Periodic Limb Movements in Sleep are Associated with Greater Cognitive Decline in Older Men without Dementia
Periodic Limb Movements in Sleep are Associated with Greater Cognitive Decline in Older Men without Dementia
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DOI：
10.5665/sleep.6158
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发表时间：
2016-10-01
期刊：
影响因子：
5.6
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
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作者：
Leng, Yue;Blackwell, Terri;Yaffe, Kristine
研究目的：探讨社区老年男性睡眠中周期性肢体运动(PLMS)与部分认知功能改变之间的关系。方法：对2636名非痴呆性老年男性进行家庭多导睡眠监测，用压电式传感器测量周期性肢体运动指数(PLMI)和周期性肢体运动唤醒指数(PLMAI)。结果：经过多因素调整后，PLMI高的男性在连线测验B部分上的下降幅度更大(P趋势=0.02)；PLMI>；=30的男性发生显著认知障碍的可能性增加48%(优势比=1.48，95%可信区间=1.05-2.07)。对睡眠效率、夜间低氧血症或多巴胺能药物使用的进一步调整以及对非帕金森病患者(n=2,607)的分析显示了类似的结果。结论：在非痴呆症的老年男性中，PLMS频率较高与认知功能，尤其是执行功能的下降更大。
Study Objectives: To examine the association between periodic limb movements in sleep (PLMS) and change in selected aspects of cognition in community-dwelling older men.Methods: We studied 2,636 older men without dementia who underwent in-home polysomnography with measurement of the periodic limb movement index (PLMI) and periodic limb movement arousal index (PLMAI) using piezoelectric sensors. Random-effects models and logistic regression were used to examine the association between PLMI, PLMAI, and 3- to 4-y change in cognition.Results: After multivariable adjustment, men with a high PLMI had greater decline on the Trail Making Test - Part B (P trend = 0.02); those with a PLMI >= 30 were 48% more likely (odds ratio = 1.48, 95% confidence interval = 1.05-2.07) to experience the development of significant cognitive impairment (>= 1 SD above mean change). Further adjustment for sleep efficiency, nocturnal hypoxemia, or dopaminergic medication use and analysis among men without Parkinson disease (n = 2,607) showed similar findings. No significant association was found for PLMAI or for Modified Mini-Mental State Examination scores.Conclusions: Among older men without dementia, higher PLMS frequency was associated with greater decline in cognition, particularly in executive function.