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Yu M, Jiang Y, Gong X, Gao X. Relationship Between Sleep Duration and Cognitive Function in Older Adults: Analysis of NHANES and UK Biobank GWAS Data. Biol Res Nurs 2024; 26:399-409. [PMID: 38302190 DOI: 10.1177/10998004241230325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To explore the relationship between sleep duration and cognitive functions in older adults using NHANES, a national US population study dataset, and to explore the causal association with Mendelian randomization (MR) using the UK Biobank. METHODS First, an observational study was conducted with the NHANES database with participants ≥60 years. Sleep duration was measured with accelerometers for 7 consecutive days. Participants were divided into habitual short sleep (<7 h) and long sleep (>9 h) groups. Cognitive functions were measured with the CERAD Word Learning sub-set, Animal Fluency, and Digit Symbol Substitution test (DSST). Multivariate regression models were used to explore relationships between sleep duration and cognitive functions. Second, bidirectional MR was conducted with data for self-reported sleep duration, which came from a genome-wide association study (GWAS) comprising 446,118 adults from the UK Biobank, and general cognitive performance, which was obtained from a recent GWAS study (N = 257,841). Inverse-variance weighted (IVW) was used as the primary estimation of the outcome. RESULTS In the observational study, 2687 participants were included. Sleep duration was associated with cognitive functions in a non-linear way. Habitual long sleep (>9°h) was associated with lower scores on DSST (OR = 0.01, p = .003) in the fully-adjusted model. The association between habitual short sleep and cognitive functions was insignificant. For the MR, genetically predicted lower general cognitive performance was causally associated with a higher prevalence of habitual short sleep (OR = 0.97, p = 5.1 × 10-7) and long sleep (OR = 0.97, p = 8.87 × 10-16). DISCUSSION Short and long sleep duration might be both causally associated with worse outcomes of cognitive functions in older adults, highlighting the importance of maintaining sleep health.
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Affiliation(s)
- Min Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Yang Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Xu Gong
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
| | - Xuemei Gao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- Center for Oral Therapy of Sleep Apnea, Peking University Hospital of Stomatology, Beijing, China
- National Center for Stomatology, Beijing, China
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Yang S, Wang S, Liu G, Li R, Li X, Chen S, Wang J, Zhao Y, Liu M, He Y. Association of Sleep Status With Cognitive Functions in Centenarians: Evidence From Hainan Centenarian Cohort. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad185. [PMID: 38150001 PMCID: PMC10873833 DOI: 10.1093/geronb/gbad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES This study aimed to analyze the association between sleep quality, sleep duration, and cognitive functions among centenarians. METHODS The baseline data of the China Hainan Centenarians Cohort Study served as the foundation for this study. Logistic regression was utilized to demonstrate the relationship between sleep status and cognitive impairment. Moreover, a canonical correlation analysis was performed to analyze the correlation between these variables. RESULTS A total of 994 centenarians were included. After adjustment, poor sleep quality centenarians had an odds ratio of 1.77 (95% confidence interval [CI]: 1.00-3.09) for cognitive impairment when compared to centenarians with normal sleep quality. Centenarians who slept for more than 9 hr had a stronger association with severe cognitive impairment, indicated by an odds ratio of 1.41 (95% CI: 1.02-1.96), compared to those who slept for 7-9 hr. Additionally, the canonical correlation analysis results revealed that the linear combination of sleep quality V1, primarily determined by sleep latency, daytime dysfunction, and subjective sleep quality, was associated with cognitive function; the linear combination of cognitive function W1, mainly determined by orientation, attention and calculation, and memory. DISCUSSION There exists a correlation between poor sleep quality and cognitive impairment in centenarians, as well as a correlation between sleep duration >9 hr at night and severe cognitive impairment. The primary cognitive domains associated with sleep quality are orientation, calculation, and memory. It is imperative to monitor and safeguard the cognitive functions linked to poor sleep quality in the older individuals, with attention to orientation, calculation, and memory.
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Affiliation(s)
- Shanshan Yang
- Department of Disease Prevention and Control, First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Guangdong Liu
- Graduate School, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Rongrong Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Xuehang Li
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Shimin Chen
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jianhua Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yali Zhao
- Central Laboratory of Hainan Hospital, Chinese People’s Liberation Army General Hospital, Sanya, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
- State Key Laboratory of Kidney Diseases, Beijing, China
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Soni R, Dale C, Garfield V, Akhtar N. A cross-sectional observational study for ethno-geographical disparities in sleep quality, brain morphometry and cognition (a SOLACE study) in Indians residing in India, and South Asians and Europeans residing in the UK - a study protocol. Front Aging Neurosci 2024; 16:1294681. [PMID: 38450379 PMCID: PMC10914976 DOI: 10.3389/fnagi.2024.1294681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction As individuals age, their sleep patterns change, and sleep disturbances can increase the risk of dementia. Poor sleep quality can be a risk factor for mild cognitive impairment (MCI) and dementia. Epidemiological studies show a connection between sleep quality and cognitive changes, with brain imaging revealing grey matter volume reduction and amyloid beta accumulation in Alzheimer's disease. However, most research has focused on Europeans, with little attention to other ethnic groups. Methods This is a cross sectional study comparing effects across countries and ethnicities. Group 1 (n = 193) will be Indians residing in India (new participant recruitment), Group 2 will be South Asians residing in UK and group 3 will be Europeans residing in the UK. For group 2 and 3 (n = 193), data already collected by UK-based Southall and Brent REvisited (SABRE) tri-ethnic study will be used. For group 1, Pittsburgh Sleep Quality Index questionnaire (PSQI) will be used for assessment of sleep quality, Indian Council of Medical Research (Neurocognitive ToolBox) (ICMR-NCTB) for cognition testing and a 3 T MRI cerebral scan for brain morphometry. The data will be compared to sleep, cognitive function and brain MRI parameters from SABRE. Discussion Racial and ethnic differences can impact the relationships of cognitive function, sleep quality and brain structure in older adults. Earlier studies have highlighted higher prevalence of poor sleep among black individuals compared to white individuals. Genetic or epigenetic mechanisms may contribute to these variations. Socio-cultural and environmental factors, such as neighbourhood, migration, lifestyle, stress and perceived discrimination may influence sleep patterns. The aim of the study is to examine the ethnogeographic variations in sleep quality, cognitive performance and brain morphometry among Indians living in India, and South Asians and Europeans residing in the UK.
