Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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A Study on the Relationship between Sleep Quality and Cognitive Function in Community Elderly

지역사회 노인에서의 수면의 질과 인지기능의 관련성에 대한 연구

  • Oh, Youn-Kyoun (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Kim, Bong-Jo (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Park, Chul-Soo (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Lee, Cheol-Soon (Department of Psychiatry, Gyeongsang National University College of Medicine) ;
  • Cha, Bo-Seok (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Lee, So-Jin (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Lee, Dong-Yun (Department of Psychiatry, Gyeongsang National University College of Medicine) ;
  • Seo, Ji-Yeong (Department of Psychiatry, Gyeongsang National University Changwon Hospital) ;
  • Choi, Jae-Won (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Lee, Young-Ji (Department of Psychiatry, Gyeongsang National University Changwon Hospital) ;
  • Lee, Jae-Hon (Department of Psychiatry, Gyeongsang National University Hospital) ;
  • Lee, Youn-Jung (Department of Psychiatry, Gyeongsang National University Hospital)
  • 오윤균 (경상대학교병원 정신건강의학과) ;
  • 김봉조 (경상대학교병원 정신건강의학과) ;
  • 박철수 (경상대학교병원 정신건강의학과) ;
  • 이철순 (경상대학교 의학전문대학원 정신건강의학교실) ;
  • 차보석 (경상대학교병원 정신건강의학과) ;
  • 이소진 (경상대학교병원 정신건강의학과) ;
  • 이동윤 (경상대학교 의학전문대학원 정신건강의학교실) ;
  • 서지영 (창원경상대학교병원 정신건강의학과) ;
  • 최재원 (경상대학교병원 정신건강의학과) ;
  • 이영지 (창원경상대학교병원 정신건강의학과) ;
  • 이재헌 (경상대학교병원 정신건강의학과) ;
  • 이윤정 (경상대학교병원 정신건강의학과)
  • Received : 2020.04.21
  • Accepted : 2020.06.22
  • Published : 2020.06.30
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Abstract

Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.

목 적 : 나이가 들수록 수면의 질은 나빠진다고 알려져 있으며 수면의 질과 인지기능 사이의 관계를 조사한 전향적 연구는 현재까지 거의 없었다. 본 연구에서는 60세 이상의 지역사회 노인을 대상으로 6년 동안 추적 조사한 자료를 바탕으로 초기 수면의 질과 인지기능 사이의 관련성을 알아보고자 하였다. 방 법 : 본 연구에서는 60세 이상의 지역사회 노인 622명을 대상으로 하였고 최종 분석에는 322명의 노인이 포함되었다. 다음과 같은 임상척도가 사용되었다. 피츠버그 수면질 척도(Pittsburgh sleep quality index, PSQI)와 한국판 신경심리 평가집(Korean version of Consortium to Establisha Registry for Alzheimer's Disease, CERAD-K). 초기 수면의 질과 6년 이후의 인지기능의 관련성을 평가하기 위해 다중 선형 회귀분석을 시행하였다. 결 과 : 초기 수면의 질(PSQI)은 6년 이후의 숫자 외우기 검사(digit span test), 시계그리기 검사(CLOX 1), 단어 목록 회상 검사(word recall test)의 결과와 유의한 관련성이 있었다. 수면의 질이 좋을수록(β = -0.167, p = 0.026) 숫자외우기 검사 점수가 증가했으며 수면의 질이 좋을수록(β = -0.157, p = 0.031) 시계 그리기 점수(CLOX 1)가 증가했다. 또한 수면의 질이 좋을수록(β = -0.140, p = 0.039) 단어 목록 회상 검사 점수(word recall test)가 증가했다. 결 론 : 본 연구에서 수면의 질과 유의한 관련성이 있는 나온 숫자외우기 검사(digit span test), 단어목록 회상 검사(word list recall), 시계 그리기 검사 (CLOX 1)는 임상에서 비교적 단시간 내에 간편하게 수행 할 수 있는 검사이다. 수면의 질이 낮은 노인을 대상으로 이른 시기에 인지기능을 평가하는 것은 중요하며 추후 위의 3가지 검사가 수면의 질이 낮은 노인에게 조기 치매 진단의 유용한 선별검사가 될 수 있음을 밝히는 연구가 더 진행되어야 할 것이다.

Keywords

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