Relationship between insomnia and cognitive function in middle-aged and elderly patients / 中华全科医师杂志

ABSTRACT

Objective@#To investigate the relationship between insomnia and cognitive function in middle-aged and elderly patients.@*Methods@#Patients aged ≥ 45 years visiting outpatient clinic of You′anmen Community Health Center from October 2016 to December 2016 were enrolled in the study. Among 850 participants there were 159 patients with persistent insomnia, 188 with paroxysmal insomnia (insomnia group) and 503 with normal sleep (normal sleep group) according to DSM-5 diagnostic criteria. The sleep quality and cognition were evaluated using Pittsburgh Sleep Quality Index(PSQI) and Montreal Cognitive Assessment(MoCA) and compared among 3 groups. Relationship between sleep quality and cognition, influencing factors of cognition were explored in this study.@*Results@#The total score and all sub-scores of PSQI in persistent insomnia group were higher than those in the normal sleep group. The total score of PSQI and all sub-scores (except hypnotic drugs and daytime dysfunction) of paroxysmal insomnia group were higher than those of normal sleep group. The total PSQI score and all sub-scores (except sleep disorders) of the persistent insomnia group were higher than those of the paroxysmal insomnia group. The total score of MoCA and the sub-scores of naming, attention, language, abstract thinking, delayed recall and orientation ability of the persistent insomnia group were lower than those of the normal sleep group (P<0.05). The language ability of paroxysmal insomnia group was lower than that of normal sleep group (P<0.05). The language ability of persistent insomnia group was lower than that of paroxysmal insomnia group (P<0.05). The total score of MoCA was negatively correlated with the total score of PSQI and sub-scores of sleep time and sleep efficiency (r=-0.162, -0.131, -0.190; P<0.05). Logistic regression analysis showed that age was a risk factor for cognitive impairment (β=0.038, P=0.000) and sleep efficiency was a protective factor for cognitive function (β=0.260, P=0.000).@*Conclusion@#The overall cognitive function of middle-aged and elderly patients with persistent insomnia is poor, the abilities of naming, attention, language, abstract thinking, delayed recall and orientation are decreased; and the cognitive function is associated with age and sleep efficiency.