DEMENTIA IN INSTITUTIONALIZED ELDERLY - RELATION TO SLEEP-APNEA
DEMENTIA IN INSTITUTIONALIZED ELDERLY - RELATION TO SLEEP-APNEA
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DOI：
10.1111/j.1532-5415.1991.tb01647.x
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发表时间：
1991-03-01
影响因子：
6.3
通讯作者：
KRIPKE, DF
中科院分区：
文献类型：
--
作者：
ANCOLIISRAEL, S;KLAUBER, MR;KRIPKE, DF
睡眠呼吸暂停的特征是短暂的低氧血症，这被认为会影响精神功能。 因此，推测和研究集中在睡眠呼吸暂停和痴呆症之间的关系上。 我们研究了235名护理之家（即机构化）患者（152名女性，中位年龄为83.5岁; 83名男性，中位年龄为79.7岁）的便携式睡眠记录设备。 Mattis痴呆评定量表和老年抑郁量表。 70%的患者每小时睡眠有五次或更多的呼吸紊乱，96%的患者表现出一定的痴呆症。 睡眠呼吸暂停与痴呆评定量表上的所有子量表均显著相关。 轻度-中度呼吸暂停患者和无呼吸暂停患者之间的痴呆等级差异很小。 然而，后两组与重度呼吸暂停患者之间存在显著差异。 特别是，DRS上反映注意力、启动和持续、概念化和记忆任务的项目区分了患有和不患有严重睡眠呼吸暂停的患者。 在那些没有抑郁症的患者中，所有严重睡眠呼吸暂停的患者也都患有严重的痴呆症。 我们的数据表明，当睡眠呼吸暂停和痴呆严重时，痴呆和睡眠呼吸暂停之间有很强的关系。 虽然因果关系不能从关联中推断出来，但我们的研究假设是睡眠呼吸暂停导致脑功能缺陷，可能是由于整体效应而不是任何特定的皮质或皮质下结构。
Sleep apnea is characterized by transient hypoxemias which are thought to affect mental functioning. Accordingly, speculation and research have focussed on relationships between sleep apnea and dementia. We studied 235 nursing home (ie institutionalized) patients (152 women with a median age of 83.5; 83 men with a median age of 79.7) with portable sleep recording equipment. The Mattis Dementia Rating Scale and the Geriatric Depression Scale were given to each. Seventy percent of the patients had five or more respiratory disturbances per hour of sleep and 96 percent showed some dementia. Sleep apnea was significantly correlated with all sub-scales on the dementia rating scale. There were trivial differences in dementia ratings between those with mild-moderate apnea and those with no apnea. There were significant differences, however, between the latter two groups and those with severe apnea. In particular, items reflecting attention, initiation and perseveration, conceptualization, and memory tasks on the DRS distinguished between those with and without severe sleep apnea. Among those patients with no depression, all patients with severe sleep apnea were also severely demented. Our data suggest that there is a strong relationship between dementia and sleep apnea when the sleep apnea and dementia are severe. Although causality cannot be inferred from associations, our hypothesis for study is that sleep apnea causes deficits in brain function, possibly due to global effects rather than any particular cortical or subcortical structure.