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Affiliation(s)
- Rishabh Soni
- Baldev Singh Sleep Electrophysiology Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Caroline Dale
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Nasreen Akhtar
- Baldev Singh Sleep Electrophysiology Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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Bliwise DL, Wang TC, Svetnik V, Zammit G, Tao P, Lines C, Herring WJ. Phase advance of bedtimes in Alzheimer's disease. Sleep 2023; 46:zsad191. [PMID: 37540589 DOI: 10.1093/sleep/zsad191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Affiliation(s)
- Donald L Bliwise
- Sleep Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Ting-Chuan Wang
- Merck Research Laboratories, Merck & Co., Inc., Rahway, NJ, USA
| | | | - Gary Zammit
- Clinilabs Drug Development Corporation, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peining Tao
- Merck Research Laboratories, Merck & Co., Inc., Rahway, NJ, USA
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Fang W, Le S, Han W, Peng-Jiao X, Shuai Y, Rui-Ling Z, Lin L, Ya-Hui X. Association between napping and cognitive impairment: A systematic review and meta-analysis. Sleep Med 2023; 111:146-159. [PMID: 37776585 DOI: 10.1016/j.sleep.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/12/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023]
Abstract
STUDY OBJECTIVES Increasing evidence suggests that napping is associated with cognitive impairment and dementia, but the conclusions are inconsistent. Moreover, the extent of the risk is uncertain. We therefore conducted a systematic review and meta-analysis to quantify the connection between napping and cognitive impairment. METHODS We performed a systematic search of PubMed, EMBASE, Web of Science, and Cochrane Library for studies that were published up to June 2023, and assessed associations between napping and cognitive impairment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed. RESULTS A total of 4535 papers were retrieved, with 20 reports assessing the relationships between napping and cognitive impairment. Pooled analysis indicated that napping was associated with dementia (OR = 1.14; 95% CI: 1.07-1.21). Importantly, we found that those napping longer than 30, 45, and 60 min/day were 35%, 41%, and 40%, respectively, more likely to have an increased risk of cognitive impairment (30 min: OR = 1.35; 95% CI: 1.24-1.48; 45 min: OR = 1.41; 95% CI: 1.27-1.58; 60 min: OR = 1.40; 95% CI: 1.26-1.56). North America and Europe showed that associations existed between napping and cognitive impairment (North America: OR = 1.15; 95% CI: 1.04-1.27; Europe: OR = 1.13; 95% CI: 1.08-1.18). CONCLUSIONS This meta-analysis indicated associations between long napping durations and cognitive impairment or dementia, suggesting that longer napping might be a potential risk factor of adverse cognitive outcomes.
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Affiliation(s)
- Wu Fang
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Shi Le
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing, China
| | - Wang Han
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xu Peng-Jiao
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yu Shuai
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhang Rui-Ling
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Lu Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing, China.
| | - Xu Ya-Hui
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
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Li J, McPhillips M, Deng Z, Fan F, Spira A. Daytime Napping and Cognitive Health in Older Adults: A Systematic Review. J Gerontol A Biol Sci Med Sci 2023; 78:1853-1860. [PMID: 36472580 PMCID: PMC10562891 DOI: 10.1093/gerona/glac239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Daytime napping may improve cognitive function in older adults. However, the association can be complicated by specific features of napping and the older adult's health. This systematic review aims to synthesize the current literature on napping and cognition in older adults and provide recommendations for future research and daytime sleep practice in older adults. METHODS Systematic searches for relative research published between January 1995 and October 2022 were conducted at PubMed, MEDLINE, PsycINFO, and Google Scholar using keywords individually and in multiple combinations. Manual searches were performed to identify additional studies. All included studies were critically appraised by 2 authors. RESULTS Thirty-five studies, including 23 observational and 12 intervention studies, were reviewed. Findings from observational studies suggest a possible inverted U-shaped association between napping duration and cognitive function: short and moderate duration of naps benefited cognitive health in older adults compared with both non-napping and long or extended napping. Findings from intervention studies suggest one session of afternoon napping might improve psychomotor function and working memory, although with some inconsistency. The effect of multiple nap sessions on cognition was inconclusive due to a limited number of studies. CONCLUSION More rigorous research studies are needed to investigate what causes different patterns of daytime napping, the associations between these distinct patterns and cognitive function, and to determine whether interventions targeting napping patterns can improve cognition in older adults. In addition, future research needs to comprehensively assess daytime napping using a combination of measures such as sleep diary and actigraphy.
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Affiliation(s)
- Junxin Li
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | | | - Zhongyue Deng
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Fangfang Fan
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Adam Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
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Zhou L, Kong J, Li X, Ren Q. Sex differences in the effects of sleep disorders on cognitive dysfunction. Neurosci Biobehav Rev 2023; 146:105067. [PMID: 36716906 DOI: 10.1016/j.neubiorev.2023.105067] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Sleep is an essential physiological function that sustains human life. Sleep disorders involve problems with the quality, duration, and abnormal behaviour of sleep. Insomnia is the most common sleep disorder, followed by sleep-disordered breathing (SDB). Sleep disorders often occur along with medical conditions or other mental health conditions. Of particular interest to researchers is the role of sleep disorders in cognitive dysfunction. Sleep disorder is a risk factor for cognitive dysfunction, yet the exact pathogenesis is still far from agreement. Little is known about how sex differences influence the changes in cognitive functions caused by sleep disorders. This narrative review examines how sleep disorders might affect cognitive impairment, and then explores the sex-specific consequences of sleep disorders as a risk factor for dementia and the potential underlying mechanisms. Some insights on the direction of further research are also presented.
