Change in Sleep and Cognition in Older Women

老年女性睡眠和认知的变化

• 批准号: 7452304
• 负责人: Katie L Stone
• 金额: $ 106.73万
• 依托单位: CALIFORNIA PACIFIC MED CTR RES INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-15 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7452304
• 关键词: Address; Age; Alcohol consumption; Archives; Attention; Biochemical Markers; Biochemical Pathway; Biological Assay; C-reactive protein; Calculi; California; Cardiovascular system; Caucasians; Caucasoid Race; Cessation of life; Characteristics; Clinic; Clinic Visits; Cognition; Comorbidity; Condition; Cross-Sectional Studies; Data; Dementia; Disease; Elderly; Foundations; Fracture; Fructosamine; Funding; Future; Home environment; Home visitation; Hour; House Call; Hypoxemia; Hypoxia; Impaired cognition; Impairment; Inflammation; Interleukin-6; Language; Longitudinal Studies; Malignant Neoplasms; Measures; Mediating; Medical; Medical center; Memory; Mental Depression; Observational Study; Osteoporosis; Outcome; Oxygen saturation measurement; Participant; Pathway interactions; Patient Self-Report; Patients; Peroxidase; Pharmaceutical Preparations; Physical activity; Polysomnography; Positioning Attribute; Psyche structure; Randomized Controlled Clinical Trials; Reaction Time; Recruitment Activity; Reporting; Research Institute; Research Personnel; Risk; Risk Factors; Sample Size; Sampling; San Francisco; Serum; Site; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Standards of Weights and Measures; Testing; Universities; Woman; Wrist; actigraphy; age related; aged; base; cognitive function; cohort; cysteine rich protein; day; design; executive function; falls; follow-up; glycemic control; indexing; mild neurocognitive impairment; mortality; novel; older women; osteoporosis with pathological fracture; prevent; study characteristics

DESCRIPTION (provided by applicant): Disturbed sleep is commonly observed in patients with poor cognition. Based on existing cross sectional studies, it is unclear whether impaired cognitive function leads to sleep disturbance, or vice versa. Furthermore, most studies have relied on subjective assessment of sleep, which is particularly inaccurate in elderly subjects. We and others have also found that poor sleep quality is associated with increased risk of mortality. However, existing studies are unable to test whether this association is due to poor sleep efficiency independent of intermittent hypoxia. The underlying mechanisms remain unclear. During an eighth examination in the multi-center Study of Osteoporotic Fractures (SOF), we used wrist actigraphy to objectively measure sleep in > 3000 older women (mean age 84). SOF, a multi-center observational study supported by NIAMS/NIA, was designed to determine risk factors for osteoporotic fractures in > 10,000 older women. Since baseline (1986-88), clinic visits were repeated about every 2 years. All participants are contacted tri-annually to assess incident falls, fractures and deaths. We propose to repeat actigraphy, and perform overnight oximetry and an extended battery of cognitive function tests in 700 older women at two clinic sites during Exam 9. These additional measures in this unique, well-characterized cohort of older women will enable us to address the following specific aims: 1) to explore the longitudinal associations between sleep and cognitive function; 2) to determine the independent relationships of actigraphic sleep quality and intermittent hypoxia (using oximetry) with specific domains of cognitive function; 3) to test the independent associations of actigraphic sleep quality and intermittent hypoxia on risk of subsequent mortality; 4) To determine whether biochemical markers of inflammation (serum IL-6 and CRP), measures of glycemic control (fructosamine), or oxidative burden (myeloperoxidase) mediate the relationships between sleep, cognition and death.

描述（由申请人提供）：认知能力差的患者通常会出现睡眠障碍。根据现有的横断面研究，尚不清楚认知功能受损是否会导致睡眠障碍，反之亦然。此外，大多数研究都依赖于对睡眠的主观评估，这对于老年受试者尤其不准确。我们和其他人还发现，睡眠质量差与死亡风险增加有关。然而，现有的研究无法测试这种关联是否是由于独立于间歇性缺氧的睡眠效率差所致。根本机制仍不清楚。在多中心骨质疏松性骨折研究 (SOF) 的第八次检查中，我们使用腕部活动记录仪来客观测量超过 3000 名老年女性（平均年龄 84 岁）的睡眠情况。 SOF 是一项由 NIAMS/NIA 支持的多中心观察性研究，旨在确定超过 10,000 名老年女性骨质疏松性骨折的危险因素。自基线（1986-88）以来，大约每两年重复一次门诊就诊。每年三次联系所有参与者，以评估跌倒、骨折和死亡事件。我们建议在检查 9 期间，在两个诊所的 700 名老年女性中重复体动记录仪、夜间血氧测定和一系列认知功能测试。在这个独特的、特征明确的老年女性群体中采取的这些额外措施将使我们能够实现以下具体目标：1）探索睡眠和认知功能之间的纵向关联； 2) 确定活动记录睡眠质量和间歇性缺氧（使用血氧测定法）与特定认知功能领域的独立关系； 3) 测试活动记录睡眠质量和间歇性缺氧与随后死亡风险的独立关联； 4) 确定炎症生化标志物（血清 IL-6 和 CRP）、血糖控制措施（果糖胺）或氧化负荷（髓过氧化物酶）是否介导睡眠、认知和死亡之间的关系。