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Desai S, Chen IY, Hom C, Doran E, Nguyen DD, Benca RM, Lott IT, Mander BA. Insomnia Symptoms Are Associated with Measures of Functional Deterioration and Dementia Status in Adults with Down Syndrome at High Risk for Alzheimer's Disease. J Alzheimers Dis 2024:JAD220750. [PMID: 38875029 DOI: 10.3233/jad-220750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Background While obstructive sleep apnea (OSA) and insomnia symptoms in neurotypical populations are associated with Alzheimer's disease (AD), their association with dementia in adults with Down syndrome (DS) remains less clear, even though these symptoms are prevalent and treatable in DS. Understanding their associations with AD-related dementia status, cognitive impairment, and functional deterioration may lead to interventions to slow decline or disease progression in adults with DS. Objective To characterize differences in OSA and insomnia symptom expression by dementia status, and to determine which sleep factors support dementia diagnosis. Methods Multimodal consensus conference was used to determine dementia status in 52 adults with DS (52.2 ± 6.4 years, 21 women). Cognitive impairment, adaptive behavior skills, and symptoms of OSA and insomnia were quantified using validated assessments for adults with DS and their primary informants. Results A sex by dementia status interaction demonstrated that older women with DS and dementia had more severe terminal insomnia but not OSA symptoms relative to older women with DS who were cognitively stable (CS). Greater insomnia symptom severity was associated with greater functional impairments in social and self-care domains adjusting for age, sex, premorbid intellectual impairment, and dementia status. Conclusions Insomnia symptoms are more severe in women with DS with dementia than in women with DS and no dementia, and regardless of dementia status or sex, more severe insomnia symptoms are associated with greater impairment in activities of daily living. These findings underscore the potential importance of early insomnia symptom evaluation and treatment in women with DS at risk of developing AD.
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Affiliation(s)
- Shivum Desai
- Department of Pediatrics, University of California, Irvine, CA, USA
- Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI, USA
| | - Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Christy Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Eric Doran
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Dana D Nguyen
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Ira T Lott
- Department of Pediatrics, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
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Chan TC, Wu BS, Lee YT, Lee PH. Effects of personal noise exposure, sleep quality, and burnout on quality of life: An online participation cohort study in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:169985. [PMID: 38218481 DOI: 10.1016/j.scitotenv.2024.169985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Chronic noise exposure in daily life not only causes physical and mental illness but also reduces quality of life. However, collecting objective data on sound exposure and subjective acoustic comfort through a traditional one-shot survey is difficult. This study applied online chatbots in social media to explore the effects of daily sound exposure, personal characteristics, noise sensitivity, burnout status, and sleep quality on quality of life using a short-term participatory cohort design. During the two-month survey in 2022, 207 participants completed at least 15 days of collection of data on sound exposure and perception, as well as periodic structural questionnaires during the follow-ups. Linear regression and generalized linear models were applied to explore the factors influencing personal burnout, the Pittsburgh Sleep Quality Index, and quality of life. A chain mediation model was applied to explore the direct and indirect effects of noise exposure on quality of life. The results showed a better quality of life among respondents who rated their home environment better, were in good health, had better daily acoustic comfort, and were less exposed to noise during the week. In contrast, respondents with lower daily acoustic comfort and a higher frequency of noise-induced sleep disturbances and mood disorders were more likely to have poorer sleep quality. A higher personal burnout was associated with poorer health, longer exposure to noise during the week, a higher frequency of noise-induced illnesses, and neurotic traits. In the mediation analyses, noise-induced sleep disturbance and better daily acoustic comfort also had important direct influences on quality of life compared to the indirect pathway through sleep quality and personal burnout. In conclusion, noise exposure in daily life not only exacerbated poor sleep quality and personal burnout but also reduced quality of life.
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Affiliation(s)
- Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung campus, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Taiwan.
| | - Bing-Sheng Wu
- Department of Geography, National Taiwan Normal University, Taipei City, Taiwan
| | - Yu-Ting Lee
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
| | - Ping-Hsien Lee
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei City, Taiwan
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Wu CY, Lee MB, Huong PTT, Chan CT, Chen CY, Liao SC. The impact of COVID-19 stressors on psychological distress and suicidality in a nationwide community survey in Taiwan. Sci Rep 2022; 12:2696. [PMID: 35177670 PMCID: PMC8854558 DOI: 10.1038/s41598-022-06511-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
COVID-19 stressors and psychological stress response are important correlates of suicide risks under the COVID-19 pandemic. This study aimed to investigate the prevalence of COVID-19 stress, its impact on mental health and associated risk factors among the general population during the outbreak of COVID-19 in July 2020 throughout Taiwan. A nationwide population-based survey was conducted using a computer-assisted telephone interview system with a stratified, proportional randomization method for the survey. The questionnaire comprised demographic variables, psychological distress assessed by the five-item Brief Symptom Rating Scale and independent psychosocial variables including COVID-19 stressors, loneliness, suicidality, and health-related self-efficacy. In total, 2094 respondents completed the survey (female 51%). The COVID-19 stress was experienced among 45.4% of the participants, with the most prevalent stressors related to daily life and job/financial concerns. Higher levels of suicidality, loneliness, and a lower level of self-efficacy had significantly higher odds of having COVID-19 stress. The structural equation model revealed that COVID-19 stress was moderately associated with psychological distress and mediated by other psychosocial risk factors. The findings call for more attention on strategies of stress management and mental health promotion for the public to prevent larger scales of psychological consequences in future waves of the COVID-19 pandemic.
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Affiliation(s)
- Chia-Yi Wu
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
- School of Nursing, National Taiwan University College of Medicine, 1, Jen-Ai Road Section 1, Taipei, 10051, Taiwan.
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pham Thi Thu Huong
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Chia-Ta Chan
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chun-Yin Chen
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
| | - Shih-Cheng Liao
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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