老年阿尔茨海默症患者睡眠行为障碍现状及影响因素  

Current status and influencing factors of sleep behavior disordersin elderly patients with Alzheimer′s disease

作　　者：赵宇 梁燕 ZHAO Yu;LIANG Yan(Department of Neurology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610000,China)

机构地区：[1]四川大学华西医院神经内科/四川大学华西护理学院,四川成都610000

出　　处：《公共卫生与预防医学》2024年第3期23-27,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的分析老年阿尔茨海默症(Alzheimer′s disease,AD)患者睡眠行为障碍现状及影响因素。方法回顾性收集2020年6月至2023年6月四川大学华西医院神经内科收治的420例老年AD患者临床资料,REM睡眠行为障碍问卷-香港(sleep behavior disorder questionnaire-Hong Kong,RBDQ-HK)评估患者睡眠行为障碍现状,并据此分为睡眠行为障碍组、无睡眠行为障碍组,单因素及多因素logistic回归分析老年AD患者睡眠行为障碍的影响因素,并对睡眠行为障碍与匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PQSI)、简易智能精神状态检查量表(Mini Mental State Examination,MMSE)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)和汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)进行相关性分析。结果420例患者,有睡眠行为障碍患者227例(54.05%),无睡眠行为障碍193例(45.95%)。睡眠行为障碍组性别为女、文化程度初中及以下、病程≥5年、病情严重程度重度、未规范化用药占比、PQSI评分、HAMA评分、HAMD评分明显高于无睡眠行为障碍组,MMSE评分明显低于无睡眠行为障碍组(P<0.05)。logistic回归分析示,性别、病程、病情严重程度、PQSI评分、HAMA评分、HAMD评分是睡眠行为障碍的危险因素,文化程度、规范化用药、MMSE评分是保护因素(P<0.05)。PQSI评分、HAMA评分、HAMD评分与RBDQ-HK评分呈正相关,MMSE评分与RBDQ-HK评分呈负相关(P<0.05)。结论老年AD患者普遍存在睡眠行为障碍,女性、文化程度低、病程长、病情严重AD患者睡眠行为障碍发生风险高,临床中通过缓解患者焦虑抑郁情绪、改善睡眠质量、认知功能,或可有效预防睡眠行为障碍的发生。Objective To analyze the current status and influencing factors of sleep behavior disorders in elderly patients with Alzheimer′s disease(AD).Methods The clinical data of 420 elderly patients with AD were collected retrospectively.The REM sleep behavior disorder questionnaire-Hong Kong(RBDQ-HK)was used to evaluate the status of sleep behavior disorders.Based on the evaluation results,the patients were divided into sleep behavior disorder group and non-sleep behavior disorder group.Logistic regression analysis was conducted to identify the influencing factors of sleep behavior disorders in elderly patients with AD.The correlation between sleep behavior disorders and the Pittsburgh Sleep Quality Index(PQSI)score,Mini Mental State Examination(MMSE)score,Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score was analyzed.Results Among the 420 patients,there were 227(54.05%)patients with sleep behavior disorders.Gender,course of disease,disease severity,PQSI score,HAMA score and HAMD score were risk factors for sleep behavior disorders,while education level,standardized medication and MMSE score were protective factors(P<0.05).PQSI score,HAMA score and HAMD score were positively correlated with the RBDQ-HK score.The MMSE score was negatively correlated with the RBDQ-HK score(P<0.05).Conclusion Sleep behavior disorders are common in elderly patients with AD.Female patients,patients with low education level,patients with long course of disease and patients in severe condition are at high risk of developing sleep behavior disorders.Clinically,alleviating anxiety and depression and improving sleep quality and cognitive function may help to prevent the occurrence of sleep behavior disorders.

关 键 词：老年人 阿尔茨海默症 睡眠行为障碍 

分 类 号：R181[医药卫生—流行病学]