Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries,Experimental Gerontology

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Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries
Experimental Gerontology ( IF 3.3 ) Pub Date : 2021-08-10 , DOI: 10.1016/j.exger.2021.111513
Lee Smith ₁ , Jae Il Shin ₂ , Louis Jacob ₃ , Christina Carmichael ₁ , Guillermo F López Sánchez ₄ , Hans Oh ₅ , Laurie T Butler ₁ , Yvonne Barnett ₁ , Damiano Pizzol ₆ , Mark A Tully ₇ , Pinar Soysal ₈ , Nicola Veronese ₉ , Ai Koyanagi ₁₀

Affiliation

Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France.
Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.
Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA.
Italian Agency for Development Cooperation - Khartoum, Sudan.
School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Northern Ireland, UK.
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093 Fatih, İstanbul, Turkey.
Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy.
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain.

Background

The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings.

Objective

To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs).

Design

Cross-sectional.

Setting

Study on Global Ageing and Adult Health (SAGE).

Subjects

32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50–114 years; 51.7% females].

Methods

MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question “Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?” and categorized as “None”, “Mild”, “Moderate”, “Severe/Extreme”. Multivariable logistic regression analysis and meta-analysis were conducted.

Results

Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50–2.16), and a low level of between-country heterogeneity was observed (I² = 28.2%).

Conclusions

Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.

中文翻译：

低收入和中等收入国家 50 岁以上成年人的睡眠问题和轻度认知障碍

背景

有限的可用文献表明，睡眠问题与轻度认知障碍 (MCI) 的风险增加有关。然而，迄今为止，在低收入环境中很少研究这种关联。

客观的

在来自六个低收入和中等收入国家 (LMIC) 的大量成年人样本中调查睡眠问题与 MCI 之间的关联。

设计

横截面。

环境

全球老龄化与成人健康研究 (SAGE)。

科目

32,715 名年龄≥50 岁且功能能力保留的个体 [年龄范围 50-114 岁；51.7% 女性]。

方法

MCI 是使用国家老龄化研究所 - 阿尔茨海默氏症协会标准定义的。睡眠问题通过以下问题进行评估：“过去 30 天内总体而言，您在睡眠方面有多少问题，例如入睡、夜间频繁醒来或早上醒来太早？” 并分类为“无”、“轻度”、“中度”、“严重/极端”。进行了多变量逻辑回归分析和荟萃分析。

结果

与没有睡眠问题相比，轻度、中度和重度/极端睡眠问题与 MCI 的几率显着高 1.40、1.83 和 2.69 倍相关，并且在年龄组和性别之间观察到类似的关联。在研究的六个国家中，严重/极度睡眠问题与 MCI（即 OR > 1）呈正相关，总体估计值为 OR = 1.80（95% CI = 1.50–2.16），国家间异质性水平较低观察到（I ² = 28.2%）。