The effect of sleep disorders on dementia risk in patients with traumatic brain injury: A large-scale cohort study.
The effect of sleep disorders on dementia risk in patients with traumatic brain injury: A large-scale cohort study.
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DOI：
10.1002/dad2.12411
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发表时间：
2023-04
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我们调查了成人创伤性脑损伤（TBI）患者睡眠障碍（SD）与痴呆事件之间的关系。2003年至2013年期间患有TBI的成年人被跟踪，直到发生痴呆症。在考克斯回归模型中，TBI时的睡眠障碍是预测因子，控制了其他痴呆风险。在52个月内，712，708名成年人中有4.6%（59%为男性，中位年龄44岁，<1%患有SD）患上了痴呆症。SD与男性和女性参与者痴呆风险增加26%和23%相关（风险比[HR] 1.26，95%置信区间[CI] 1.11-1.42和HR 1.23，95% CI 1.09-1.40）。在男性受试者中，SD与早发性痴呆风险增加93%相关（HR 1.93，95% CI 1.29-2.87）;女性受试者中不存在这种情况（HR 1.38，95% CI 0.78-2.44）。在全省范围的队列中，TBI时的SD与痴呆事件独立相关。测试TBI后性别特异性SD护理的临床试验是及时的。TBI和睡眠障碍相互关联，并与痴呆症有关。目前尚不清楚睡眠障碍是否会对脑损伤造成性别特异性痴呆风险。在这项研究中，睡眠障碍的存在增加了男女痴呆症的风险。这种风险因睡眠障碍的类型而异，这在性别之间是不同的。对脑损伤患者的睡眠障碍意识和护理对于预防痴呆症至关重要。
We investigated the association between sleep disorders (SDs) and incident dementia in adults with traumatic brain injury (TBI). Adults with a TBI between 2003 and 2013 were followed until incident dementia. Sleep disorders at TBI were predictors in Cox regression models, controlling for other dementia risks. Over 52 months, 4.6% of the 712,708 adults (59% male, median age 44, <1% with SD) developed dementia. An SD was associated with a 26% and a 23% of increased risk of dementia in male and female participants (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.11–1.42 and HR 1.23, 95% CI 1.09–1.40, respectively). In male participants, SD was associated with a 93% increased risk of early‐onset dementia (HR 1.93, 95% CI 1.29–2.87); this did not hold in female participants (HR 1.38, 95% CI 0.78–2.44). In a province‐wide cohort, SDs at TBI were independently associated with incident dementia. Clinical trials testing sex‐specific SD care after TBI for dementia prevention are timely. TBI and sleep disorders are linked to each other, and to dementia. It is unclear if sleep disorders pose a sex‐specific dementia risk in brain injury. In this study, presence of a sleep disorder increased dementia risk in both sexes. The risk differed by type of sleep disorder, which differed between the sexes. Sleep disorder awareness and care in persons with brain injury is vital for dementia prevention.