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Affiliation(s)
- Lv Zhou
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Jingting Kong
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoli Li
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Qingguo Ren
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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Camilleri M, Subramanian T, Pagan F, Isaacson S, Gil R, Hauser RA, Feldman M, Goldstein M, Kumar R, Truong D, Chhabria N, Walter BL, Eskenazi J, Riesenberg R, Burdick D, Tse W, Molho E, Robottom B, Bhatia P, Kadimi S, Klos K, Shprecher D, Marquez-Mendoza O, Hidalgo G, Grill S, Li G, Mandell H, Hughes M, Stephenson S, Vandersluis J, Pfeffer M, Duker A, Shivkumar V, Kinney W, MacDougall J, Zasloff M, Barbut D. Oral ENT-01 Targets Enteric Neurons to Treat Constipation in Parkinson Disease : A Randomized Controlled Trial. Ann Intern Med 2022; 175:1666-1674. [PMID: 36343348 DOI: 10.7326/m22-1438] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Parkinson disease (PD) is associated with α-synuclein (αS) aggregation within enteric neurons. ENT-01 inhibits the formation of αS aggregates and improved constipation in an open-label study in patients with PD. OBJECTIVE To evaluate the safety and efficacy of oral ENT-01 for constipation and neurologic symptoms in patients with PD and constipation. DESIGN Randomized, placebo-controlled phase 2b study. (ClinicalTrials.gov: NCT03781791). SETTING Outpatient. PATIENTS 150 patients with PD and constipation. INTERVENTION ENT-01 or placebo daily for up to 25 days. After baseline assessment of constipation severity, daily dosing was escalated to the prokinetic dose, the maximum dose (250 mg), or the tolerability limit, followed by a washout period. MEASUREMENTS The primary efficacy end point was the number of complete spontaneous bowel movements (CSBMs) per week. Neurologic end points included dementia (assessed using the Mini-Mental State Examination [MMSE]) and psychosis (assessed using the Scale for the Assessment of Positive Symptoms adapted for PD [SAPS-PD]). RESULTS The weekly CSBM rate increased from 0.7 to 3.2 in the ENT-01 group versus 0.7 to 1.2 in the placebo group (P < 0.001). Improvement in secondary end points included SBMs (P = 0.002), stool consistency (P < 0.001), ease of passage (P = 0.006), and laxative use (P = 0.041). In patients with dementia, MMSE scores improved by 3.4 points 6 weeks after treatment in the ENT-01 group (n = 14) versus 2.0 points in the placebo group (n = 14). Among patients with psychosis, SAPS-PD scores improved from 6.5 to 1.7 six weeks after treatment in the ENT-01 group (n = 5) and from 6.3 to 4.4 in the placebo group (n = 6). ENT-01 was well tolerated, with no deaths or drug-related serious adverse events. Adverse events were predominantly gastrointestinal, including nausea (34.4% [ENT-01] vs. 5.3% [placebo]; P < 0.001) and diarrhea (19.4% [ENT-01] vs. 5.3% [placebo]; P = 0.016). LIMITATION Longer treatment periods need to be investigated in future studies. CONCLUSION ENT-01 was safe and significantly improved constipation. PRIMARY FUNDING SOURCE Enterin, Inc.
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Affiliation(s)
| | | | - Fernando Pagan
- Department of Neurology, Georgetown University Hospital, Washington, DC (F.P.)
| | - Stuart Isaacson
- Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, Florida (S.I.)
| | - Ramon Gil
- Parkinson's Disease Treatment Center of SW Florida, Port Charlotte, Florida (R.G.)
| | - Robert A Hauser
- USF Parkinson's Disease and Movement Disorder Center, Tampa, Florida (R.A.H.)
| | - Mary Feldman
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (M.F.)
| | - Mark Goldstein
- JEM Headlands Research Institute, Atlantis, Florida (M.G.)
| | - Rajeev Kumar
- Rocky Mountain Movement Disorder Center, Englewood, Colorado (R.K.)
| | - Daniel Truong
- The Parkinson's and Movement Disorder Institute, Fountain Valley, California (D.T.)
| | - Nisha Chhabria
- Palm Beach Neurology and Premiere Research Institute, West Palm Beach, Florida (N.C.)
| | - Benjamin L Walter
- Parkinson's and Movement Disorders Center, Cleveland Clinic, Cleveland, Ohio (B.L.W.)
| | | | | | - Daniel Burdick
- Booth Gardner Parkinson's Care Center, EvergreenHealth, Kirkland, Washington (D.B.)
| | - Winona Tse
- Parkinson's and Movement Disorders Center, Icahn School of Medicine at Mount Sinai, New York, New York (W.T.)
| | - Eric Molho
- Parkinson's Disease and Movement Center, Albany Medical College, Albany, New York (E.M.)
| | | | | | - Srinath Kadimi
- Associated Neurologists of Southern Connecticut, Fairfield, Connecticut (S.K.)
| | - Kevin Klos
- The Movement Disorder Clinic of Oklahoma, Tulsa, Oklahoma (K.K.)
| | - David Shprecher
- Banner Sun Health Research Institute, Sun City, Arizona (D.S.)
| | | | - Gonzalo Hidalgo
- The Neuromedical Clinic of Central Louisiana, Alexandria, Louisiana (G.H.)
| | - Stephen Grill
- Parkinson's and Movement Disorders Center of Maryland, Elkridge, Maryland (S.G.)
| | - George Li
- MEDSOL Clinical Research, Port Charlotte, Florida (G.L.)
| | - Howard Mandell
- Metrolina Neurological Associates, Indian Land, South Carolina (H.M.)
| | - Mary Hughes
- Premier Neurology, Greer, South Carolina (M.H.)
| | | | - Joel Vandersluis
- Elias Research, Neurology Diagnostics, Inc., Dayton, Ohio (J.V.)
| | - Michael Pfeffer
- Allied Biomedical Neurologic Research Institute, Miami, Florida (M.P.)
| | - Andrew Duker
- University of Cincinnati, Cincinnati, Ohio (A.D.)
| | - Vikram Shivkumar
- University Physicians and Surgeons, Inc., Marshall Health, Huntington, West Virginia (V.S.)
| | | | - James MacDougall
- MacDougall Statistical Institute, Haverhill, Massachusetts (J.M.)
| | - Michael Zasloff
- Medstar-Georgetown Transplant Institute, Washington, DC, and Enterin Research Institute and Enterin, Inc., Philadelphia, Pennsylvania (M.Z.)
| | - Denise Barbut
- Enterin Research Institute and Enterin, Inc., Philadelphia, Pennsylvania (D.B.)
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Menczel Schrire Z, Gordon CJ, Palmer JR, Murray J, Hickie I, Rogers NL, Lewis SJG, Terpening Z, Pye JE, Naismith SL, Hoyos CM. Actigraphic and melatonin alignment in older adults with varying dementia risk. Chronobiol Int 2022; 40:91-102. [PMID: 36408793 DOI: 10.1080/07420528.2022.2144744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Circadian rhythms alter with ageing and may be aetiologically linked to neurodegeneration. This study explored the association between clinical markers and 1) dim light melatonin onset (DLMO) time and 2) phase angle derived from sleep midpoint, in older adults with varying dementia risks. Participants completed 14 days of actigraphy followed by in-lab measurement of salivary melatonin, from which DLMO time and phase angle were computed. Eighty participants (age = 65.5, SD = 9.6), 44 males (55%), MMSE (28.6, SD = 1.5) were included in the analysis. Sex (t = 2.15, p = .04), sleep onset (r = 0.49, p < .001) and midpoint (r = 0.44, p < .001) also correlated with DLMO time. Multiple linear regression showed chronotype, average actigraphy-derived light exposure during the DLMO window (window 2 h prior to DLMO to 2 h post), early biological day (6-10 h post DLMO time) and late biological day (10-14 h post DLMO time) were predictive of DLMO time (adjusted R2 = 0.75). Sleep offset, depression severity, average light exposure during the early biological night and early and late biological day were shown to be predictive variables in the estimation of phase angle (adjusted R2 = 0.78). The current study highlights the potential use of clinical variables, such as actigraphy-derived light, as circadian markers in ageing which could be easily implemented into existing clinical practice and could yield potential targets focusing on chronotherapeutic interventions.
