认知障碍老年人身体活动、认知功能与睡眠质量的关系：基于静息脑电的中介效应分析

doi:10.3969/j.issn.1006-9771.2024.12.010

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (12): 1442-1451.doi: 10.3969/j.issn.1006-9771.2024.12.010

认知障碍老年人身体活动、认知功能与睡眠质量的关系：基于静息脑电的中介效应分析

马晓晨¹, 李淑璠¹, 贾舒祺¹, 刘聪¹, 张振宇², 韩东洋¹()

1.上海体育大学体育教育学院，上海市 200438
2.上海立信会计金融学院体育与健康学院，上海市 201620

收稿日期:2024-10-06 修回日期:2024-11-13 出版日期:2024-12-25 发布日期:2024-12-30
通讯作者: 韩东洋，男，汉族，河南洛阳市人，助教，硕士研究生，主要研究方向：运动与健康促进。韩东洋，E-mail： 13183079018@163.com E-mail:13183079018@163.com
作者简介:马晓晨(2000-)，女，汉族，安徽阜阳市人，硕士研究生，主要研究方向：运动与健康促进。
基金资助:
1.上海市人类运动能力开发与保障重点实验室资助项目(上海体育学院)(11DZ2261100);2. 国家社会科学基金项目(22BTY076)

Relationship of physical activity and cognitive function to sleep quality in older adults with cognitive impairment: a mediating effect of resting EEG

MA Xiaochen¹, LI Shufan¹, JIA Shuqi¹, LIU Cong¹, ZHANG Zhenyu², HAN Dongyang¹()

1. Shanghai University of Sport, Shanghai 200438, China
2. Shanghai Lixin University of Accounting and Finance, Shanghai 201620, China

Received:2024-10-06 Revised:2024-11-13 Published:2024-12-25 Online:2024-12-30
Contact: HAN Dongyang E-mail:13183079018@163.com
Supported by:
Shanghai Key Lab of Human Performance (Shanghai University of Sport)(11DZ2261100);National Social Science Fund of China(22BTY076)

摘要/Abstract

摘要：

目的基于静息脑电(EEG)分析认知障碍老年人身体活动、睡眠质量与认知功能的关系，探讨特异性EEG指标在身体活动影响睡眠质量中的中介作用。

方法 2024年3月至5月，于上海市松江区辰富佳苑、蔷薇九里社区和金山区鲁堰社区招募137例认知障碍老年人，使用蒙特利尔认知评估量表(MoCA)、国际身体活动问卷短卷(IPAQ-SF)和匹兹堡睡眠质量指数(PSQI)进行评估，并采集5 min EEG信号。

结果不同认知障碍程度老年人的PSQI评分有非常高度显著性差异(t = -7.400, P < 0.001)。PSQI总分与MoCA评分呈显著负相关(r = -0.412, P < 0.001)，与身体活动水平(PAL)呈显著负相关(r = -0.363, P < 0.001)。θ (F3、F4)功率值与PSQI总分和PAL均呈显著相关(P < 0.01)。身体活动可通过θ(F3+F4)功率值的部分中介(效应量-0.0004，95%CI -0.0007~-0.0002)路径对认知障碍老年人的睡眠质量产生影响。

结论老年人的认知障碍越严重，睡眠质量越差；身体活动水平越高，睡眠质量越好。身体活动可通过影响θ(F3+F4)功率值间接影响认知障碍老年人的睡眠质量。

关键词: 身体活动, 睡眠质量, 认知障碍, 老年人, 静息脑电

Abstract:

Objective To investigate the relationship of physical activity (PA) and cognitive function to sleep quality in older adults with cognitive impairment based on resting electroencephalogram (EEG), and to explore the mediating role of specific EEG markers in the relationship between PA and sleep quality.

Methods From March to May, 2024, 137 older adults were recruited from Chenfu Jiayuan and Qiangwei Jiuli in Songjiang district, and Luyan communities in Jinshan district, Shanghai. The assessments included Montreal Cognitive Assessment (MoCA), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Pittsburgh Sleep Quality Index (PSQI), along with a five-minute EEG recording.

Results There was significant difference in sleep quality among older adults with different levels of cognitive impairment (t = -7.400, P < 0.001). The PSQI total score was negatively correlated with MoCA scores (r = -0.412, P < 0.001) and total physical activity level (PAL) (r = -0.363, P < 0.001). The θ power in the frontal areas (F3, F4) was significantly correlated with both PSQI scores and PAL (P < 0.01). The θ power in F3 + F4 exhibited a significant partial (effect size = -0.0004, 95%CI -0.0007 to -0.0002) mediating effect between PA and sleep quality in older adults with cognitive impairment.

