Sleep medication use and incident dementia in a nationally representative sample of older adults in the US.

Sleep medication use and incident dementia in a nationally representative sample of older adults in the US.
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DOI:
10.1016/j.sleep.2020.11.004
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发表时间:
2021-03
期刊:
影响因子:
4.8
通讯作者:
Czeisler CA
Czeisler CA
中科院分区:
医学2区
文献类型:
--
作者:
Robbins R;DiClemente RJ;Troxel AB;Jean-Louis G;Butler M;Rapoport DM;Czeisler CA

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睡眠困难在老年人中很常见,睡眠困难的临床治疗通常包括安眠药物(药物和非药物)。我们的研究使用美国 65 岁及以上老年人的全国代表性数据,调查了 8 年来安眠药的使用情况和痴呆症的发生情况。我们使用了从国家健康和老龄化趋势研究 (NHATS) 中收集的数据,这是一项针对医疗保险受益人的全国代表性纵向研究。常规睡眠药物使用(药理学和非药理学)被定义为“大多数晚上”或“每晚”使用。使用经过验证的评估记忆、方向和执行功能的仪器对参与者进行痴呆症筛查。我们使用 Cox 比例风险模型和估计生存曲线进行前瞻性分析,以检查常规睡眠药物使用与痴呆事件之间的关系。对年龄、性别、婚姻状况、教育程度和慢性病进行控制分析。在基线受访者 (n= 6,373) 中,大多数参与者 (21%) 年龄在 70 至 74 岁之间。参与者中有 59% 是女性,样本包括非西班牙裔白人 (71%)。在基线时,我们的研究样本中有 15% 的人表示经常使用安眠药,这代表了美国 460 万老年人。协变量调整比例风险模型显示,常规使用安眠药物与痴呆发生相关(HR=1.30,95%CI:1.10 至 1.53,p<.01)。我们的研究观察到,在一项针对美国老年人的全国代表性研究中,历时 8 年的数据显示,15% 的老年人表示经常使用安眠药,但在整个随访期间,定期使用安眠药与痴呆症的发生有关。未来的研究可能会研究改善老年人睡眠的行为方法。
Sleep difficulties are common among older adults, and clinical management of sleep difficulties commonly includes sleep medication (pharmacological and nonpharmacological). Our research examines sleep medication use and incident dementia over 8 years using nationally representative data from older adults ages 65 years and older in the United States. We used data collected from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of Medicare beneficiaries. Routine sleep medication use (pharmacological and non-pharmacological) was defined as use “most nights” or “every night.” Participants were screened for dementia with validated instruments that assessed memory, orientation, and executive function. We conduct prospective analyses to examine the relationship between routine sleep medication use and incident dementia using Cox proportional hazards modeling and estimated survival curves. Analyses controlled for age, sex, marital status, education, and chronic conditions. Among respondents at baseline (n= 6,373), most participants (21%) were age 70 to 74 years of age. Participants were 59% female and the sample comprised non-Hispanic White (71%). At baseline, 15% of our study sample reported using sleep medication routinely, which is representative of 4.6 million older adults in the US. Covariate adjusted proportional hazard models revealed that routinely using sleep medication was associated with incident dementia (HR=1.30, 95%CI: 1.10 to 1.53, p<.01). Our study observed, in a nationally representative study of older adults in the US across 8 years of data that 15% of older adults report routinely using sleep medication, yet routine use of sleeping medication was associated with incident dementia across the follow-up interval. Future research may examine behavioral approaches to improving sleep among older adults.
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发表时间: 2001-04-11
影响因子: 120.7
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