{"title":"在美国全国老年人样本中，睡眠障碍和10年痴呆风险的种族差异。","authors":"Roger Wong, Jason Rafael Grullon","doi":"10.1192/bjo.2024.814","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Race/ethnicity and sleep disturbances are associated with dementia risk.</p><p><strong>Aims: </strong>To explore racial-ethnic disparities in sleep disturbances, and whether race/ethnicity moderates the relationship between sleep disturbances and dementia risk among older adults.</p><p><strong>Method: </strong>We analysed ten annual waves (2011-2020) of prospective cohort data from the National Health and Aging Trends Study, a nationally representative USA sample of 6284 non-Hispanic White (<i>n</i> = 4394), non-Hispanic Black (<i>n</i> = 1311), Hispanic (<i>n</i> = 342) and non-Hispanic Asian (<i>n</i> = 108) community-dwelling older adults. Sleep disturbances were converted into three longitudinal measures: (a) sleep-initiation difficulty (trouble falling asleep within 30 min), (b) sleep-maintenance difficulty (trouble falling asleep after waking up early) and (c) sleep medication usage (taking medication to sleep). Cox proportional hazards models analysed time to dementia, after applying sampling weights and adjusting for sociodemographic characteristics and health.</p><p><strong>Results: </strong>Black, Hispanic and Asian respondents exhibited higher frequencies of sleep-initiation and sleep-maintenance difficulties, but had less sleep medication usage, compared with White older adults. Among Hispanic respondents, sleep-initiation difficulty was associated with significantly decreased dementia risk (adjusted hazard ratio (aHR) = 0.34, 95% CI 0.15-0.76), but sleep-maintenance difficulty was associated with increased dementia risk (aHR = 2.68, 95% CI 1.17-6.13), compared with White respondents. Asian respondents using sleep medications had a significantly higher dementia risk (aHR = 3.85, 95% CI 1.64-9.04). There were no significant interactions for Black respondents.</p><p><strong>Conclusions: </strong>Sleep disturbances are more frequent among older Black, Hispanic and Asian adults, and should be considered when addressing dementia disparities. Research is needed to explore how certain sleep disturbances may elevate dementia risk across different racial and ethnic subgroups.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"10 6","pages":"e219"},"PeriodicalIF":3.9000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698159/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sleep disturbances and racial-ethnic disparities in 10-year dementia risk among a national sample of older adults in the USA.\",\"authors\":\"Roger Wong, Jason Rafael Grullon\",\"doi\":\"10.1192/bjo.2024.814\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Race/ethnicity and sleep disturbances are associated with dementia risk.</p><p><strong>Aims: </strong>To explore racial-ethnic disparities in sleep disturbances, and whether race/ethnicity moderates the relationship between sleep disturbances and dementia risk among older adults.</p><p><strong>Method: </strong>We analysed ten annual waves (2011-2020) of prospective cohort data from the National Health and Aging Trends Study, a nationally representative USA sample of 6284 non-Hispanic White (<i>n</i> = 4394), non-Hispanic Black (<i>n</i> = 1311), Hispanic (<i>n</i> = 342) and non-Hispanic Asian (<i>n</i> = 108) community-dwelling older adults. Sleep disturbances were converted into three longitudinal measures: (a) sleep-initiation difficulty (trouble falling asleep within 30 min), (b) sleep-maintenance difficulty (trouble falling asleep after waking up early) and (c) sleep medication usage (taking medication to sleep). Cox proportional hazards models analysed time to dementia, after applying sampling weights and adjusting for sociodemographic characteristics and health.