Combined effect of cognitive dysfunction and sleep disturbance on mortality risk: NHANES 2011-2014.

IF 3.6 3区 医学 Q1 PSYCHIATRY
Tian-Shin Yeh, Yi-Chen Huang, Shu-Chuan Ho, Co-Yih Siow, Hsin-Chien Lee, Jose I Recio-Rodriguez, Jia-Ying Sung, Jowy Tani
{"title":"Combined effect of cognitive dysfunction and sleep disturbance on mortality risk: NHANES 2011-2014.","authors":"Tian-Shin Yeh, Yi-Chen Huang, Shu-Chuan Ho, Co-Yih Siow, Hsin-Chien Lee, Jose I Recio-Rodriguez, Jia-Ying Sung, Jowy Tani","doi":"10.1186/s12991-025-00593-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Both cognitive dysfunction and sleep disturbances are individually linked to heightened risks of chronic illnesses and mortality. However, their combined impact on all-cause and cardiovascular mortality remains underexplored.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, focusing on participants aged ≥ 60 years who completed cognitive tests and sleep-related questionnaires. Cognitive function was evaluated using three standardized tests: The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test, and the Digit Symbol Substitution Test. Participants with global cognitive z-scores below - 1 were classified as having low cognitive function. Sleep disturbance was identified based on self-reported diagnoses of sleep disorders or complaints of trouble sleeping. Mortality data were sourced from the National Death Index. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHR) for all-cause and cardiovascular mortality, with adjustments for potential confounders.</p><p><strong>Results: </strong>A total of 3,170 participants ≥ 60 years of age were included for analysis. Participants with low cognitive function alone had an adjusted hazard ratio (aHR) of 1.59 (95% CI: 1.12-2.26) for all-cause mortality. The risk increased to an aHR of 1.73 (95% CI: 1.07-2.79) when both low cognitive function and sleep disturbances were present. Stratified analyses revealed that the associations between cognitive function, sleep disturbance, and mortality risks varied across sex, BMI, and chronic kidney disease status.</p><p><strong>Conclusions: </strong>The combination of low cognitive function and sleep disturbances is associated with a higher risk of all-cause and cardiovascular mortality, exceeding the risk of either condition alone. These findings emphasize the need to consider both factors together when assessing mortality risk in older adults.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"52"},"PeriodicalIF":3.6000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406422/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of General Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12991-025-00593-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Both cognitive dysfunction and sleep disturbances are individually linked to heightened risks of chronic illnesses and mortality. However, their combined impact on all-cause and cardiovascular mortality remains underexplored.

Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, focusing on participants aged ≥ 60 years who completed cognitive tests and sleep-related questionnaires. Cognitive function was evaluated using three standardized tests: The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test, and the Digit Symbol Substitution Test. Participants with global cognitive z-scores below - 1 were classified as having low cognitive function. Sleep disturbance was identified based on self-reported diagnoses of sleep disorders or complaints of trouble sleeping. Mortality data were sourced from the National Death Index. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHR) for all-cause and cardiovascular mortality, with adjustments for potential confounders.

Results: A total of 3,170 participants ≥ 60 years of age were included for analysis. Participants with low cognitive function alone had an adjusted hazard ratio (aHR) of 1.59 (95% CI: 1.12-2.26) for all-cause mortality. The risk increased to an aHR of 1.73 (95% CI: 1.07-2.79) when both low cognitive function and sleep disturbances were present. Stratified analyses revealed that the associations between cognitive function, sleep disturbance, and mortality risks varied across sex, BMI, and chronic kidney disease status.

Conclusions: The combination of low cognitive function and sleep disturbances is associated with a higher risk of all-cause and cardiovascular mortality, exceeding the risk of either condition alone. These findings emphasize the need to consider both factors together when assessing mortality risk in older adults.

Abstract Image

Abstract Image

认知功能障碍和睡眠障碍对死亡风险的综合影响:NHANES 2011-2014。
背景:认知功能障碍和睡眠障碍都与慢性疾病和死亡率的增加有关。然而,它们对全因死亡率和心血管死亡率的综合影响仍未得到充分探讨。方法:本研究利用2011 - 2014年国家健康与营养调查(NHANES)的数据,重点研究年龄≥60岁的参与者,完成认知测试和睡眠相关问卷。认知功能通过三种标准化测试进行评估:阿尔茨海默病注册协会(CERAD)、动物流畅性测试和数字符号替代测试。总体认知z分数低于- 1的参与者被归类为认知功能低下。睡眠障碍是根据自我报告的睡眠障碍诊断或睡眠困难的抱怨来确定的。死亡率数据来源于国家死亡指数。采用Cox比例风险回归计算全因死亡率和心血管死亡率的校正风险比(aHR),并对潜在混杂因素进行校正。结果:共有3170名≥60岁的参与者被纳入分析。仅认知功能低下的参与者的全因死亡率校正风险比(aHR)为1.59 (95% CI: 1.12-2.26)。当认知功能低下和睡眠障碍同时存在时,风险增加到1.73 (95% CI: 1.07-2.79)。分层分析显示,认知功能、睡眠障碍和死亡风险之间的关联因性别、BMI和慢性肾脏疾病状况而异。结论:认知功能低下和睡眠障碍的合并与全因死亡率和心血管死亡率较高相关,超过任何一种单独情况的风险。这些发现强调在评估老年人死亡风险时需要同时考虑这两个因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信