Associations between sleep-disordered breathing, nocturnal hypoxemia, and subsequent cognitive decline in older community-dwelling men: the Osteoporotic Fractures in Men Sleep Study.
Associations between sleep-disordered breathing, nocturnal hypoxemia, and subsequent cognitive decline in older community-dwelling men: the Osteoporotic Fractures in Men Sleep Study.
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DOI：
10.1111/jgs.13321
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发表时间：
2015-03
影响因子：
6.3
通讯作者：
Osteoporotic Fractures in Men Study Group
中科院分区：
文献类型：
--
作者：
Blackwell T;Yaffe K;Laffan A;Redline S;Ancoli-Israel S;Ensrud KE;Song Y;Stone KL;Osteoporotic Fractures in Men Study Group
睡眠呼吸障碍（SDB）是一组在老年人中常见的疾病，其特征是睡眠期间呼吸暂停，通常伴有低氧血症。很少有研究探讨睡眠障碍是否与认知能力下降有关。一项基于人群的纵向研究。在美国有6个中心。2，636名无轻度认知障碍的社区老年男性（年龄76.0 ± 5.3岁），随访3.4 ± 0.5年。SDB，通过家庭多导睡眠图测量：夜间低氧血症[≥1%的睡眠时间，血氧饱和度（SaO 2）<90% vs <1%;氧饱和度下降指数（ODI：每小时睡眠中氧饱和度下降≥3%的次数）];呼吸暂停低通气指数（AHI，每小时睡眠中氧饱和度下降≥3%的呼吸暂停和低通气次数）。在基线和2个随访时间点通过改良简易精神状态检查（3 MS）和Trails B测试测量认知下降。预测因子和认知能力下降的关系用线性混合模型进行了检验，该模型调整了多种混杂因素。模型进一步调整潜在的介质（睡眠持续时间，睡眠片段，静息SaO 2）。夜间低氧血症与3 MS的更大下降有关。睡眠时间≥1%且SaO 2 <90%的男性调整后的年下降率为0.43，而参考组男性为0.25（P = .003）。对外直接投资每增加5个点，平均每年下降0.36个点（P = 0.01）。结果对于进一步调整潜在介质是稳健的。AHI和认知功能下降之间的关联没有达到显著性。未观察到与SD B和Trails B测试中的下降相关。在老年社区居民中，夜间低氧血症与整体认知功能下降有一定的相关性，这表明夜间氧合对认知功能的重要性。
Sleep-disordered breathing (SDB) is a group of disorders common among older adults, characterized by breathing pauses during sleep often accompanied by hypoxemia. Few studies have examined if SDB is associated with cognitive decline. A population-based longitudinal study. 6 centers in the United States. 2,636 community-dwelling older men (age 76.0 ± 5.3 years) without mild cognitive impairment, followed 3.4 ± 0.5 years. SDB, measured by in-home polysomnography: nocturnal hypoxemia [≥1% of sleep time with oxygen saturation (SaO2) <90% vs. <1%; oxygen desaturation index (ODI: number of oxygen desaturations ≥3% per hour sleep)]; apnea-hypopnea index (AHI, number of apneas and hypopneas at ≥3% desaturation per hour sleep). Cognitive decline, measured by the Modified Mini-Mental State examination (3MS) and Trails B test at baseline and 2 follow-up timepoints. Associations of predictors and cognitive decline were examined with linear mixed models adjusted for multiple confounders. Models were further adjusted by potential mediators (sleep duration, sleep fragmentation, resting SaO2). Nocturnal hypoxemia was related to greater decline on the 3MS. Men with ≥1% of sleep time with SaO2<90% had an adjusted annualized decline of 0.43 points compared to 0.25 for men in the referent group (P = .003). For each 5-point increase in ODI there was an average annualized decline of 0.36 points (P = .01). Results were robust to further adjustment for potential mediators. The association between AHI and cognitive decline did not reach significance. No associations were seen with SDB and decline on the Trails B test. Among older community-dwelling men, there was a modest association of nocturnal hypoxemia with global cognitive decline, suggesting the importance of overnight oxygenation to cognitive function.
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影响因子：
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