia over 15 years, and to explore whether the association is independent of nighttime sleep disturbances and if it differs by race. We examined 3,068 community-dwelling older adults (aged 74.1 ± 2.9 years, 41.7% Black, 51.5% female) without dementia. Sleep medication use was recorded three times by asking “Do you take sleeping pills or other medications to help you sleep?” with the response options: “Never (0)”, “Rarely (≤1/month)”, “Sometimes (2–4/month)”, “Often (5–15/month)”, or “Almost Always (16–30/month)”. Incident dementia was defined using hospitalization records, dementia medication prescription or clinically significant decline in global cognition. 138 (7.71%) of Whites and 34 (2.66%) of Blacks reported taking sleep medications “often or almost always”. Whites were almost twice as likely to take all prescription hypnotics. 617 participants developed dementia over the follow-up. After adjustment for all covariates, participants who reported taking sleep medications ≥ 5/month versus ≤1/month were significantly more likely to develop dementia, and the association was only observed among Whites (HR = 1.79,1.21–2.66) but not Blacks (HR = 0.84,0.38–1.83); p for interaction = 0.048. Further adjustment for nighttime sleep did not appreciably alter the results. The association was similar for the cumulative frequency of sleep medication use and remained after introducing a time lag of 3 years. Frequent sleep medication use was associated with an increased risk of dementia in White older adults. Further research is needed to determine underlying mechanisms.