社区老年人夜间睡眠时间与认知功能障碍的关联研究  

Association of Nighttime Sleep Duration with Cognitive Impairment among Community-dwelling Older Adults

作　　者：聂欢欢 李淮彪 杨林胜[1] 胡冰 孙良 盛杰[1] 张冬梅[4] 陈贵梅[4] 程北京 孟相龙 徐佩茹 薛贵芝 陶芳标[1,5] NIE Huanhuan;LI Huaibiao;YANG Linsheng;HU Bing;SUN Liang;SHENG Jie;ZHANG Dongmei;CHEN Guimei;CHENG Beijing;MENG Xianglong;XU Peiru;XUE Guizhi;TAO Fangbiao(School of Public Health,Anhui Medical University,Hefei 230032,China;The First Affiliated Hospital of USTC,Hefei 230032,China;Fuyang Center for Disease Control and Prevention,Fuyang 341200,China;School of Health Management,Anhui Medical University,Hefei 230032,China;Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics,Hefei 230032,China)

机构地区：[1]安徽医科大学公共卫生学院,安徽省合肥市230032 [2]中国科学技术大学第一附属医院,安徽省合肥市230032 [3]阜阳市疾病预防与控制中心,安徽省阜阳市341200 [4]安徽医科大学卫生管理学院,安徽省合肥市230032 [5]出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室,安徽省合肥市230032

出　　处：《中国全科医学》2023年第10期1250-1256,共7页Chinese General Practice

基　　金：安徽省高校自然科学基金重点项目(KJ2017A189);安徽医科大学博士科研资助基金(XJ201525);阜阳市居民疾病谱调查与分析(K2018160)。

摘　　要：背景随着我国人口快速老龄化,老年人认知功能障碍正日益成为突出的公共卫生问题。目的探讨社区老年人夜间睡眠时间与认知功能障碍的关联。方法本研究数据来源于2018年7—9月建立的阜阳市老年人健康与环境可控性队列,最终纳入认知功能数据和睡眠时间数据完整的4837例老年人为本研究对象。提取其中的一般人口学特征(性别、年龄、地区、文化程度、职业、婚姻状况等)、生活方式、慢性病患病情况、睡眠时间和认知功能数据。采用二元Logistic回归模型分析夜间睡眠时间与认知功能障碍的关联。采用限制性立方样条模型绘制睡眠时间与认知功能障碍的剂量-反应曲线。结果4837例老年人中,平均睡眠时间为(6.95±1.75)h,其中1773例(36.65%)每天睡眠时间≤6 h,2088例(43.17%)每天睡眠时间为>6~8 h,976例(20.18%)每天睡眠时间>8 h;认知功能障碍检出率为37.44%(1811/4837)。调整性别、年龄、地区、文化程度等混杂因素后,总人群睡眠时间≤6 h和>8 h的老年人认知功能障碍检出率分别是睡眠时间>6~8 h者的1.26倍[95%CI(1.09,1.46)]和1.22倍[95%CI(1.03,1.46)](P<0.05)。在男性人群中,睡眠时间>8 h的老年人认知功能障碍检出率是睡眠时间>6~8 h者的1.35倍[95%CI(1.06,1.72)](P<0.05);在女性人群中,睡眠时间≤6 h的老年人认知功能障碍检出率是睡眠时间>6~8 h者的1.29倍[95%CI(1.06,1.58)](P<0.05)限制性立方样条曲线结果显示,睡眠时间与认知功能障碍发生风险呈近似“U”形关系,低点在7 h左右。结论夜间睡眠时间较短和较长可能都是老年人认知功能障碍的独立、剂量依赖性的关联因素;最佳的睡眠时间在7 h左右;男性睡眠时间较长与认知功能障碍的关联强度较高,女性睡眠时间较短与认知功能障碍的关联强度较高。Background With the rapid population aging in China,cognitive impairment in older adults has become a growing public health concern.Objective To examine the association between nighttime sleep duration and cognitive impairment among community-dwelling older adults.Methods Data were derived from the cohort of Older Adult Health and Modifiable Environmental Factors established in Fuyang City from July to September 2018,among whom a total of 4837 older adults with complete data on cognitive function and sleep time were included in this study.General demographic characteristics[gender,age,living area(urban or rural),education level,occupation,marital status],living habits,the history of chronic diseases,sleep duration,and overall cognitive function were extracted.Binary Logistic regression models were used to analyze the association between nighttime sleep duration and cognitive impairment.Restrictive cubic splines were used to further determine potential dose-response relationships between them.Results The participants had a mean nighttime sleep duration of(6.95±1.75)hours,among whom 1773(36.65%)slept≤6 hours per day,2088(43.17%)slept>6-8 hours per day,and 976(20.18%)slept>8 hours per day.The detection rate of cognitive impairment was 37.44%(1811/4837).After adjusting for gender,age,living area,education level and other confounding factors,the detection rate of cognitive impairment was 1.26[95%CI(1.09,1.46)]times higher in older adults with nighttime sleep duration of≤6 hours,and was 1.22[95%CI(1.03,1.46)]times higher in older adults with nighttime sleep duration of>8 hours than in those with nighttime sleep duration of>6-8 hours(P<0.05).The detection rate of cognitive impairment in male older adults with nighttime sleep duration of>8hours was 1.35[(95%CI(1.06,1.72)]times higher than in those with nighttime sleep duration of>6-8 hours(P<0.05).The detection rate of cognitive impairment in female older adults with nighttime sleep duration of≤6 hours was 1.29[95%CI(1.06,1.58)]times higher than in those with nigh

关 键 词：老年人 认知功能障碍 睡眠障碍 睡眠时间 限制性立方样条模型 

分 类 号：R741[医药卫生—神经病学与精神病学]