老年2型糖尿病患者夜间睡眠时长对认知障碍的影响-东南大学学报医学版

老年2型糖尿病患者夜间睡眠时长对认知障碍的影响

单位：扬州疾病预防控制中心, 江苏扬州 225000

分类号：R587.1;R749.16

出版年·卷·期（页码）：2025·44·第三期（412-419）

摘要：

目的: 分析60岁及以上2型糖尿病(T2DM)患者认知障碍的流行状况,评估夜间睡眠时长对认知障碍的影响。方法: 采用多阶段整群随机抽样的方法,于2023年5~10月份抽取6个县市区1 149例60岁及以上糖尿病患者,通过问卷调查获取受访者的基本信息、生活方式、疾病史以及夜间睡眠时长等相关情况,并使用AD8+CSI-D工具筛选是否存在认知障碍,采用多因素Logistic回归分析方法和限制性立方样条图研究夜间睡眠时长对认知障碍的影响。结果: 本研究中认知障碍检出率为43.52%;多因素Logistics回归分析显示:与夜间睡眠时长6.1~7.0 h相比,≤5 h和7.1~8.0 h患认知障碍风险是前者的1.550倍[95%CI(1.031~2.330)]和1.555倍[95%CI(1.104~2.189)];分层分析显示,女性夜间睡眠时长≤5 h的认知障碍发生率高于男性,≥80岁夜间睡眠时长≤5 h和7.1~8.0 h认知障碍发生风险高于70~79岁;限制性立方样条图结果显示:老年糖尿病患者夜间睡眠时长与认知障碍的关系呈近似U型曲线关系。结论: 夜间睡眠时长过长或过短与认知障碍正向关联,存在性别和年龄差异。

Objective: To analyze the prevalence of cognitive impairment in patients with type 2 diabetes mellitus(T2DM) aged 60 years and above, and to evaluate the effect of length of sleep at night on cognitive impairment. Methods: A multi-stage cluster random sampling method was used to select 1 149 diabetic patients aged 60 years and above from 6 counties and urban areas from May to October 2023. The basic information, lifestyle, disease history and length of sleep at night of the interviewees were obtained through a questionnaire survey, and the existence of cognitive impairment was screened using AD8+CSI-D. Multivariate Logistic regression analysis and restricted cubic spline plot were used to study the effect of length of sleep at night on cognitive impairment. Results: The detection rate of cognitive impairment was 43.52%. Multi-factor Logistics regression analysis showed that the risk of cognitive impairment was 1.550 times[95%CI(1.031-2.330)] and 1.555 times[95%CI(1.104-2.189)] for ≤5 h and 7.1-8.0 h compared with 6.1-7.0 h for length of sleep at night. Stratified analysis showed that the incidence of cognitive impairment in women with length of sleep at night ≤5 h was higher than that in men, and the risk of cognitive impairment in women ≥80 years old with length of sleep at night ≤5 h and 7.1-8.0 h was higher than that in 70-79 years old. The results of restricted cubic spline plot showed that the relationship between length of sleep at night and cognitive impairment in elderly diabetic patients was approximately U-shaped. Conclusion: Long or short night sleep length is positively associated with cognitive impairment, and there are gender and age differences.

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