Zhongguo quanke yixue (Jan 2024)
Correlations of Cognitive Function with Insomnia Severity, Serum Levels of 25-hydroxy Vitamin D3 and Tumor Necrosis Factor-α in Elderly Patients with Chronic Insomnia
Abstract
Background As one of the most common diseases in the elderly, chronic insomnia is often accompanied by cognitive impairment and seriously affects the quality of life of the elderly. The biological mechanism of cognitive impairment in elderly patients with chronic insomnia still remains unclear. Objective To investigate the correlation of cognitive function with insomnia severity, serum 25-hydroxy vitamin D3 [25 (OH) D3], tumor necrosis factor-α (TNF-α) in elderly patients with chronic insomnia. Methods A total of 105 elderly patients with chronic insomnia in the 901th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from June 2020 to June 2022 were selected as the research subjects. Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7) were tested before enrollment. The patients were divided into 32 cases in the mild insomnia group, 38 cases in the moderate insomnia group and 35 cases in the severe insomnia group according to the PSQI score. Photoplethysmography (PPG) was used to assess the objective sleep quality of patients, monitor the total sleep time, sleep latency, sleep efficiency and arousal times; the cognitive function of patients was evaluated by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Serum levels of 25 (OH) D3 and TNF-α were detected by enzyme-linked immunosorbent assay. Results The sleep latency, arousal times and the level of TNF-α in the severe insomnia group were higher than those in the mild and moderate insomnia groups, with lower total sleep time in the severe insomnia group compared to the mild insomnia group and lower sleep efficiency compared to the mild and moderate insomnia groups (P<0.05) ; sleep latency in the moderate insomnia group was higher than that in the mild insomnia group, with lower sleep efficiency compared to the mild insomnia group (P<0.05). MMSE and MoCA scores were lower in the severe insomnia group than the mild insomnia and moderate insomnia groups, and lower in the moderate insomnia group than the mild insomnia group (P<0.05). Serum TNF-α level was higher and 25 (OH) D3 level was lower in the severe insomnia group than the mild and moderate insomnia groups (P<0.05) ; serum TNF-α level was higher in the moderate insomnia group than the mild insomnia group, and 25 (OH) D3 level was lower than the mild insomnia group (P<0.05). Spearman correlation analysis results showed that MMSE and MoCA scores were positively correlated with total sleep time, sleep efficiency and 25 (OH) D3 level (P<0.05), and negatively correlated with insomnia severity, sleep latency, arousal times and TNF-α level (P<0.05) . Conclusion Cognitive impairment in elderly patients with chronic insomnia may be associated with insomnia severity, reduced serum 25 (OH) D3 level and elevated TNF-α level.
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