Epidemiology Of Sleep Disorders In The Elderly And Patients With Alzheimer’s Disease From Countryside Of Shandong Province

Objective:To investigate the prevalence of sleep disorders and related factors in the elderly and patients with Alzheimer’s disease (AD) from Shandong Province.Methods:This was a cross-sectional study which is divided into two phases. We conducted an epidemiologic survey on residents aged 65 to 85 in Yanlou, Yanggu, Liaocheng city, Shandong Province in August and December of 2014. According to NIA-AA (National Institute of Aging and Alzheimer’s Association) criteria, MCI and AD dementia were diagnosed, and amnestic MCI, a subtype of MCI, was further selected. Investigate materials included general questionnaire including basic information, Pittsburgh sleep quality index (PSQI), Mini-Mental State Examination (MMSE) and Hamilton’s Depression Scale (HAMD).Results:2635 people from this area were investigated,136 people were excluded because of obvious reasons of poor quality of sleep, such as the barking of dogs. Eventually 2499 people were included in analysis, of which 2064 (82.59%) were of normal cognitive function,306 (12.2%) patients with aMCI and 129 (5.16%) with AD dementia. The prevalence of sleep disorders was 53.1%,64.4%, and 53.5% in group of normal cognitive function, aMCI and AD dementia respectively. The prevalence of sleep disorders in aMCI group was significantly higher than both normal and AD dementia population. Scores of 5 items (sleep quality, sleep latency, sleep disturbances, use of sleep medications and daytime dysfunction) and the total score of PSQI in aMCI group were significantly higher than that in normal population. Total score of PSQI and all items in AD dementia group except for use of sleep medications and daytime dysfunction, were of no significant differences compared to normal and aMCI group. Spearman correlation analysis revealed that total score of PSQI and the MMSE score were significantly negatively correlated (r=-0.085,P<0.01). In AD group, the total score of PSQI and HAMD score had significant positive correlation (r = 0.257, P<0.01). Logistic regression analysis showed that the risk factors of sleep disorders among the rural elderly with normal cognitive are female, low levels of knowledge, smoking, disequilibrium of eating habits, halophilic, hypertension, diabetes, coronary heart disease, COPD and more life events. Female, farming, smoking, disequilibrium of eating habits and coronary heart disease were the risk factors for sleep disorders of aMCI, while coronary heart disease were the risk factors of sleep disorders in patients with AD dementia group.Conclusion:1. Sleep disorders, which are related to female, low levels of knowledge, halophilic, disequilibrium of eating habits, smoking, more life events and chronic diseases, are common in elderly people in rural areas and more attention should be paid to take the corresponding preventive measures.2. Sleep disorders are common in patients with aMCI and AD dementia, and are related to depression. Female, farming, smoking, unbalanced diet, coronary heart disease are risk factors for sleep disorders of aMCI. Coronary heart disease is a risk factor for sleep disorders of AD dementia.3. The prevalence of sleep disorders in aMCI group was significantly higher than normal group, suggested that sleep disorders may be early diagnostic symbols and treatment targets of AD.4. Sleep disorders are relative to low cognitive function. However there is no necessary link between the subjective feeling of sleep quality and the progress of AD. Hence, sleep disorders can’t be treated as a transformation symbol of aMCI to AD dementia.