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老年人睡眠问题与主观认知下降的关联研究进展
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Abstract:
随着全球人口老龄化的加剧，老年人的健康问题日益突出，其中认知健康与睡眠障碍的关联备受关注。主观认知下降(SCD)作为阿尔茨海默病(AD)的临床前阶段，可显著增加进展为轻度认知障碍(MCI)和AD的风险。本文系统综述了老年人睡眠问题与SCD的关联研究进展。流行病学数据显示，认知正常的中老年人群中SCD的患病率约为40%~60%，且存在显著的地区差异。研究表明，睡眠问题(如睡眠不足、睡眠质量差)与SCD密切相关：纵向研究显示SCD患者的总睡眠时间和卧床时间显著低于非SCD组，失眠症状的恶化与自我报告记忆力下降的风险增加相关。但现有研究多基于横断面设计，缺乏长期随访。未来需结合多组学数据、开展队列研究及个体化干预策略，以明确睡眠与SCD的因果关联及睡眠干预对SCD的临床转化价值。
With the global acceleration of population aging, health challenges among older adults have become increasingly prominent, particularly the interplay between cognitive health and sleep disturbances. Subjective cognitive decline (SCD), recognized as a pre-clinical stage of Alzheimer’s disease (AD), substantially elevates the risk of progression to mild cognitive impairment (MCI) and AD. This review systematically synthesizes the research progress of the association between sleep-related issues and SCD in older populations. Epidemiological studies indicate that the prevalence of SCD ranges from 40% to 60% among cognitively intact middle-aged and older adults, with marked geographical disparities. Studies demonstrate a robust correlation between sleep impairments (e.g. insufficient sleep duration, poor sleep quality) and SCD: longitudinal analyses reveal significantly reduced total sleep time and time in bed among SCD cohorts compared to non-SCD groups while deteriorating insomnia symptoms are associated with heightened risks of self-reported memory decline. However, current research predominantly relies on cross-sectional designs and lacks long-term follow-up data. Future investigations should integrate multi-omics approaches, prioritize cohort studies, and develop individualized intervention strategies to elucidate causal relationships between sleep patterns and SCD progression and the clinical translational value of sleep interventions for SCD.
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