基于纵向数据联合模型的中国中老年人午睡时长与认知功能减退的关联研究
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国家自然科学基金(82073671,81703296),上海市卫生健康委员会科研项目(202340038)


Association between nap duration and cognitive decline in middle-aged and elderly people in China based on longitudinal data joint model
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Supported by National Natural Science Foundation of China (82073671, 81703296) and Scientific Research Project of Shanghai Municipal Health Commission (202340038)

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    摘要:

    目的 利用纵向数据联合模型探索中国中老年人午睡时长和认知功能减退之间的关联。方法 基于递归特征消除的方法对中国健康与养老追踪调查(CHARLS)数据进行自变量筛选。采用多因素Cox比例风险回归模型分析基线午睡时长对认知功能结局的影响;同时构建纵向数据和时间-事件数据联合模型,以分析午睡时长与认知功能减退的关联。结果 纳入10 314名受访者,共计40 579次随访记录,中位随访时间为10(8,10)年,共有2 975人(28.8%)发生了认知功能减退。基于递归特征消除方法筛选出的4个关键自变量分别是衰弱指数、年龄、受教育程度和社会参与程度。多因素Cox比例风险回归模型分析结果显示,基线午睡时长对认知功能减退的影响不显著(P=0.453)。联合模型分析结果显示,午睡时长的纵向变化与认知功能减退存在关联(HR=1.112,95%CI 1.099~1.126)。结论 基于联合模型发现午睡时长与认知功能减退存在关联,较长的午睡时间与认知功能减退风险增加相关,长时间午睡是认知功能减退的危险因素。纵向数据联合模型可为健康问题相关危险因素的关联性分析探索提供方法学支持。

    Abstract:

    Objective To explore the association between nap duration and cognitive decline using a joint model of longitudinal data in China's aging population. Methods Variables from the China Health and Retirement Longitudinal Study (CHARLS) were selected using recursive feature elimination. A multivariate Cox proportional hazards model was used to assess the effect of baseline napping on cognitive decline. A joint model integrating longitudinal data and time-to-event data was constructed to examine the association between nap duration and cognitive decline. Results This study included 10 314 participants, with a total of 40 579 follow-up records, and the median follow-up time was 10 (8, 10) years. A total of 2 975 (28.8%) people developed cognitive decline. Based on the recursive feature elimination method, 4 key independent variables were selected and included, namely frailty index, age, education level and social participation level. The multivariate Cox proportional hazards model showed that nap duration at baseline had no effect on cognitive function outcomes (P=0.453). The joint model showed that longitudinal changes in nap duration were significantly associated with cognitive decline (hazard ratio=1.112, 95% confidence interval 1.099-1.126). Conclusion Based on the joint model, it is found that nap duration is associated with cognitive decline, longer nap duration is associated with an increased risk of cognitive decline, and long nap duration is a risk factor for cognitive decline. The longitudinal data joint model can provide methodological support for the analysis of the association between risk factors and related health problems.

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  • 收稿日期:2024-06-28
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  • 在线发布日期: 2026-02-12
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