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Affiliation(s)
- Zoe Menczel Schrire
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Jake R Palmer
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Jade Murray
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Ian Hickie
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Naomi L. Rogers
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Simon JG Lewis
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Zoe Terpening
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
| | - Jonathon E Pye
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Camilla M Hoyos
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
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11
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Álvarez-Bueno C, Mesas AE, Reina-Gutierrez S, Saz-Lara A, Jimenez-Lopez E, Martinez-Vizcaino V. Napping and cognitive decline: a systematic review and meta-analysis of observational studies. BMC Geriatr 2022; 22:756. [PMID: 36109701 PMCID: PMC9479293 DOI: 10.1186/s12877-022-03436-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND No clear evidence is available for the influence of napping on cognitive function in older adults. This systematic review and meta-analysis aimed to elucidate the cross-sectional and longitudinal relationships between napping and cognitive function (global cognition and memory) and to explore whether some individual characteristics and sleep characteristics can modify this relationship. METHODS We systematically searched Medline (via PubMed), Web of Science, and Scopus. DerSimonian and Lair and Hartung-Knapp-Sidik-Jonkman random effects methods were used to compute pooled estimates of odds ratios (ORs) and their respective 95% confidence intervals (95% CIs) for the association of global cognition and memory with napping. The mean age, the night sleep time (hours), and the percentage of women, no nappers, and people in the less night-time sleep duration category were used for meta-regressions. RESULTS Twenty-five studies were included in this systematic review and meta-analysis, 18 cross-sectional and seven longitudinal studies, including 95,719 participants older than 60 years. The pooled ORs from the cross-sectional analyses were 1.03 (95% CI: 1.01 to 1.06) for global cognition and 1.06 (95%: 0.90 to 1.26) for memory. The pooled ORs from the longitudinal analyses were 1.00 (95% 0.85 to 1.18) for global cognition and 1.08 (95% 0.98 to 1.19) for memory. These associations were not modified by individual or sleep characteristics. CONCLUSION Our data confirm the absence of association between napping and global cognition and memory regardless of the characteristics of the population. This information might be considered when providing lifestyle recommendations to adults with and without cognitive complaints.
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Affiliation(s)
- Celia Álvarez-Bueno
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.441660.10000 0004 0418 6711Universidad Politécnica Y Artística del Paraguay, Asunción, 001518 Paraguay
| | - Arthur Eumann Mesas
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.411400.00000 0001 2193 3537Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brasil
| | - Sara Reina-Gutierrez
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain
| | - Alicia Saz-Lara
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain
| | - Estela Jimenez-Lopez
- Department of Psychiatry Hospital, Virgen de La Luz, Cuenca, Spain ,grid.469673.90000 0004 5901 7501CIBERSAM (Biomedical Research, Networking Centre in Mental Health), Barcelona, Spain
| | - Vicente Martinez-Vizcaino
- grid.8048.40000 0001 2194 2329Universidad de Castilla-La Mancha, Health and Social Care Research Center, 16071 Cuenca, Spain ,grid.441837.d0000 0001 0765 9762Faculty of Health Sciences, Universidad Autónoma de Chile, 1670 Talca, Chile
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12
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Excessive sleep increased the risk of incidence of cognitive impairment among older Chinese adults: a cohort study based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Int Psychogeriatr 2022; 34:725-734. [PMID: 33658084 DOI: 10.1017/s1041610221000168] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
STUDY OBJECTIVES Based on a cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we aimed to evaluate the relationship between sleep duration and the incidence of cognitive impairment among older Chinese adults. METHODS We conducted a prospective analysis based on 3692 participants from the CLHLS at baseline (in 2011), and as a 3-year follow-up (till 2014), 531 participants (14.4%) had cognitive impairment, which was defined as a Mini-Mental State Examination score <24. Sleep duration was classified into three groups: short (≤5 hours/day), normal (>5 but <10 hours), and long (≥10 hours/day). A logistic regression model was used to examine the association between baseline sleep duration and cognitive impairment after adjusting for sociodemographic data, living habits, and health conditions. RESULTS Five hundred sixty-two participants (15.2%) were in the short-duration group, and 608 participants (16.5%) were in the long-duration group. After adjusting for multiple potential confounders, compared with normal sleep duration, long sleep duration was associated with the incidence of cognitive impairment (OR = 1.309, 95% CI: 1.019-1.683), especially among men (OR = 1.527, 95% CI: 1.041-2.240) and those having a primary and above education level (OR = 1.559, 95% CI: 1.029-2.361). No significant association was observed between short sleep duration and cognitive impairment (OR = 0.860, 95% CI: 0.646-1.145). CONCLUSIONS Excessive sleep may increase the risk of cognitive impairment in older individuals. It may be a suggestive sign of early neurodegeneration and may be a useful clinical tool to identify those at a higher risk of progressing to cognitive impairment.
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13
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Blackman J, Morrison HD, Lloyd K, Gimson A, Banerjee LV, Green S, Cousins R, Rudd S, Harding S, Coulthard E. The past, present, and future of sleep measurement in mild cognitive impairment and early dementia—towards a core outcome set: a scoping review. Sleep 2022; 45:6563140. [PMID: 35373837 PMCID: PMC9272273 DOI: 10.1093/sleep/zsac077] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/28/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study Objectives
Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment.
Methods
This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure.
Results
Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters.
Conclusions
Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.
