Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women.
Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women.
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DOI：
10.1002/ana.22468
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发表时间：
2011-11
影响因子：
11.2
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
--
作者：
Tranah, Gregory J.;Blackwell, Terri;Stone, Katie L.;Ancoli-Israel, Sonia;Paudel, Misti L.;Ensrud, Kristine E.;Cauley, Jane A.;Redline, Susan;Hillier, Teresa A.;Cummings, Steven R.;Yaffe, Kristine
以前的横断面研究已经观察到痴呆患者活动节律的改变，但因果关系的方向尚不清楚。我们确定了在社区居住的老年妇女中测量的昼夜活动节律是否与痴呆或轻度认知障碍（MCI）事件有前瞻性相关。从骨质疏松性骨折研究队列（平均年龄83岁）的1，282名健康社区居民女性中收集活动节律数据，腕关节活动记录至少3个24小时周期。每名参与者完成了神经心理学测试组合，并在大约5年后由专家小组裁定临床认知状态（痴呆，MCI，正常）。所有分析均根据人口统计学、BMI、功能状态、抑郁、药物、酒精、咖啡因、吸烟、健康状况和合并症进行调整。经过4.9年的随访，195名（15%）妇女患上了痴呆症，302名（24%）患上了MCI。活动节律降低的老年女性发生痴呆或MCI的可能性更高，当比较幅度（比值比[OR]= 1.57，95%CI，1.09 -2.25）或节律稳健性（OR= 1.57，95%CI，1.10 -2.26）最低四分位数的女性与最高四分位数的女性时。与平均活动时间（1：34 PM-3：51 PM）的女性相比，活动高峰时间晚于3：51 PM的女性患痴呆或MCI的风险增加（OR= 1.83，95%CI，1.29 -2.61）。年龄较大的健康女性，昼夜节律活动幅度和稳健性降低，节律延迟，患痴呆症和MCI的几率增加。如果得到证实，未来的研究应该检查影响活动节律的干预措施（体力活动，明亮的光线照射）是否会降低老年人认知能力下降的风险。
Previous cross-sectional studies have observed alterations in activity rhythms in dementia patients but the direction of causation is unclear. We determined whether circadian activity rhythms measured in community-dwelling older women are prospectively associated with incident dementia or mild cognitive impairment (MCI). Activity rhythm data were collected from 1,282 healthy community-dwelling women from the Study of Osteoporotic Fractures cohort (mean age 83 years) with wrist actigraphy for a minimum of three 24-hour periods. Each participant completed a neuropsychological test battery and had clinical cognitive status (dementia, MCI, normal) adjudicated by an expert panel approximately 5 years later. All analyses were adjusted for demographics, BMI, functional status, depression, medications, alcohol, caffeine, smoking, health status, and co-morbidities. After 4.9 years of follow-up, 195 (15%) women had developed dementia and 302 (24%) had developed MCI. Older women with decreased activity rhythms had a higher likelihood of developing dementia or MCI when comparing those in the lowest quartiles of amplitude (Odds ratio[OR]=1.57,95% CI,1.09–2.25) or rhythm robustness (OR=1.57,95%CI,1.10–2.26) to women in the highest quartiles. An increased risk of dementia or MCI (OR=1.83,95% CI,1.29–2.61) was found for women whose timing of peak activity occurred later in the day (after 3:51PM) when compared to those with average timing (1:34PM–3:51PM). Older, healthy women with decreased circadian activity rhythm amplitude and robustness, and delayed rhythms have increased odds of developing dementia and MCI. If confirmed, future studies should examine whether interventions (physical activity, bright light exposure) that influence activity rhythms will reduce the risk of cognitive deterioration in the elderly.
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DOI：
10.1523/jneurosci.2191-08.2008
发表时间：
2008-11-12
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Chen R;Seo DO;Bell E;von Gall C;Lee C
通讯作者：
Lee C
影响因子：
2.7
作者：
Espeland, Mark A.;Rapp, Stephen R.;Bassford, Tamsen
通讯作者：
Bassford, Tamsen
影响因子：
5.6
作者：
Buysse, DJ;Monk, TH;Begley, A
通讯作者：
Begley, A
衰老和痴呆症中的睡眠障碍
影响因子：
5.8
作者：
Bombois, S.;Derambure, P.;Monaca, C.
通讯作者：
Monaca, C.
影响因子：
3.1
作者：
Ancoli-Israel, Sonia;Gehrman, Philip;Levi, Leah
通讯作者：
Levi, Leah