Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case-control study

Shunxin Lv; Huachen Jiao; Xia Zhong; Ying Qu; Mengdi Zhang; Rui Wang; Donghai Liu

doi:10.3389/fpubh.2024.1446781

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case-control study

Front Public Health. 2024 Nov 1:12:1446781. doi: 10.3389/fpubh.2024.1446781. eCollection 2024.

Authors

Shunxin Lv¹, Huachen Jiao², Xia Zhong³, Ying Qu¹, Mengdi Zhang¹, Rui Wang¹, Donghai Liu⁴

Affiliations

¹ The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
² Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
³ Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
⁴ School of Laboratory Animal & Shandong Laboratory Animal Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.

Abstract

Background: Previous studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.

Methods: A total of 2072 older adults hypertensive patients were included in this case-control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.

Results: After adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958-3.360, p < 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754-3.473, p < 0.001; OR = 2.385, 95%CI: 1.367-4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: -0.37312, -0.04194).

Conclusion: Poor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

Keywords: cognitive impairment; mediation analysis; older adults hypertension; physical activity; sleep quality.

MeSH terms

Aged
Aged, 80 and over
Case-Control Studies
China / epidemiology
Cognitive Dysfunction*
Exercise
Female
Humans
Hypertension* / complications
Male
Middle Aged
Risk Factors
Sleep Quality*
Surveys and Questionnaires

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Key R&D Program of Shandong Province, China (Major Scientific and Technological Innovation Project) (NO.2021SFGC0503).