阿尔茨海默病及轻度认知障碍患者睡眠与认知的相关研究  

The correlation of sleep with cognitive function in patients with Alzheimer's disease and mild cognitive impairment

作　　者：闫逸冰 吴兴启 耿直 王璐[1,2] 肖桂贤 王晓静 周珊珊 卫玲[1,2,3] 田仰华 汪凯[1,2,3] Yan Yibing;Wu Xingqi;Geng Zhi;Wang Lu;Xiao Guixian;Wang Xiaojing;Zhou Shanshan;Wei Ling;Tian Yanghua;Wang Kai(Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Anhui Key Laboratory of Cognitive and Neuropsychiatric Diseases,Hefei 230022,China;Anhui Collaborative Innovation Center for Neuromental Diseases and Mental Health,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022 [2]认知与神经精神疾病安徽省重点实验室,合肥230022 [3]安徽省神经精神疾病与心理健康协同创新中心,合肥230022

出　　处：《中华老年医学杂志》2021年第5期570-575,共6页Chinese Journal of Geriatrics

基　　金：国家重大研发计划(2016YFC1300604、2016YFC1306404、2018YFC1314200);安徽省重点研究与开发计划(1704f0804030)。

摘　　要：目的探究轻度阿尔茨海默病(AD)与轻度认知障碍(MCI)患者的睡眠质量是否均存在损伤,并进一步探索其睡眠质量与认知功能之间的关系。方法共收集30例轻度AD,39例MCI患者,以及人口统计学相匹配的43例健康对照。采用匹兹堡睡眠质量指数量表(PSQI)评估其睡眠质量,同时采用简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)及成套神经心理学量表评估其认知功能,并探索三组被试睡眠质量与认知功能的关联。结果轻度AD、MCI和对照组三组间的睡眠时间[0.0(1.0)分比1.00(2.0)比1.0(1.0)分,F=8.18,P=0.02]和日间功能得分[1.0(1.0)分比1.0(1.0)比0.0(1.0)分,F=8.73,P=0.01]差异有统计学意义。Spearman相关性分析提示,轻度AD患者的睡眠障碍得分与数字广度倒背(DSB)(r=-0.43,P=0.02)呈负相关,日间功能得分与日常生活能力量表(ADL)(r=0.39,P=0.03)呈正相关。而在MCI组中患者的睡眠质量得分与DSB量表得分(r=-0.40,P=0.01)呈负相关,睡眠障碍得分与ADL(r=0.45,P<0.01)呈正相关,日间功能得分与数字广度正背(DSF)(r=-0.42,P=0.01)、DSB(r=-0.62,P<0.01)、与言语流畅性(VFT-S)(r=-0.33,P=0.04)呈负相关,PSQI总分与DSF(r=-0.45,P=0.01)、DSB(r=-0.44,P=0.01)呈负相关。结论轻度AD和MCI患者的睡眠时间延长,日间功能受损,且轻度AD和MCI患者的睡眠质量与记忆、注意和日常生活能力存在相关。Objective To explore whether sleep quality suffers in patients with mild Alzheimer's disease(AD)and mild cognitive impairment(MCI),and to further investigate the correlation between sleep disorders and cognitive function in these patients.Methods In this study,30 mild AD patients,39 MCI patients and 43 demographically matched healthy controls were enrolled.Sleep quality was assessed by the Pittsburgh sleep quality index(PSQI),and cognitive function was assessed by the mini-mental state examination(MMSE),the Montreal cognitive assessment(MoCA)and a set of neuropsychological scales.The correlation of sleep quality with cognitive function was analyzed for the three groups.Results Differences were significant in sleep time score[0.0(1.0),1.0(2.0)vs.1.0(1.0),F=8.18,P=0.02]and daytime function score[1.0(1.0),1.0(1.0)vs.0.0(1.0),F=8.73,P=0.01]between mild AD,MCI and health control groups.Spearman correlation analysis suggested that scores of sleep disorders were negatively correlated with DSB(r=-0.43,P=0.02)and scores of daytime function were positively correlated with ADL(r=0.39,P=0.03)in patients with mild AD.In addition,scores of sleep quality were negatively correlated with the DSB score(r=-0.40,P=0.01),scores of sleep disorders were positively correlated with ADL(r=0.45,P<0.01),scores of daytime function were negatively correlated with DSF(r=-0.42,P=0.01),DSB(r=-0.62,P<0.01)and VFT-S(r=-0.33,P=0.04),and the total PSQI score was negatively correlated with DSF(r=-0.45,P=0.01)and DSB(r=-0.44,P=0.01)in the MCI group.Conclusions Patients with mild AD and MCI have longer sleep time and impaired daytime function than healthy people,and sleep quality is correlated with memory,attention and daily living ability in patients with mild AD and MCI.

关 键 词：阿尔茨海默病 认知障碍 睡眠 

分 类 号：R749.16[医药卫生—神经病学与精神病学]