Conclusion Older adults with more severe cognitive impairment tend to have poorer sleep quality, whereas higher PAL is associated with better sleep quality. PA can indirectly influence sleep quality in older adults with cognitive impairment by affecting θ power (F3 + F4).

Key words: physical activity, sleep quality, cognitive impairment, older adults, electroencephalography

中图分类号:

R749.1

马晓晨, 李淑璠, 贾舒祺, 刘聪, 张振宇, 韩东洋. 认知障碍老年人身体活动、认知功能与睡眠质量的关系：基于静息脑电的中介效应分析[J]. 《中国康复理论与实践》, 2024, 30(12): 1442-1451.

MA Xiaochen, LI Shufan, JIA Shuqi, LIU Cong, ZHANG Zhenyu, HAN Dongyang. Relationship of physical activity and cognitive function to sleep quality in older adults with cognitive impairment: a mediating effect of resting EEG[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(12): 1442-1451.

图/表 6

表1

不同认知障碍程度老年人基本信息比较"

变量		轻度认知障碍(n = 59)	中重度认知障碍(n = 78)	t值/χ²值	P值
体质量指数/(kg $⋅$ m^-2)		24.47±2.94	23.72±3.46	1.348	0.180
年龄/岁		69.95±6.80	74.69±7.85	-3.708	< 0.001
教育年限/年		6.66±2.90	4.58±3.64	3.729	< 0.001
性别/n	男	36	41	0.975	0.323
	女	23	37
居住地/n	农村	45	63	0.407	0.523
	城市	14	15
听力下降/n	是	24	42	2.333	0.127
	否	35	36
视力下降/n	是	37	53	0.409	0.523
	否	22	25
吸烟/n	有	24	25	1.088	0.297
	无	35	53
饮酒/n	有	26	24	2.563	0.109
	无	33	54
过去1年发生跌倒/n	有	13	25	1.682	0.195
	无	46	53
慢性疾病/n	有	39	57	0.779	0.377
	无	20	21

表1

图1

表2

表3

表4

图2

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变量	脑区指标	δ	θ	α1	α2	β1	β2
PSQI评分	Fp1+Fp2	-0.177^a	0.124	0.019	-0.065	0.029	0.084
	F3+F4	-0.082	0.404^b	0.042	-0.028	0.081	0.126
	F7+F8	-0.175^a	0.294^b	0.041	0.017	0.074	0.146
	C3+C4	-0.189^a	0.312^b	0.051	0.015	0.106	0.171^a
	P3+P4	-0.143	0.309^b	0.045	0.018	0.087	0.141
	O1+O2	-0.195^a	0.352^b	0.075	0.038	0.124	0.195^a
	T3+T4	-0.210^a	0.011	0.110	0.023	0.063	0.114
	T5+T6	-0.244^b	0.323^b	0.054	0.025	0.114	0.198^a
PAL评分	FP1+FP2	-0.038	-0.189^a	0.079	0.125	-0.026	-0.136
	F3+F4	0.003	-0.306^b	0.071	0.094	-0.052	-0.118
	F7+F8	-0.016	-0.094	0.171^a	0.139	0.092	0.019
	C3+C4	-0.010	-0.117	0.158	0.160	0.075	-0.021
	P3+P4	-0.015	-0.091	0.171^a	0.154	0.098	0.038
	O1+O2	0.037	-0.101	0.161	0.163	0.087	-0.034
	T3+T4	-0.001	-0.084	0.096	0.100	-0.018	-0.130
	T5+T6	0.030	-0.101	0.185^a	0.166	0.096	-0.052

结果变量	预测变量	整体拟合指数			回归系数
结果变量	预测变量	R值	R²值	F值	β	t值	P值
θ (F3＋F4)	PAL	0.3060	0.0936	13.9468	-0.0018	-3.7345	0.0003
PSQI总分	PAL	0.3630	0.1318	20.4942	-0.0014	-4.5271	0.0000
PSQI总分	PAL	0.4762	0.2268	19.6475	-0.0010	-3.3086	0.0012
	θ (F3＋F4)				0.2058	4.0564	0.0001

项目	效应值	Boot SE值	Boot95%CI		效应占比/%
项目	效应值	Boot SE值	下限	上限	效应占比/%
直接效应	-0.0010	0.0003	-0.0016	-0.0004	71.43
间接效应	-0.0004	0.0001	-0.0007	-0.0002	28.57
总效应	-0.0014	0.0003	-0.0020	-0.0008

认知障碍老年人身体活动、认知功能与睡眠质量的关系：基于静息脑电的中介效应分析

Relationship of physical activity and cognitive function to sleep quality in older adults with cognitive impairment: a mediating effect of resting EEG

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