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Affiliation(s)
- Jonathan Blackman
- Bristol Medical School, University of Bristol , Bristol , UK
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | - Hamish Duncan Morrison
- Bristol Medical School, University of Bristol , Bristol , UK
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | - Katherine Lloyd
- Bristol Medical School, University of Bristol , Bristol , UK
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | - Amy Gimson
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | | | - Sebastian Green
- Bristol Medical School, University of Bristol , Bristol , UK
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | - Rebecca Cousins
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
| | - Sarah Rudd
- Library and Knowledge Service, North Bristol NHS Trust , Bristol , UK
| | - Sam Harding
- Research and Innovation, North Bristol NHS Trust , Bristol , UK
| | - Elizabeth Coulthard
- Bristol Medical School, University of Bristol , Bristol , UK
- Bristol Brain Centre, North Bristol NHS Trust , Bristol , UK
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14
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Li C, Yan Y. Afternoon Napping Durations in Chinese Population Over 60 Years Old: Longitudinal Associations With Cognitive Performance. Front Public Health 2022; 10:911498. [PMID: 35874996 PMCID: PMC9302202 DOI: 10.3389/fpubh.2022.911498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Previous studies indicated inconsistent associations between daytime napping and cognitive decline. This study aimed to examine the associations between self-reported changes in napping and longitudinal cognitive performance. Methods A national representative sample of 4,024 participants over 60 was obtained from the China Health and Retirement Longitudinal Study from 2011 to 2018. Afternoon napping and potential factors were collected by a questionnaire. Cognitive performance was assessed on three aspects. The generalized additive models and generalized estimating equations were used to examine relationships between daytime napping and longitudinal global cognition, and generalized linear models were used to examine the longitudinal associations between change in napping at four waves and cognition in wave 4. Results After controlling the potential confounders, participants with afternoon napping were significantly related to better global cognition than no nappers at baseline. A change from short napping to no/long napping was associated with worse cognitive performance (β = −2.593, P < 0.001). A move from no napping to short/long napping was also associated with lower cognition scores (β = −0.694, P < 0.001). For participants with moderate napping, a >30 min increase (β = −1.558, P < 0.001) in afternoon napping was associated with worse cognitive function in wave 4. Conclusion We observed that adults over 60 years old with napping <30 min per day may be at lower risk of cognitive decline. Change in napping, especially a move to extreme napping would be a risk marker underlying health conditions that impact cognition or go along with cognitive decline.
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15
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Tai XY, Chen C, Manohar S, Husain M. Impact of sleep duration on executive function and brain structure. Commun Biol 2022; 5:201. [PMID: 35241774 PMCID: PMC8894343 DOI: 10.1038/s42003-022-03123-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 11/08/2022] Open
Abstract
Sleep is essential for life, including daily cognitive processes, yet the amount of sleep required for optimal brain health as we grow older is unclear. Poor memory and increased risk of dementia is associated with the extremes of sleep quantity and disruption of other sleep characteristics. We examined sleep and cognitive data from the UK Biobank (N = 479,420) in middle-to-late life healthy individuals (age 38-73 years) and the relationship with brain structure in a sub-group (N = 37,553). Seven hours of sleep per day was associated with the highest cognitive performance which decreased for every hour below and above this sleep duration. This quadratic relationship remained present in older individuals (>60 years, N = 212,006). Individuals who sleep between six-to-eight hours had significantly greater grey matter volume in 46 of 139 different brain regions including the orbitofrontal cortex, hippocampi, precentral gyrus, right frontal pole and cerebellar subfields. Several brain regions showed a quadratic relationship between sleep duration and volume while other regions were smaller only in individuals who slept longer. These findings highlight the important relationship between the modifiable lifestyle factor of sleep duration and cognition as well as a widespread association between sleep and structural brain health.
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Affiliation(s)
- Xin You Tai
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK.
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK.
| | - Cheng Chen
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Sanjay Manohar
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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16
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Liu R, Tang S, Wang Y, Dong Y, Hou T, Ren Y, Cong L, Liu K, Qin Y, Sindi S, Du Y, Qiu C. Self-reported sleep characteristics associated with dementia among rural-dwelling Chinese older adults: a population-based study. BMC Neurol 2022; 22:5. [PMID: 34979998 PMCID: PMC8722012 DOI: 10.1186/s12883-021-02521-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sleep characteristics associated with dementia are poorly defined and whether their associations vary by demographics and APOE genotype among older adults are unclear. METHODS This population-based cross-sectional study included 4742 participants (age ≥ 65 years, 57.1% women) living in rural China. Sleep parameters were measured using the self-rated questionnaires of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE). Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and the National Institute on Aging-Alzheimer's Association criteria for Alzheimer's disease (AD). Data were analysed using multiple logistic and general linear regression models. RESULTS Dementia was diagnosed in 173 participants (115 with AD). Multivariable-adjusted odds ratio (OR) of dementia was 1.71 (95%CI, 1.07-2.72) for sleep duration ≤4 h/night (vs. > 6-8 h/night), 0.76 (0.49-1.18) for > 4-6 h/night, 1.63 (1.05-2.55) for > 8 h/night, 1.11 (1.03-1.20) for lower sleep efficiency (per 10% decrease), and 1.85 (1.19-2.89) for excessive daytime sleepiness. Very short sleep duration (≤4 h/night), lower sleep efficiency, and excessive daytime sleepiness were significantly associated with being diagnosed with AD (multivariable-adjusted OR range = 1.12-2.07; p < 0.05). The associations of sleep problems with dementia and AD were evident mainly among young-old adults (65-74 years) or APOE ε4 carriers. Among dementia-free participants, these sleep characteristics were significantly associated with a lower MMSE score. CONCLUSIONS Self-reported sleep problems in dementia are characterized by very short or long sleep duration, low sleep efficiency, and excessive daytime sleepiness, especially among young-old people and APOE ε4 carriers. TRIAL REGISTRATION ChiCTR1800017758 (Aug 13, 2018).
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Affiliation(s)
- Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People's Republic of China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People's Republic of China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People's Republic of China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People's Republic of China
| | - Keke Liu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Shandong Academy of Clinical Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yu Qin
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Shireen Sindi
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China. .,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China. .,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, People's Republic of China.
