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杨萌柳, 曾燕, 许浪, 刘丹, 刘璋, 程桂荣. 老年人失眠及其类型对认知障碍患病影响[J]. 中国公共卫生, 2023, 39(6): 734-739. DOI: 10.11847/zgggws1140402
引用本文: 杨萌柳, 曾燕, 许浪, 刘丹, 刘璋, 程桂荣. 老年人失眠及其类型对认知障碍患病影响[J]. 中国公共卫生, 2023, 39(6): 734-739. DOI: 10.11847/zgggws1140402
YANG Mengliu, ZENG Yan, XU Lang, LIU Dan, LIU Zhang, CHENG Guirong. Effects of insomnia and its subtypes on cognitive impairment in Chinese elderly: an analysis on data from a nationwide survey and a follow-up study in Hubei province[J]. Chinese Journal of Public Health, 2023, 39(6): 734-739. DOI: 10.11847/zgggws1140402
Citation: YANG Mengliu, ZENG Yan, XU Lang, LIU Dan, LIU Zhang, CHENG Guirong. Effects of insomnia and its subtypes on cognitive impairment in Chinese elderly: an analysis on data from a nationwide survey and a follow-up study in Hubei province[J]. Chinese Journal of Public Health, 2023, 39(6): 734-739. DOI: 10.11847/zgggws1140402

老年人失眠及其类型对认知障碍患病影响

Effects of insomnia and its subtypes on cognitive impairment in Chinese elderly: an analysis on data from a nationwide survey and a follow-up study in Hubei province

  • 摘要:
      目的  了解老年人失眠及其类型对认知障碍患病的影响,为采取相应的干预措施提供参考依据。
      方法  收集2018 — 2020年中国多中心痴呆调查(CMDS)和湖北省老年记忆队列(HAMCS)中10 829名 ≥ 65岁老年人的认知功能筛查相关数据,采用多因素非条件logistic回归模型分析失眠及其常见类型对轻度认知功能障碍(MCI)和痴呆的影响。
      结果  10 829名 ≥ 65岁老年人中,失眠者3478人,失眠率为32.1%;MCI者3 191例,MCI患病率为29.5%;痴呆者865例,痴呆患病率为8.0%。在控制了性别、年龄、受教育年限、婚姻状况、居住地、社交活动、是否体育锻炼、是否饮酒、有无高血压、有无糖尿病、有无焦虑或抑郁和有无慢性便秘等混杂因素后,多因素非条件logistic回归分析结果显示,失眠、入睡困难和白天多睡老年人MCI的患病风险分别为非失眠、非入睡困难和非白天多睡老年人的1.139倍(OR = 1.139,95%CI = 1.033~1.256)、1.150倍(OR = 1.150,95%CI = 1.023~1.294)和1.345倍(OR = 1.345,95%CI = 1.051~1.722),白天多睡老年人痴呆的患病风险为非白天多睡老年人的1.984倍(OR = 1.984,95%CI = 1.389~2.835)。
      结论  老年人失眠可增加其认知障碍的患病风险,其中入睡困难老年人的MCI患病风险较高,而白天多睡老年人的MCI和痴呆患病风险均较高。

     

    Abstract:
      Objective  To examine effects of insomnia and its subtypes on incidence of cognitive impairment among elderly residents in China and to provide evidence for developing relevant intervention programs.
      Methods  The data on mild cognitive impairment (MCI) and dementia screening and their associates for 10 829 community elderly aged ≥ 65 years were collected from the China Multicentre Dementia Survey (CMDS) and the Hubei Aging and Memory Cohort Study (HAMCS) conducted from 2018 to 2020. Unconditional multivariate logistic regression model was used to analyze the effects of insomnia and its subtypes on MCI and dementia.
      Results  Of the 10 829 elderly, 3478 (32.1%) were assessed as having insomnia; 3 191 (29.5%) were identified suffering from MCI; and 865 (8.0%) were diagnosed with dementia. After controlling for gender, age, years of education, marital status, residence, social activities, physical exercise, alcohol drinking, hypertension, diabetes, anxiety or depression, and chronic constipation, multivariate logistic regression analysis revealed following significant risk factors of MCI: insomnia (odds ratio OR = 1.139, 95% confidence interval 95%CI: 1.033 – 1.256), difficulty in falling asleep (OR = 1.150, 95%CI: 1.023 – 1.294), and excessive daytime sleep (OR = 1.345, 95%CI: 1.051 – 1.722); the analysis also showed that the elderly with excessive daytime sleep were at an increased risk of dementia (OR = 1.984, 95%CI: 1.389 – 2.835).
      Conclusion  In Chinese elderly, insomnia could increase the risk of cognitive impairment; having difficulty in falling asleep is associated with increased MCI incidence and with excessive daytime sleep is related to high incidence of dementia.

     

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