</p><p><strong>Results: </strong>Black, Hispanic and Asian respondents exhibited higher frequencies of sleep-initiation and sleep-maintenance difficulties, but had less sleep medication usage, compared with White older adults. Among Hispanic respondents, sleep-initiation difficulty was associated with significantly decreased dementia risk (adjusted hazard ratio (aHR) = 0.34, 95% CI 0.15-0.76), but sleep-maintenance difficulty was associated with increased dementia risk (aHR = 2.68, 95% CI 1.17-6.13), compared with White respondents. Asian respondents using sleep medications had a significantly higher dementia risk (aHR = 3.85, 95% CI 1.64-9.04). There were no significant interactions for Black respondents.</p><p><strong>Conclusions: </strong>Sleep disturbances are more frequent among older Black, Hispanic and Asian adults, and should be considered when addressing dementia disparities. 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引用次数: 0
摘要
背景：种族/民族和睡眠障碍与痴呆风险相关。目的：探讨睡眠障碍的种族差异，以及种族/民族是否调节老年人睡眠障碍与痴呆风险之间的关系。方法：我们分析了来自国家健康与老龄化趋势研究的10年前瞻性队列数据（2011-2020年），这是一个具有全国代表性的美国样本，包括6284名非西班牙裔白人（n = 4394）、非西班牙裔黑人（n = 1311）、西班牙裔（n = 342）和非西班牙裔亚裔（n = 108）社区居住的老年人。睡眠障碍被转化为三个纵向测量：(a)睡眠开始困难（30分钟内入睡困难），(b)睡眠维持困难（早起后入睡困难）和(c)睡眠药物使用（服药入睡）。在应用抽样权重并根据社会人口特征和健康状况进行调整后，Cox比例风险模型分析了患痴呆症的时间。结果：与白人老年人相比，黑人、西班牙裔和亚裔受访者表现出更高频率的睡眠开始和睡眠维持困难，但睡眠药物的使用较少。在西班牙裔受访者中，与白人受访者相比，睡眠开始困难与痴呆风险显著降低相关（调整风险比(aHR) = 0.34, 95% CI 0.15-0.76），但睡眠维持困难与痴呆风险增加相关（aHR = 2.68, 95% CI 1.17-6.13）。使用睡眠药物的亚洲受访者患痴呆症的风险明显更高（aHR = 3.85, 95% CI 1.64-9.04）。黑人受访者没有明显的互动。结论：睡眠障碍在老年黑人、西班牙裔和亚裔成年人中更为常见，在解决痴呆差异时应予以考虑。需要进行研究来探索某些睡眠障碍是如何在不同的种族和民族亚群体中提高痴呆风险的。
Sleep disturbances and racial-ethnic disparities in 10-year dementia risk among a national sample of older adults in the USA.
Background: Race/ethnicity and sleep disturbances are associated with dementia risk.
Aims: To explore racial-ethnic disparities in sleep disturbances, and whether race/ethnicity moderates the relationship between sleep disturbances and dementia risk among older adults.
Method: We analysed ten annual waves (2011-2020) of prospective cohort data from the National Health and Aging Trends Study, a nationally representative USA sample of 6284 non-Hispanic White (n = 4394), non-Hispanic Black (n = 1311), Hispanic (n = 342) and non-Hispanic Asian (n = 108) community-dwelling older adults. Sleep disturbances were converted into three longitudinal measures: (a) sleep-initiation difficulty (trouble falling asleep within 30 min), (b) sleep-maintenance difficulty (trouble falling asleep after waking up early) and (c) sleep medication usage (taking medication to sleep). Cox proportional hazards models analysed time to dementia, after applying sampling weights and adjusting for sociodemographic characteristics and health.
Results: Black, Hispanic and Asian respondents exhibited higher frequencies of sleep-initiation and sleep-maintenance difficulties, but had less sleep medication usage, compared with White older adults. Among Hispanic respondents, sleep-initiation difficulty was associated with significantly decreased dementia risk (adjusted hazard ratio (aHR) = 0.34, 95% CI 0.15-0.76), but sleep-maintenance difficulty was associated with increased dementia risk (aHR = 2.68, 95% CI 1.17-6.13), compared with White respondents. Asian respondents using sleep medications had a significantly higher dementia risk (aHR = 3.85, 95% CI 1.64-9.04). There were no significant interactions for Black respondents.
Conclusions: Sleep disturbances are more frequent among older Black, Hispanic and Asian adults, and should be considered when addressing dementia disparities. Research is needed to explore how certain sleep disturbances may elevate dementia risk across different racial and ethnic subgroups.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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