A population-based prospective study on rest-activity rhythm and mild cognitive impairment among Hong Kong healthy community-dwelling older adults.
A population-based prospective study on rest-activity rhythm and mild cognitive impairment among Hong Kong healthy community-dwelling older adults.
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一项基于人群的前瞻性研究对香港健康居住的老年人的静息节奏和轻度认知障碍。
DOI：
10.1016/j.nbscr.2021.100065
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发表时间：
2021-05
影响因子：
--
通讯作者：
Tse LA
中科院分区：
文献类型：
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作者：
Yi Lee PM;Ling Kwok BH;Ting Ma JY;Tse LA
在以人群为基础的研究中，关于静息-活动昼夜节律与认知功能障碍之间关系的研究相对较少，来自亚洲人群的证据也较少。我们的目的是研究香港健康社区居住的老年人中，体动计测量的静息-活动昼夜节律与轻度认知障碍（MCI）或认知障碍的关系。我们于2018年4月至9月招募了174名年龄≥65岁的香港健康成年人（36名男性vs. 138名女性），并随访了12个月。在基线和随访研究中，参与者被邀请佩戴腕动计7天。我们使用活动记录仪数据来计算他们的节律中线统计量（MESOR）、振幅、峰值相位和节律百分比。采用蒙特利尔认知评定量表（莫卡）评估基线和随访时的认知评分。进行多变量逻辑回归模型以估计休息-活动昼夜节律参数与MCI的关联;而多项逻辑回归模型用于检查节律参数与认知评分变化之间的关联（即，随访12个月时，病情恶化：<-1，病情稳定：-1至1，认知功能改善：≥2）。基线时静息-活动昼夜节律参数与MCI或认知障碍之间无相关性。多项Logistic回归分析结果显示，与平均峰值（下午1：24 -3：00）的受试者相比，延迟峰值（下午3：00后）的受试者不太可能有更好的认知能力（校正比值比（AOR）= 0.32，95%可信区间（CI）= 0.11-0.88）。在一年的随访中，与基线测量结果相比，将其顶相延迟24分钟的参与者也不太可能具有更好的认知功能（AOR = 0.26，95%CI = 0.08-0.79）。基线调查和后续研究的结果一致证实，在亚洲人群中，顶峰期延迟的老年人（特别是考虑到大多数参与者是女性）不太可能拥有更好的认知能力。具有延迟的顶相的老年人不太可能有更好的认知能力。在1年的随访中，那些顶相额外延迟24分钟的患者不太可能有更好的认知能力。亚洲人群的腕动记录休息-活动昼夜节律的证据有限。
Relatively few studies investigated the association between rest-activity circadian rhythm and cognitive impairment in population-based study, and the evidence from Asian populations is sparse. We aimed to examine the relationship of actigraphy measured rest-activity circadian rhythm with mild cognitive impairment (MCI) or cognitive impairment in Hong Kong healthy community-dwelling older adults. We recruited 174 Hong Kong healthy adults aged ≥65 years (36 male vs. 138 female) during April–September 2018, and followed up them for 12 months. Participants were invited to wear wrist actigraphy for 7 days in both baseline and follow-up study. We used the actigraph data to calculate their midline statistic of rhythm (MESOR), amplitude, acrophase and percent rhythm. Montreal Cognitive Assessment (MoCA) was used to assess their cognitive scores at baseline and follow-up. Multivariate logistic regression model was performed to estimate the association of rest-activity circadian rhythm parameters with MCI; whilst multinomial logistic regression model was used to examine the association between rhythm parameters and changes of cognitive scores (i.e., worsen: <-1, stable: -1 to 1, better cognition: ≥2) after 12-months follow-up respectively. There was no association between rest-activity circadian rhythm parameters and MCI or cognitive impairment at baseline. Compared to those with an averaged value of acrophase (1:24pm-3:00pm), results of multinominal logistic regression showed that participants with a delayed acrophase (after 3:00pm) were less likely to have better cognition (adjusted odds ratio (AOR) = 0.32, 95% confidence interval (CI) = 0.11–0.88). Upon one year of follow-up, participants who delayed their acrophase for 24 min than their baseline measurements were also less likely to have better cognitive functions (AOR = 0.26, 95%CI = 0.08–0.79). Results from both the baseline survey and follow-up study consistently confirmed that older adults, especially in light of the majority of participants being the females, with delayed acrophase were less likely to have better cognition in the Asian population. Older adults with delayed acrophase were less likely to have better cognition. On 1-year follow-up, those with an additional 24-min delay in acrophase were less likely to have better cognition. There is limited evidence of actigraphy rest-activity circadian rhythm from Asian populations.