The Association Between Cognitive Behavioral Therapy for Insomnia and Incident Cognitive Impairment Among Older Veterans

被引：0
作者：
Kusumoto, Hana [1 ]
Khakharia, Anjali [2 ,3 ,4 ]
Bramoweth, Adam D. [5 ]
Phillips, Lawrence [6 ]
Fung, Constance H. [7 ,8 ]
Eisenstein, Rina [2 ,3 ,4 ]
Vaughan, Camille P. [2 ,3 ,4 ]
机构：
[1] Univ Colorado, Dept Internal Med, Anschutz Med Campus,12605 East 16Th Ave, Aurora, CO 80045 USA
[2] Atlanta VA Healthcare Syst, Decatur, GA USA
[3] Emory Univ, Dept Med, Div Geriatr & Gerontol, Sch Med, Atlanta, GA USA
[4] Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs, Atlanta, GA USA
[5] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA
[6] Emory Univ, Dept Med, Div Endocrinol Lipids & Metab, Sch Med, Atlanta, GA USA
[7] UCLA, David Geffen Sch Med, Los Angeles, CA USA
[8] VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, North Hills, CA USA
来源：
JOURNAL OF APPLIED GERONTOLOGY | 2025年
关键词：
dementia; chronic insomnia; cognitive behavioral therapy for insomnia; sedative hypnotics; SLEEP; DISSEMINATION; PERFORMANCE; HYPNOTICS; DEMENTIA; ADULTS; IMPACT; RISK;
D O I：
10.1177/07334648251330666
中图分类号：
R4 [临床医学]; R592 [老年病学];
学科分类号：
1002 ; 100203 ; 100602 ;
摘要：
Among older adults, chronic insomnia is a risk factor for cognitive decline. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the initial treatment. We conducted a retrospective cohort study of 84,739 Veterans, using national Veterans Health Administration data, to evaluate the association between CBT-I completion and incident cognitive impairment among older Veterans. Veterans were classified as administration of Any CBT-I versus Referral only using electronic documented notes. Incident cognitive impairment was defined by dementia-related diagnosis codes or an associated medication prescription. Among Veterans not using sedative-hypnotics, there was a decreased incidence of cognitive impairment for Veterans completing Any CBT-I compared to Referral only, RR= 0.87 (95% CI: 0.80-0.98). Yet, for Veterans taking sedative-hypnotic medications, there was an increased incidence of cognitive impairment between groups, RR= 1.18 (95% CI: 1.07-1.30). CBT-I may offer a protective effect from incident cognitive impairment; however, the presence of sedative-hypnotics reverses this trend.
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页数：10
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