Correlations between sleep disorder and cognitive function in elderly patients with mild cognitive impairment

doi:10.3969/j.issn.1004-583X.2022.07.004

Abstract

Abstract:

Objective To explore the sleep disorders (SD) in elderly patients with mild cognitive impairment (MCI) and corresponding correlations with cognitive function. Methods A total of 171 eligible patients with MCI in a community located in Nanchong, Sichuan from November 2018 to January 2019 were included. The overall sleep conditions of patients was assessed by the Pittsburgh sleep quality index (PSQI). The enrolled patients were divided into MCI with SD group (MCI-SD group) and MCI without SD group (MCI-NSD group) according to scoring results. Montreal cognitive assessment-basic (MoCA-B), mini-mental status examination (MMSE), auditory verbal learning test (AVLT), Boston naming test (BNT), animal verbal fluency test (AFT), trail making test (TMT) were applied to evaluate the overall cognition, memory, language and executive function of MCI patients, and the differences in overall cognitive function and cognitive domain between two groups were comparatively analyzed. Results SD was found in 70 (40.9%) out of 171 MCI patients, and the differences in the gender, age and education level between two groups were not statistically significant (all $P$ >0.05), while the differences in the sleep quality, time of sleep onset, sleep duration, sleep efficiency, night sleep disorders, hypnotic drug and daytime function were statistically significant (all $P$ <0.05). Compared to the MCI-NSD group, MoCA-B, MMSE, and BNT scores of MCI-SD group were significantly lowered, and the total time spent on TMT-A was significantly increased (all $P$ <0.05). The time to fall asleep in the MCI-SD group was negatively correlated with the total score of MMSE and positively correlated with the total time spent in TMT-A; the sleep efficiency was negatively correlated with total scores of MMSE; total scores of PSQI were negatively correlated with total scores of MoCA-B and MMSE and were positively correlated with the total time spent in TMT-A. The total time spent on BNT and TMT-A was considered to be an independent risk factor for MCI patients complicated with SD (all $P$ <0.05). Conclusion MCI patients are found to have higher incidence of SD, and long-term sleep disorder may lead to or aggravate the decline of cognitive dysfunction, especially the impacts on language naming and executive function may be more significant.

Key words: cognitive dysfunction, sleep disorder, cognition

CLC Number:

R741

Li Zhongmei, Ran Li, Jiang Yi, Guo Zhiwei, Mu Qiwen. Correlations between sleep disorder and cognitive function in elderly patients with mild cognitive impairment[J]. Clinical Focus, 2022, 37(7): 607-611.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.07.004

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I7/607

Figures/Tables 5

组别	例数	年龄(岁)	性别(例)		文化程度(例)
组别	例数	年龄(岁)	男	女	文盲	小学	初中	高中	大学
MCI-SD组	70	67.21±4.65	19	51	13	33	22	1	1
MCI-NSD组	101	67.95±5.07	42	59	11	43	33	11	3
统计值		$t$ =0.966	χ²=3.758		χ²=7.647
$P$ 值		0.336	0.530		0.105

组别	例数	年龄(岁)	性别(例)		文化程度(例)
组别	例数	年龄(岁)	男	女	文盲	小学	初中	高中	大学
MCI-SD组	70	67.21±4.65	19	51	13	33	22	1	1
MCI-NSD组	101	67.95±5.07	42	59	11	43	33	11	3
统计值		$t$ =0.966	χ²=3.758		χ²=7.647
$P$ 值		0.336	0.530		0.105

组别	例数	PSQI量表总分	睡眠质量评分	入睡时间评分	睡眠时间评分	睡眠效率评分	夜间睡眠障碍评分	催眠药物评分	日间功能评分
MCI-SD组	70	9.57±2.76	1.61±0.71	2.07±1.01	1.74±0.96	1.73±1.18	1.66±0.56	0.19±0.67	0.57±0.71
MCI-NSD组	101	3.54±1.58	0.72±0.55	0.63±0.77	0.50±0.72	0.27±0.63	1.18±0.50	0.00±0.00	0.29±0.48
$t$ 值		16.502	8.847	10.039	9.251	9.475	5.74	2.334	2.914
$P$ 值		0.000	0.000	0.000	0.000	0.000	0.000	0.023	0.004

