Hana Kusumoto, Anjali Khakharia, Adam D Bramoweth, Lawrence Phillips, Constance H Fung, Rina Eisenstein, Camille P Vaughan
{"title":"认知行为疗法治疗失眠症与老年退伍军人认知障碍的关系。","authors":"Hana Kusumoto, Anjali Khakharia, Adam D Bramoweth, Lawrence Phillips, Constance H Fung, Rina Eisenstein, Camille P Vaughan","doi":"10.1177/07334648251330666","DOIUrl":null,"url":null,"abstract":"<p><p>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 <i>Any CBT-I</i> versus <i>Referral only</i> 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 <i>Any CBT-I</i> compared to <i>Referral only</i>, 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.</p>","PeriodicalId":47970,"journal":{"name":"Journal of Applied Gerontology","volume":" ","pages":"156-165"},"PeriodicalIF":2.0000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Association Between Cognitive Behavioral Therapy for Insomnia and Incident Cognitive Impairment Among Older Veterans.\",\"authors\":\"Hana Kusumoto, Anjali Khakharia, Adam D Bramoweth, Lawrence Phillips, Constance H Fung, Rina Eisenstein, Camille P Vaughan\",\"doi\":\"10.1177/07334648251330666\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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 <i>Any CBT-I</i> versus <i>Referral only</i> 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 <i>Any CBT-I</i> compared to <i>Referral only</i>, 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.</p>\",\"PeriodicalId\":47970,\"journal\":{\"name\":\"Journal of Applied Gerontology\",\"volume\":\" \",\"pages\":\"156-165\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2026-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Applied Gerontology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/07334648251330666\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Applied Gerontology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/07334648251330666","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GERONTOLOGY","Score":null,"Total":0}
The Association Between Cognitive Behavioral Therapy for Insomnia and Incident Cognitive Impairment Among Older Veterans.
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.
期刊介绍：
The Journal of Applied Gerontology (JAG) is the official journal of the Southern Gerontological Society. It features articles that focus on research applications intended to improve the quality of life of older persons or to enhance our understanding of age-related issues that will eventually lead to such outcomes. We construe application broadly and encourage contributions across a range of applications toward those foci, including interventions, methodology, policy, and theory. Manuscripts from all disciplines represented in gerontology are welcome. Because the circulation and intended audience of JAG is global, contributions from international authors are encouraged.
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