The Association Between Cognitive Behavioral Therapy for Insomnia and Incident Cognitive Impairment Among Older Veterans.

IF 2.2 3区医学 Q2 GERONTOLOGY

Journal of Applied Gerontology Pub Date : 2025-04-02 DOI:10.1177/07334648251330666

Hana Kusumoto, Anjali Khakharia, Adam D Bramoweth, Lawrence Phillips, Constance H Fung, Rina Eisenstein, Camille P Vaughan

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Abstract

Among older adults, chronic insomnia is a risk factor for cognitive decline. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the initial treatment. We conducted a retrospective cohort study of 84,739 Veterans, using national Veterans Health Administration data, to evaluate the association between CBT-I completion and incident cognitive impairment among older Veterans. Veterans were classified as administration of Any CBT-I versus Referral only using electronic documented notes. Incident cognitive impairment was defined by dementia-related diagnosis codes or an associated medication prescription. Among Veterans not using sedative-hypnotics, there was a decreased incidence of cognitive impairment for Veterans completing Any CBT-I compared to Referral only, RR= 0.87 (95% CI: 0.80-0.98). Yet, for Veterans taking sedative-hypnotic medications, there was an increased incidence of cognitive impairment between groups, RR= 1.18 (95% CI: 1.07-1.30). CBT-I may offer a protective effect from incident cognitive impairment; however, the presence of sedative-hypnotics reverses this trend.

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认知行为疗法治疗失眠症与老年退伍军人认知障碍的关系。

在老年人中，慢性失眠是认知能力下降的一个危险因素。失眠的认知行为疗法（CBT-I）被推荐作为初始治疗。我们对84,739名退伍军人进行了回顾性队列研究，使用国家退伍军人健康管理局的数据，以评估老年退伍军人中CBT-I完成与偶发性认知障碍之间的关系。退伍军人被分为任意CBT-I管理和仅使用电子文档记录的转诊。偶发性认知障碍由痴呆相关诊断代码或相关药物处方定义。在未使用镇静催眠药物的退伍军人中，完成任何CBT-I的退伍军人与仅转诊的退伍军人相比，认知障碍发生率降低，RR= 0.87 （95% CI: 0.80-0.98）。然而，对于服用镇静催眠药物的退伍军人，两组之间认知障碍的发生率增加，RR= 1.18 （95% CI: 1.07-1.30）。CBT-I可能对偶发性认知障碍有保护作用；然而，镇静催眠药的出现扭转了这一趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Gerontology GERONTOLOGY-

CiteScore

5.10

自引率

13.30%

发文量

202

期刊介绍： The Journal of Applied Gerontology (JAG) is the official journal of the Southern Gerontological Society. It features articles that focus on research applications intended to improve the quality of life of older persons or to enhance our understanding of age-related issues that will eventually lead to such outcomes. We construe application broadly and encourage contributions across a range of applications toward those foci, including interventions, methodology, policy, and theory. Manuscripts from all disciplines represented in gerontology are welcome. Because the circulation and intended audience of JAG is global, contributions from international authors are encouraged.