组别	例数	PSQI量表总分	睡眠质量评分	入睡时间评分	睡眠时间评分	睡眠效率评分	夜间睡眠障碍评分	催眠药物评分	日间功能评分
MCI-SD组	70	9.57±2.76	1.61±0.71	2.07±1.01	1.74±0.96	1.73±1.18	1.66±0.56	0.19±0.67	0.57±0.71
MCI-NSD组	101	3.54±1.58	0.72±0.55	0.63±0.77	0.50±0.72	0.27±0.63	1.18±0.50	0.00±0.00	0.29±0.48
$t$ 值		16.502	8.847	10.039	9.251	9.475	5.74	2.334	2.914
$P$ 值		0.000	0.000	0.000	0.000	0.000	0.000	0.023	0.004

组别	例数	MoCA-B 总分	MMSE 总分	AVLT评分		BNT评分	VFT评分	TMT总耗时数(s)
组别	例数	MoCA-B 总分	MMSE 总分	延迟回忆	再认	BNT评分	VFT评分	TMT-A	TMT-B
MCI-SD组	70	17.67±4.59	24.64±3.89	2.37±2.17	16.89±3.81	15.64±5.05	11.50±3.84	140.99±62.39	285.19±96.89
MCI-NSD组	101	19.64±3.74	25.81±3.19	2.75±2.24	17.49±3.64	18.50±4.57	11.68±3.58	114.07±43.21	263.05±85.97
$t$ 值		3.089	2.152	1.109	1.039	3.857	0.319	3.127	1.571
$P$ 值		0.002	0.033	0.269	0.300	0.000	0.750	0.002	0.118

组别	例数	MoCA-B 总分	MMSE 总分	AVLT评分		BNT评分	VFT评分	TMT总耗时数(s)
组别	例数	MoCA-B 总分	MMSE 总分	延迟回忆	再认	BNT评分	VFT评分	TMT-A	TMT-B
MCI-SD组	70	17.67±4.59	24.64±3.89	2.37±2.17	16.89±3.81	15.64±5.05	11.50±3.84	140.99±62.39	285.19±96.89
MCI-NSD组	101	19.64±3.74	25.81±3.19	2.75±2.24	17.49±3.64	18.50±4.57	11.68±3.58	114.07±43.21	263.05±85.97
$t$ 值		3.089	2.152	1.109	1.039	3.857	0.319	3.127	1.571
$P$ 值		0.002	0.033	0.269	0.300	0.000	0.750	0.002	0.118

项目	MoCA-B总分		MMSE总分		AVLT延迟回忆		AVLT再认
项目	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
PSQI总分	-0.237	0.049	-0.280	0.019	-0.048	0.696	-0.161	0.182
睡眠质量	-0.132	0.274	0.035	0.772	-0.057	0.639	-0.123	0.309
入睡时间	-0.190	0.114	-0.266	0.026	-0.050	0.678	-0.164	0.174
睡眠时间	-0.077	0.526	-0.183	0.129	-0.175	0.147	0.002	0.988
睡眠效率	-0.191	0.114	-0.320	0.007	-0.102	0.402	-0.112	0.356
夜间睡眠障碍	-0.038	0.754	-0.010	0.934	0.156	0.197	-0.123	0.311
催眠药物	-0.052	0.668	-0.037	0.759	0.015	0.899	0.182	0.131
日间功能	-0.042	0.731	-0.028	0.820	-0.101	0.406	0.041	0.735
项目	BNT评分		VFT评分		TMT-A		TMT-B
项目	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
PSQI总分	-0.042	0.730	0.020	0.869	0.236	0.049	0.094	0.440
睡眠质量	-0.035	0.773	0.028	0.819	0.233	0.053	0.052	0.667
入睡时间	-0.088	0.467	-0.210	0.810	0.370	0.002	0.089	0.466
睡眠时间	0.036	0.766	0.131	0.280	0.085	0.486	-0.035	0.772
睡眠效率	-0.074	0.541	0.008	0.951	0.137	0.258	0.107	0.376
夜间睡眠障碍	0.020	0.871	0.141	0.245	0.139	0.251	0.116	0.339
催眠药物	-0.009	0.941	-0.065	0.591	-0.030	0.807	-0.053	0.661
日间功能	0.068	0.579	-0.055	0.651	-0.061	0.615	0.024	0.841

