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

Abstract

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

CLC Number:

R749.1

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.

Figures/Tables 6

Table 1

Comparison of basic information between older adults with different levels of cognitive impairment"

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

Table 1

Figure 1

Table 2

Table 3

Table 4

Figure 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

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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