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, 250021, Jinan, Shandong, People's Republic of China. .,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China. .,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
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17
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Wang L, Li J, Wang Z, Du Y, Sun T, Na L, Niu Y. Social capital and cognitive decline: Does sleep duration mediate the association? PLoS One 2021; 16:e0252208. [PMID: 34043692 PMCID: PMC8158899 DOI: 10.1371/journal.pone.0252208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics at School of Public Health of Guangdong Medical University, Dongguan, China
| | - Yong Du
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine at Ningxia Medical University, Yinchuan, China
| | - Ting Sun
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Li Na
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China.,School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
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18
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Kim REY, Kim HJ, Kim S, Abbott RD, Thomas RJ, Yun CH, Lee HW, Shin C. A longitudinal observational population-based study of brain volume associated with changes in sleep timing from middle to late-life. Sleep 2021; 44:5973752. [PMID: 33170277 DOI: 10.1093/sleep/zsaa233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 10/06/2020] [Indexed: 01/22/2023] Open
Abstract
STUDY OBJECTIVES Sleep behaviors are related to brain structure and function, but the impact of long-term changes in sleep timing on brain health has not been clearly addressed. The purpose of this study was to examine the association of longitudinal changes in sleep timing from middle to late-life with gray matter volume (GMV), an important marker of brain aging. METHODS We enrolled 1798 adults (aged 49-82 years, men 54.6%) who underwent magnetic resonance imaging (MRI) between 2011 and 2014. Midsleep time (MST) on free days corrected for sleep debt on workdays was adopted as a marker of sleep timing. Data on MST were available at the time of MRI assessment and at examinations that were given 9 years earlier (2003-2004). Longitudinal changes in MST over the 9-year period were derived and categorized into quartiles. Subjects in quartile 1 were defined as "advancers" (MST advanced ≥ 1 h) while those in quartile 4 were defined as "delayers" (MST delayed ≥ 0.2 h). Quartiles 2-3 defined a reference group (MST change was considered modest). The relationship of GMV with MST changes over 9 years was investigated. RESULTS Nine-year change in MST were significantly associated with GMV. Compared to the reference group, advancers had smaller GMVs in the frontal and temporal regions. A delay in MST was also associated with smaller cerebellar GMV. CONCLUSIONS In middle-to-late adulthood, the direction of change in MST is associated with GMV. While advancers and delayers in MST tend to present lower GMV, associations appear to differ across brain regions.
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Affiliation(s)
- Regina E Y Kim
- College of Medicine, Korea University, Republic of Korea.,College of Psychiatry, University of Iowa, Iowa City, IA
| | - Hyeon Jin Kim
- Department of Neurology and Medical Science, School of Medicine, Ewha Woman University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea
| | - Soriul Kim
- College of Medicine, Korea University, Republic of Korea
| | | | - Robert J Thomas
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and the Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA
| | - Chang-Ho Yun
- Department of Neurology, Seoul National University Bundang Hospital, Republic of Korea
| | - Hyang Woon Lee
- Department of Neurology and Medical Science, School of Medicine, Ewha Woman University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.,Department of Computational Medicine, System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Republic of Korea
| | - Chol Shin
- College of Medicine, Korea University, Republic of Korea
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19
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Guarnieri B, Maestri M, Cucchiara F, Lo Gerfo A, Schirru A, Arnaldi D, Mattioli P, Nobili F, Lombardi G, Cerroni G, Bartoli A, Manni R, Sinforiani E, Terzaghi M, Arena MG, Silvestri R, La Morgia C, Di Perri MC, Franzoni F, Tognoni G, Mancuso M, Sorbi S, Bonuccelli U, Siciliano G, Faraguna U, Bonanni E. Multicenter Study on Sleep and Circadian Alterations as Objective Markers of Mild Cognitive Impairment and Alzheimer’s Disease Reveals Sex Differences. J Alzheimers Dis 2020; 78:1707-1719. [DOI: 10.3233/jad-200632] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Circadian and sleep disturbances are associated with increased risk of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Wearable activity trackers could provide a new approach in diagnosis and prevention. Objective: To evaluate sleep and circadian rhythm parameters, through wearable activity trackers, in MCI and AD patients as compared to controls, focusing on sex dissimilarities. Methods: Based on minute level data from consumer wearable devices, we analyzed actigraphic sleep parameters by applying an electromedical type I registered algorithm, and the corresponding circadian variables in 158 subjects: 86 females and 72 males (42 AD, 28 MCI, and 88 controls). Moreover, we used a confusion-matrix chart method to assess accuracy, precision, sensitivity, and specificity of two decision-tree models based on actigraphic data in predicting disease or health status. Results: Wake after sleep onset (WASO) was higher (p < 0.001) and sleep efficiency (SE) lower (p = 0.003) in MCI, and Sleep Regularity Index (SRI) was lower in AD patients compared to controls (p = 0.004). SE was lower in male AD compared to female AD (p = 0.038) and SRI lower in male AD compared to male controls (p = 0.008), male MCI (p = 0.047), but also female AD subjects (p = 0.046). Mesor was significantly lower in males in the overall population. Age reduced the dissimilarities for WASO and SE but demonstrated sex differences for amplitude (p = 0.009) in the overall population, controls (p = 0.005), and AD subjects (p = 0.034). The confusion-matrices showed good predictive power of actigraphic data. Conclusion: Actigraphic data could help identify disease or health status. Sex (possibly gender) differences could impact on neurodegeneration and disease trajectory with potential clinical applications.
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Affiliation(s)
- Biancamaria Guarnieri
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Michelangelo Maestri
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federico Cucchiara
- SONNOLab, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Lo Gerfo
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Schirru
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | - Pietro Mattioli
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale San Martino, Genoa, Italy
| | | | - Gianluigi Cerroni
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Antonella Bartoli
- Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy
- Villaserena Foundation for the Research, Città S. Angelo, Pescara, Italy
| | - Raffaele Manni
- Sleep and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Sinforiani
- Neuropsychology/Alzheimer's Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Michele Terzaghi
- Sleep and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Maria Grazia Arena
- Center for Cognitive Disorders and Dementias, Alzheimer's Disease Assessment Unit, UOC of Neurology and Neuromuscular Disorders, AOU Policlinico, ``G. Martino'', University of Messina, Messina, Italy
| | - Rosalia Silvestri
- Sleep Medicine Center, UOSD of Neurophysiopathology and Movement Disorders, AOU Policlinico ``G.~Martino'', Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna Bologna, Italy
| | - Maria Caterina Di Perri
- Sleep Medicine Center, UOSD of Neurophysiopathology and Movement Disorders, AOU Policlinico ``G.~Martino'', Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Ferdinando Franzoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michelangelo Mancuso
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Ubaldo Bonuccelli
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Siciliano
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- SONNOLab, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Enrica Bonanni
- Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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20
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Garbarino S, Lanteri P, Prada V, Falkenstein M, Sannita WG. Circadian Rhythms, Sleep, and Aging. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Abstract. Circadian mechanisms and the sleep-wakefulness rhythms guarantee survival, adaptation, efficient action in everyday life or in emergencies and well-being. Disordered circadian processes at central and/or cellular levels, sleep disorders, and unhealthy wakefulness/sleep rhythms can impair the physiological circadian organization and result in subjective, professional, or behavioral changes ranging from functional inadequacy to higher risks at work or on the road to medical relevance. Circadian rhythms and the sleep organization change ontogenetically; major changes result from normal aging and from the multiple diseases that are often associated. There are circular functional interactions involving sleep/sleep disorders, the autonomic and immune systems, and the functional changes in the circadian system due to aging that deserve attention but have been overlooked thus far.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
| | - Paola Lanteri
- Department of Diagnostics and Applied Technology, Neurophysiopathology Center, Fondazione IRCCS, Istituto Neurologico C. Besta, Milano, Italy
| | - Valeria Prada
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
| | | | - Walter G. Sannita
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genova, Polyclinic Hospital San Martino IRCCS, Genova, Italy
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21
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Thapa N, Kim B, Yang JG, Park HJ, Jang M, Son HE, Kim GM, Park H. The Relationship between Chronotype, Physical Activity and the Estimated Risk of Dementia in Community-Dwelling Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3701. [PMID: 32456356 PMCID: PMC7277473 DOI: 10.3390/ijerph17103701] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/10/2023]
Abstract
Our study examined the association between chronotype, daily physical activity, and the estimated risk of dementia in 170 community-dwelling older adults. Chronotype was assessed with the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ). Daily physical activity (of over 3 METs) was measured with a tri-axial accelerometer. The Korean version of the Mini-Mental State Examination (K-MMSE) was used to measure the estimated risk of dementia. The evening chronotype, low daily physical activity, and dementia were positively associated with each other. The participants with low physical activity alongside evening preference had 3.05 to 3.67 times higher estimated risk of developing dementia, and participants with low physical activity and morning preference had 1.95 to 2.26 times higher estimated risk than those with high physical activity and morning preference. Our study design does not infer causation. Nevertheless, our findings suggest that chronotype and daily physical activity are predictors of the risk of having dementia in older adults aged 70 years and above.
