Daytime sleepiness is associated with dementia and cognitive decline in older Italian adults: A population-based study
Daytime sleepiness is associated with dementia and cognitive decline in older Italian adults: A population-based study
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DOI：
10.1016/j.sleep.2009.07.018
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发表时间：
2010-04-01
期刊：
影响因子：
4.8
通讯作者：
Valente, M.
中科院分区：
文献类型：
--
作者：
Merlino, G.;Piani, A.;Valente, M.
目的：老年痴呆症的发生与几个通常不可改变的危险因素有关。最近的流行病学研究将他们的兴趣集中在认知能力下降和睡眠之间的可能联系上，这是一个潜在的可改变的风险因素。由于有争议的结果和局限性，以前的研究，我们决定重新审视睡眠障碍和认知功能障碍之间的关系在elderized.Methods：七百五十名年龄在65岁或以上的受试者被招募。采用简易精神状态检查量表（MMSE）和整体恶化量表（GDS）评分评估认知功能下降的严重程度。痴呆的诊断是通过DSM-IV标准。对老年人进行了访谈，以评估是否存在几种睡眠投诉（失眠、打鼾和/或睡眠呼吸暂停、坐立不安和/或腿部抽搐、梦游和噩梦）。通过有效的问卷调查评估白天过度嗜睡。每个老年人的主要照顾者参加了采访，提供的信息，如果受试者无法回答，因为mental impairment.Results：86个人被诊断为痴呆症，其中很大一部分（47.8%），特别是，被确认为受阿尔茨海默氏病。老年人的每种睡眠投诉的患病率如下：失眠84.7%，打鼾和/或睡眠呼吸暂停26.2%，坐立不安和/或腿部抽搐25.7%，梦游0.5%，噩梦6.4%和白天嗜睡30.6%。在睡眠障碍中，白天过度嗜睡与老年痴呆症的存在独立相关。此外，过度的白天嗜睡的频率逐渐增加，在不同类别的认知能力下降，通过MMSE和GDS scores.Conclusions：inflammation，在我们的样本中最常见的睡眠投诉，是不相关的认知能力下降的存在。与失眠相反，白天过度嗜睡与痴呆症有显著相关。需要进一步的研究，以调查这种关联的方向，并评估日间嗜睡作为神经退行性疾病，特别是阿尔茨海默病，在一些老年人的早期标志物的可能作用。(C)2010 Elsevier B. V.保留所有权利。
Objective: The occurrence of dementia among the elderly has been associated with several, often not modifiable, risk factors. Recent epidemiological studies focused their interest on a possible association between cognitive decline and sleep, a potentially modifiable risk factor. Due to controversial results and limitations of the previous studies, we decided to reexamine the relationship between disturbed sleep and cognitive impairment in the elderly.Methods: Seven hundred fifty subjects aged 65 years or older were recruited. The Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS) scores were used to evaluate the severity of cognitive decline. Diagnosis of dementia was made by means of the DSM-IV criteria. The older adults were interviewed in order to assess the presence of several sleep complaints (insomnia, snoring and/or witnessed sleep apneas, restlessness and/or leg jerks, sleepwalking and nightmares). Excessive daytime sleepiness was evaluated by means of a validated questionnaire. The principal caregiver of each older adult took part in the interview, providing the information if the subject was unable to answer because of mental impairment.Results: Eighty-six individuals were diagnosed as demented; a large part of them (47.8%), in particular, were recognized as being affected by Alzheimer's disease. The prevalence of each sleep complaint in the older adults was as follows: insomnia 84.7%, snoring and/or witnessed sleep apneas 26.2%, restlessness and/or jerks in the legs 25.7%, sleepwalking 0.5%, nightmares 6.4% and daytime somnolence 30.6%. Among sleep disturbances, excessive daytime sleepiness was independently associated with the presence of dementia in the elderly. In addition, the frequency of excessive daytime sleepiness increased progressively across the different categories of cognitive decline, as measured by means of MMSE and GDS scores.Conclusions: Insomnia, the most common sleep complaint in our sample, was not associated with the presence of cognitive decline. As opposed to insomnia, excessive daytime sleepiness was significantly related to dementia. Further studies are needed in order to investigate the direction of this association and to evaluate the possible role of daytime somnolence as an early marker of neurodegenerative disease, particularly Alzheimer's disease, in some older adults. (C) 2010 Elsevier B.V. All rights reserved.