中老年睡眠障碍与认知功能相关性分析

Analysis of Correlation between Sleep Disorder and Cognitive Function in the Middle and the Old

摘要: 目的：研究具有睡眠障碍人群其认知功能的改变。方法：在青岛社区选取教育程度为小学及以上50~80岁人群，共327名参与者完成匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)测试，按照PSQI测试总分 > 7分认定为睡眠障碍作为筛查标准进行分组，分睡眠良好组(PSQI < 7)，睡眠障碍组。对五个认知领域进行神经心理测试：包括情景记忆、注意力和处理速度、视觉空间能力、语言能力和执行能力，利用听觉词语学习测试(the Auditory Verbal Learning Test, AVLT)和复杂图形模仿(Rey Osterrieth Complex Figure Test, ROCF)情景记忆。连线测试A (the Trail Making Test A, TMT-A)和符号数字模式测试(Symbol Digit Modalities Test, SDMT)评估注意力和处理速度。ROCF复刻部分和CDT时钟绘制测试评估视觉空间。波士顿命名测试(the Boston Naming Test, BNT)和词语流畅性(Verbal fluency)评估语言能力。由连线测试B (the Trail Making Test B, TMT-B)和Stroop色字测验(Stroop Color-word Test, Stroop)评估执行功能。比较两组各认知功能差异，并对PSQI各因子及各认知功能进行相关性分析。结果睡眠良好组与睡眠障碍组受试者在注意功能、执行功能差异有统计学意义(P < 0.05)，在记忆、语言及视空间差异均无统计学意义(P > 0.05)。表示注意功能的SDMT得分与PSQI总分、入睡时间、睡眠效率呈负相关，相关性显著；表示执行功能的Stroop得分与PSQI总分呈正相关；性别与PSQI总分、主观睡眠质量、入睡时间、睡眠时间呈正相关，相关性显著；年龄与睡眠效率、催眠药物呈正相关，相关性显著。结论：本研究显示，睡眠障碍主要影响注意及执行功能，调节睡眠障碍可有助于预防认知功能损伤。

Abstract: Objective: To study the changes of cognitive function in people with sleep disorder. Methods: Right-handed people aged 50 - 80 years old with primary school education and above in Qingdao community were selected. A total of 327 participants completed PSQI, the groups were grouped according to the PSQI total score of >7 for the presence of sleep disorders as the screening criteria. Neuropsychological tests were carried out in five cognitive areas: episodic memory, attention and processing speed, visual-spatial ability, language ability and executive ability. Episodic memory tests were comprised of the Auditory Verbal Learning Test (AVLT) and Recall component of Rey Osterrieth Complex Figure Test (ROCF). Attention and processing speed tests were comprised of the Trail Making Test A (TMT-A) and Symbol Digit Modalities Test (SDMT). Visual-spatial tests were comprised of the Copy component of ROCF and Clock-Drawing Test (CDT). Language ability tests were comprised of the Boston Naming Test (BNT) and Verbal fluency. Executive function tests were comprised of the Trail Making Test B (TMT-B) and Stroop Color-word Test (Stroop). Results: In the two groups, attention and executive had significant differences (P < 0.05). Here were no significant differences in memory, language and visual space (P > 0.05). SDMT score of attention function was negatively correlated with PSQI total score, time to sleep and sleep efficiency, significant correlation. Gender was positively correlated with PSQI total score, subjective sleep quality, sleeping time, and sleeping time. Age was positively correlated with sleep efficiency and hypnotic drugs, and the correlation was significant. Conclusion: Sleep disorders mainly affect attention and executive function. Each factor of PSQI is related to different cognitive fields, which shows that sleep can be specifically regulated through changes in each cognitive field.