主观记忆减退的社区老年人群睡眠情况分析

doi:10.3969/j.issn.1003-9198.2021.06.006

摘要/Abstract

摘要： 目的研究主观记忆减退(SMD)老人睡眠特征,以期进一步发现SMD人群的特点。方法选择2017年11月参与上海市杨浦区社区健康调查的社区老年人群作为研究对象,按是否存在持续SMD分为SMD组(147例)和对照组(177例),采用匹兹堡睡眠质量量表(Pittsburgh Sleep Quality Index, PSQI)、Epworth嗜睡量表 (the Epworth Sleeping Scale, ESS)评估老人睡眠情况。结果 SMD组(25.9%)存在睡眠问题的比例高于对照组(13.0%),SMD组睡眠时长、睡眠受扰和日间思睡的比例(44.9%,7.5%,11.6%)分别高于对照组(33.3%,2.3%,3.4%),差异具有统计学意义。Logistic回归分析结果显示,简版老年抑郁量表(GDS)评分(OR=1.198,95% CI:1.059~1.235)、ESS评分(OR=1.068,95% CI:1.007~1.133)、睡眠质量问题(OR=1.944,95% CI:1.072~3.525)、高血压史(OR=1.609, 95% CI:1.016~2.548)与SMD相关。结论存在SMD的老年人更易出现睡眠问题,并且抑郁情绪、日间嗜睡、睡眠质量问题、高血压史是SMD的风险因素。

关键词: 老年人, 主观记忆减退, 睡眠

Abstract: Objective To study the sleep problems in the elderly with subjective memory decline (SMD), and to further discover the characteristics of SMD. Methods The elderly people who participated in the community health survey of Shanghai Yangpu District in November 2017 were selected. They were divided into two groups, SMD group (147 cases) and corrtrol group (177 cases) according to the existence of persistent SMD. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleeping Scale (ESS) were used to evaluate the sleep condition. Results SMD group had a higher proportion of sleep quality problems than the control group (25.9% vs 13.0%). The proportion of sleep duration, sleep disturbance and daytime dysfunction in SMD group (44.9%, 7.5%, 11.6%) were higher than those in the control group (33.3%, 2.3%, 3.4%), with statistically significant differences. Logistic regression analysis showed that the Geriatric Depression Scale (GDS) score (OR=1.198, 95% CI:1.059-1.235), ESS score (OR=1.068, 95% CI:1.007-1.133), sleep quality (OR=1.944,95% CI:1.072-3.525), hypertension (OR=1.609, 95% CI:1.016-2.548) were the risk factors for SMD. Conclusions The elderly people with SMD are more prone to presenting with sleep problems. Depressive mood, daytime sleepiness, sleep quality problems and hypertension are risk factors for SMD.

Key words: aged, subjective memory decline, sleep

中图分类号:

R 749.1

朱墨, 房圆, 李霞. 主观记忆减退的社区老年人群睡眠情况分析[J]. 实用老年医学, 2021, 35(6): 560-563.

ZHU Mo, FANG Yuan, LI Xia. Analysis of sleep condition of elderly people with subjective memory decline in the community[J]. Practical Geriatrics, 2021, 35(6): 560-563.

参考文献

[1] JESSEN F, AMARIGLIO R E, VAN BOXTEL M, et al. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease[J]. Alzheimers Dement, 2014, 10(6):844-852.
[2] RABIN L A, SMART C M, CRANE P K, et al. Subjective cognitive decline in older adults: an overview of self-report measures used across 19 international research studies[J]. J Alzheimers Dis, 2015, 48 (Suppl) 1:S63-S86.
[3] 刘芸, 董永海, 李晓云, 等. 中国60岁以上老年人睡眠障碍患病率的Meta分析[J]. 现代预防医学, 2014, 41(8):1442-1445,1449.
[4] JU Y E, MCLELAND J S, TOEDEBUSCH C D, et al. Sleep quality and preclinical Alzheimer disease[J]. JAMA Neurology, 2013, 70(5):587-593.
[5] GAUGLER J E, EDWARDS A B, FEMIA E E, et al. Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement[J]. J Gerontol B Psychol Sci Soc Sci, 2000, 55(4):247-255.
[6] 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2):103-107.
[7] TSAPANOU A, VLACHOS G S, COSENTINO S, et al. Sleep and subjective cognitive decline in cognitively healthy elderly: results from two cohorts[J]. J Sleep Res,2019, 28(5):e12759.
[8] DAI X J, JIANG J, ZHANG Z, et al. Plasticity and susceptibility of brain morphometry alterations to insufficient sleep[J]. Front Psychiatry, 2018, 9: 266.
[9] ZLATAR Z Z, MUNIZ M, GALASKO D, et al. Subjective cognitive decline correlates with depression symptoms and not with concurrent objective cognition in a clinic-based sample of older adults[J]. J Gerontol B Psychol Sci Soc Sci,2018, 73(7):1198-1202.
[10]MOGLE J, HILL N L, BHARGAVA S, et al. Memory complaints and depressive symptoms over time: a construct-level replication analysis[J]. BMC Geriatr, 2020, 20(1):57.
[11]YU J, RAWTAER I, FAM J, et al. Sleep correlates of depression and anxiety in an elderly Asian population[J]. Psychogeriatrics, 2016, 16(3):191-195.
[12]NGUYEN L A, HAWS K A, FITZHUGH M C, et al. Interactive effects of subjective memory complaints and hypertension on learning and memory performance in the elderly[J]. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn,2016, 23(2):154-170.
[13]于方, 吴晓青, 侯志峰, 等. 主观记忆减退者患轻度认知障碍的相关影响因素[J]. 第二军医大学学报, 2016, 37(5):654-657.
[14]邹颋, 季宏, 史青凌, 等. 老年综合评估及高血压管理在住养高血压老人中的应用研究[J]. 实用老年医学,2020, 34(11):1150-1152,1156.
[15]DEINER S, LIU X, LIN H M, et al. Subjective cognitive complaints in patients undergoing major non-cardiac surgery: a prospective single centre cohort trial[J]. Br J Anaesth,2019, 122(6):742-750.