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Affiliation(s)
- Ngeemasara Thapa
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Boram Kim
- Department of Neurology, Dong-A University Hospital, Busan 49201, Korea;
| | - Ja-Gyeong Yang
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Hye-Jin Park
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Minwoo Jang
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Ha-Eun Son
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Gwon-Min Kim
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
| | - Hyuntae Park
- Department of Healthcare and Science, Dong-A University, Busan 49315, Korea; (N.T.); (J.-G.Y.); (H.-J.P.); (M.J.); (H.-E.S.); (G.-M.K.)
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22
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Cabanel N, Speier C, Müller MJ, Kundermann B. Actigraphic, but not subjective, sleep measures are associated with cognitive impairment in memory clinic patients. Psychogeriatrics 2020; 20:133-139. [PMID: 31264318 DOI: 10.1111/psyg.12474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 04/02/2019] [Accepted: 05/20/2019] [Indexed: 01/23/2023]
Abstract
AIM Sleep disturbances are prevalent in various dementia subtypes but rarely investigated in early clinical stages. Although memory clinics have become an established institution for the early diagnosis of dementia, sleep assessment is not part of their routine diagnostics. This study aimed to examine whether subjective and objective sleep variables are related to cognitive impairment in patients referred to a memory clinic. METHODS On two consecutive days, patients underwent routine diagnostic procedures, including a neuropsychological examination (consortium to establish a registry for alzheimer's disease), and had their sleep quality evaluated by the Pittsburgh Sleep Quality Index and overnight hand-wrist actigraphy. RESULTS Data of 31 patients (age, M ± SEM: 74.1 ± 1.5; 18 women, 13 men; Clinical Dementia Rating: 0-1) were analysed. One had been diagnosed with subjective cognitive impairment, 13 with mild cognitive impairment with or without depression, and 17 with dementia syndrome due to Alzheimer's and/or cerebrovascular disease. Compared to patients with subjective or mild cognitive impairment, dementia patients showed a significantly increased nocturnal acceleration magnitude; other differences in subjective and objective sleep measures were not significant. Comparing patients with subjectively poor (Pittsburgh Sleep Quality Index > 5: n = 9) and good sleep (Pittsburgh Sleep Quality Index ≤ 5: n = 22) yielded no differences in any neuropsychological and clinical variables. In contrast, patients with low actigraphically recorded sleep efficiency (<85%: n = 11) exhibited a significantly more impaired cognitive performance than those in the high sleep efficiency group (≥85%: n = 20). Correlation analyses demonstrated that actigraphically assessed disturbed sleep continuity accompanied by increased night-time motor activity was substantially associated with cognitive impairment. CONCLUSION This study highlights that objectively assessed, but not self-reported, parameters of disturbed sleep are closely related to cognitive dysfunction in the early stages of dementia of different aetiologies. Possible diagnostic and treatment implications are discussed.
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Affiliation(s)
- Nicole Cabanel
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Germany.,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Christa Speier
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Germany
| | - Matthias J Müller
- Oberberg Group, Berlin, Germany.,Justus-Liebig University of Giessen, Germany
| | - Bernd Kundermann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Germany.,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
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23
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Kumar S, Smith KR, Serrano Negron YL, Harbison ST. Short-Term Memory Deficits in the SLEEP Inbred Panel. Clocks Sleep 2019; 1:471-488. [PMID: 32596662 PMCID: PMC7318870 DOI: 10.3390/clockssleep1040036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although sleep is heritable and conserved across species, sleep duration varies from individual to individual. A shared genetic architecture between sleep duration and other evolutionarily important traits could explain this variability. Learning and memory are critical traits sharing a genetic architecture with sleep. We wanted to know whether learning and memory would be altered in extreme long or short sleepers. We therefore assessed the short-term learning and memory ability of flies from the Sleep Inbred Panel (SIP), a collection of 39 extreme long- and short-sleeping inbred lines of Drosophila. Neither long nor short sleepers had appreciable learning, in contrast to a moderate-sleeping control. We also examined the response of long and short sleepers to enriched social conditions, a paradigm previously shown to induce morphological changes in the brain. While moderate-sleeping control flies had increased daytime sleep and quantifiable increases in brain structures under enriched social conditions, flies of the Sleep Inbred Panel did not display these changes. The SIP thus emerges as an important model for the relationship between sleep and learning and memory.
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24
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Gutman SA, Amarantos K, Berg J, Aponte M, Gordillo D, Rice C, Smith J, Perry A, Wills T, Chen E, Peters R, Schluger Z. Home Safety Fall and Accident Risk Among Prematurely Aging, Formerly Homeless Adults. Am J Occup Ther 2019; 72:7204195030p1-7204195030p9. [PMID: 29953833 DOI: 10.5014/ajot.2018.028050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Homelessness prematurely ages people. A large subgroup of formerly homeless adults between ages 40 and 64 yr have health conditions similar to or worse than people categorized as elderly. Little is known about the impact of this group's chronic health conditions on their ability to safely function in supportive housing. METHOD Home safety visits were carried out with 25 formerly homeless adults, ages 40-64 yr, now residing in supportive housing. RESULTS Participants had physical, cognitive, and mental health problems that significantly interfered with their ability to perform daily life skills, safely function in an apartment, and manage chronic health conditions. Home safety hazards included cluttered walking paths, the presence of steps, and the lack of grab bars and nonskid flooring. CONCLUSION The homeless population would benefit from aging specialists, such as occupational therapists, who could help people to maintain and function more safely in their homes. Without such services, this population may be at risk for home safety events leading to hospitalization and mortality.
