Excessive Sleepiness is Predictive of Cognitive Decline in the Elderly
Excessive Sleepiness is Predictive of Cognitive Decline in the Elderly
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DOI：
10.5665/sleep.2070
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发表时间：
2012-09-01
期刊：
影响因子：
5.6
通讯作者：
Dauvilliers, Yves
中科院分区：
文献类型：
--
作者：
Jaussent, Isabelle;Bouyer, Jean;Dauvilliers, Yves
研究目的：检查基线时报告的睡眠投诉与（失眠投诉和白天过度嗜睡（EDS））和药物治疗，与社区居住的老年人认知能力下降。设计：一项为期8年的纵向研究。设置：法国三城市研究。参与者：一共有四个，894名来自法国3个城市的非痴呆患者，他们的简易精神状态检查（MMSE）评分>=测量和结果：使用问卷来评估失眠投诉（睡眠质量差（SQ）、启动睡眠困难（DIS）、维持睡眠困难（DMS）、清晨觉醒（EMA））、EDS和基线时的睡眠药物。认知功能下降定义为在2年、4年和8年随访期间MMSE评分降低4分。Logistic回归模型根据社会人口统计学、行为、身体和精神健康变量以及载脂蛋白E基因型进行调整。EDS独立地增加了认知功能下降的风险（OR = 1.26，95%CI = 1.02-1.56），尤其是对于那些在随访期间也发生痴呆的患者（OR = 1.39，95%CI = 1.00-1.97）。失眠主诉次数和DMS与MMSE认知功能下降呈负相关（3-4次主诉的OR = 0.77，95%CI = 0.60-0.98; OR = 0.81，95%CI = 0.68-0.96）。失眠的其他3个组成部分（SQ，DIS，EMA）没有显着相关的MMSE认知decline.Conclusions：我们的研究结果表明，EDS可能与独立的老年人群认知能力下降的风险。这些结果可能具有重要的公共卫生意义，因为EDS可能是认知能力下降和痴呆发作的早期标志物和潜在可逆风险因素。
Study Objectives: To examine the association of sleep complaints reported at baseline (insomnia complaints and excessive daytime sleepiness (EDS)) and medication, with cognitive decline in community-dwelling elderly.Design: An 8-yr longitudinal study.Setting: The French Three-City Study.Participants: There were 4,894 patients without dementia recruited from 3 French cities and having a Mini-Mental Status Examination (MMSE) score >= 24 points at baseline.Measurements and Results: Questionnaires were used to evaluate insomnia complaints (poor sleep quality (SQ), difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA)), EDS, and sleep medication at baseline. Cognitive decline was defined as a 4-point reduction in MMSE score during follow-up at 2, 4, and 8 yr. Logistic regression models were adjusted for sociodemographic, behavioral, physical, and mental health variables, and apolipoprotein E genotype. EDS independently increased the risk of cognitive decline (odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.02-1.56), especially for those patients who also developed dementia during the follow-up period (OR = 1.39, 95% CI = 1.00-1.97). The number of insomnia complaints and DMS were negatively associated with MMSE cognitive decline (OR = 0.77, 95% CI = 0.60-0.98 for 3-4 complaints, OR = 0.81, 95% CI = 0.68-0.96, respectively). The 3 other components of insomnia (SQ, DIS, EMA) were not significantly associated with MMSE cognitive decline.Conclusions: Our results suggest that EDS may be associated independently with the risk of cognitive decline in the elderly population. Such results could have important public health implications because EDS may be an early marker and potentially reversible risk factor of cognitive decline and onset of dementia.