项目	MoCA-B总分		MMSE总分		AVLT延迟回忆		AVLT再认
项目	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
PSQI总分	-0.237	0.049	-0.280	0.019	-0.048	0.696	-0.161	0.182
睡眠质量	-0.132	0.274	0.035	0.772	-0.057	0.639	-0.123	0.309
入睡时间	-0.190	0.114	-0.266	0.026	-0.050	0.678	-0.164	0.174
睡眠时间	-0.077	0.526	-0.183	0.129	-0.175	0.147	0.002	0.988
睡眠效率	-0.191	0.114	-0.320	0.007	-0.102	0.402	-0.112	0.356
夜间睡眠障碍	-0.038	0.754	-0.010	0.934	0.156	0.197	-0.123	0.311
催眠药物	-0.052	0.668	-0.037	0.759	0.015	0.899	0.182	0.131
日间功能	-0.042	0.731	-0.028	0.820	-0.101	0.406	0.041	0.735
项目	BNT评分		VFT评分		TMT-A		TMT-B
项目	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值	$r$ 值	$P$ 值
PSQI总分	-0.042	0.730	0.020	0.869	0.236	0.049	0.094	0.440
睡眠质量	-0.035	0.773	0.028	0.819	0.233	0.053	0.052	0.667
入睡时间	-0.088	0.467	-0.210	0.810	0.370	0.002	0.089	0.466
睡眠时间	0.036	0.766	0.131	0.280	0.085	0.486	-0.035	0.772
睡眠效率	-0.074	0.541	0.008	0.951	0.137	0.258	0.107	0.376
夜间睡眠障碍	0.020	0.871	0.141	0.245	0.139	0.251	0.116	0.339
催眠药物	-0.009	0.941	-0.065	0.591	-0.030	0.807	-0.053	0.661
日间功能	0.068	0.579	-0.055	0.651	-0.061	0.615	0.024	0.841

变量	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
变量	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
性别	-0.022	0.038	0.329	0.566	0.978	0.908	1.054
年龄	-0.037	0.410	0.008	0.928	0.431	0.431	2.155
受教育水平	-	-	-	>0.05	-	-	-
MoCA-B总分	-0.031	0.059	0.279	0.597	0.969	0.863	1.088
MMSE总分	0.023	0.063	0.134	0.715	1.023	0.905	1.157
AVLT延迟回忆	-0.056	0.089	0.339	0.528	0.946	0.795	1.125
AVLT再认	-0.033	0.054	0.364	0.546	0.968	0.870	1.077
BNT评分	-0.114	0.051	5.076	0.024	0.892	0.808	0.985
VFT评分	0.099	0.054	3.376	0.066	1.104	0.993	1.226
TMT-A	0.013	0.005	7.042	0.008	1.013	1.003	1.023
TMT-B	0.005	0.003	2.891	0.089	0.995	0.990	1.001

变量	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	95% $C I$
变量	回归系数	标准误	Waldχ²值	$P$ 值	$O R$ 值	下限	上限
性别	-0.022	0.038	0.329	0.566	0.978	0.908	1.054
年龄	-0.037	0.410	0.008	0.928	0.431	0.431	2.155
受教育水平	-	-	-	>0.05	-	-	-
MoCA-B总分	-0.031	0.059	0.279	0.597	0.969	0.863	1.088
MMSE总分	0.023	0.063	0.134	0.715	1.023	0.905	1.157
AVLT延迟回忆	-0.056	0.089	0.339	0.528	0.946	0.795	1.125
AVLT再认	-0.033	0.054	0.364	0.546	0.968	0.870	1.077
BNT评分	-0.114	0.051	5.076	0.024	0.892	0.808	0.985
VFT评分	0.099	0.054	3.376	0.066	1.104	0.993	1.226
TMT-A	0.013	0.005	7.042	0.008	1.013	1.003	1.023
TMT-B	0.005	0.003	2.891	0.089	0.995	0.990	1.001

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