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Affiliation(s)
- Sharon A Gutman
- Sharon A. Gutman, PhD, OTR, FAOTA, is Professor of Rehabilitation and Regenerative Medicine, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY;
| | - Kevin Amarantos
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Jan Berg
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Melissa Aponte
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Daniela Gordillo
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Christopher Rice
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Jonathan Smith
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Anna Perry
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Tamara Wills
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Ethan Chen
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Richard Peters
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
| | - Zachary Schluger
- Kevin Amarantos, MS, OTR, Jan Berg, MS, OTR, Melissa Aponte, MS, OTR, Daniela Gordillo, MS, OTR, Christopher Rice, MS, OTR, Jonathan Smith, MS, OTR, Anna Perry, MS, OTR, Tamara Wills, MS, OTR, Ethan Chen, MS, OTR, Richard Peters, MS, OTR, and Zachary Schluger, MS, OTR, are Occupational Therapists, Programs in Occupational Therapy, Columbia University Medical Center, New York, NY
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25
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Lin JF, Li FD, Chen XG, He F, Zhai YJ, Pan XQ, Wang XY, Zhang T, Yu M. Association of postlunch napping duration and night-time sleep duration with cognitive impairment in Chinese elderly: a cross-sectional study. BMJ Open 2018; 8:e023188. [PMID: 30552262 PMCID: PMC6303738 DOI: 10.1136/bmjopen-2018-023188] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To analyse the independent and combined associations of postlunch napping duration and night-time sleep duration with risk of cognitive impairment among Chinese elderly. DESIGN A cross-sectional study. SETTING We analysed the data from Zhejiang Ageing and Health Cohort, a population-based survey of seven counties located in Zhejiang province in eastern China. PARTICIPANTS 10 740 participants aged 60 years or older were included in final analysis. PRIMARY AND SECONDARY OUTCOME MEASURES Cognitive impairment was assessed through Mini-Mental State Examination. Data on sleep-related characteristics was collected in the behavioural habits section within the questionnaire. RESULTS Relative to participants with 1-30 min of postlunch napping, those who did not nap and who napped longer had significantly higher risks for cognitive impairment. OR of cognitive impairment were 1.41 (95% CI 1.14 to 1.75) for participants with longer night-time sleep duration (≥9 hours), compared with those sleeping 7-8.9 hours. In addition, combined effects were further identified. Participants with both longer night-time sleep duration (≥9 hours) and longer postlunch napping duration (>60 min) (OR=2.01, 95% CI 1.30 to 3.13), as well as those with both longer night-time sleep duration (≥9 hours) and appropriate postlunch napping duration (1-30 min) (OR=2.01, 95% CI 1.20 to 3.38), showed significantly higher risk of cognitive impairment than those with sleeping 7-8 hours and napping 1-30 min. Meanwhile, a 34% increase in odds of cognitive impairment was observed in participants with both shorter night-time sleep duration (5-6.9 hours) and no napping. CONCLUSION Both postlunch napping duration and night-time sleep duration were independently and jointly associated with cognitive impairment, which needs verification in prospective studies.
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Affiliation(s)
- Jun-Fen Lin
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fu-Dong Li
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiao-Geng Chen
- Director Office, Jingning Center for Disease Prevention and Control, Lishui, China
| | - Fan He
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yu-Jia Zhai
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiao-Qing Pan
- Department of Non-Communicable Disease Control and Prevention, Jingning Center for Disease Prevention and Control, Lishui, China
| | - Xin-Yi Wang
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Tao Zhang
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Min Yu
- Director Office, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Nakakubo S, Doi T, Makizako H, Tsutsumimoto K, Hotta R, Kurita S, Kim M, Suzuki T, Shimada H. Sleep condition and cognitive decline in Japanese community‐dwelling older people: Data from a 4‐year longitudinal study. J Sleep Res 2018; 28:e12803. [DOI: 10.1111/jsr.12803] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/26/2018] [Accepted: 11/02/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Sho Nakakubo
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
| | - Takehiko Doi
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
- Department of Physical Therapy School of Health Sciences Faculty of Medicine Kagoshima University Kagoshima Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
- Japan Society for the Promotion of Science Tokyo Japan
| | - Ryo Hotta
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
- Department of Early Childhood Education Kindai University Junior College Iizuka Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
| | - Minji Kim
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
| | - Takao Suzuki
- National Center for Geriatrics and Gerontology Obu Aichi Japan
- Research Institute of Aging and Development Oberlin University Tokyo Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology Center for Gerontology and Social Science National Center for Geriatrics and Gerontology Obu Japan
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Sleep, hippocampal volume, and cognition in adults over 90 years old. Aging Clin Exp Res 2018; 30:1307-1318. [PMID: 30178444 DOI: 10.1007/s40520-018-1030-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/18/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several lines of research support associations between sleep and cognition in older adults. However, there is a paucity of data regarding sleep and cognition in nonagenarians and centenarians. AIMS The current study examined self-reported sleep quantity and sleep quality in relation to hippocampal volume and cognition in adults aged 90 and older. METHODS A total of 144 participants of The 90+ Study completed The Medical Outcomes Study sleep questionnaire. Participants reported subjective sleep duration in hours and three sleep quality factors: sleep problems, adequacy, and somnolence. Neuropsychological assessments of memory, global cognition, language, and executive function were completed, on average, 61 days from the questionnaire. Hippocampal volume on 3 T MRI, adjusted for intracranial volume, was obtained in 82 participants. We performed multiple linear regressions, controlling for age, sex, education, sleep medication, and depression, to examine sleep characteristics in relation to hippocampal volume and cognitive performance in all the subjects and then stratified by cognition. RESULTS Sleep duration > 8 h was associated with lower scores in tests of global cognition, memory, and executive function compared to sleep duration of 7-8 h when collapsing across cognitive status, but only with memory in cognitively impaired subjects, and not in cognitively normal subjects. CONCLUSIONS AND DISCUSSION Long-sleep duration is associated with poorer global cognition, memory, and executive function in the oldest-old, and is only associated with memory in cognitively impaired oldest-old. Additional research is necessary to determine if sleep duration is a risk factor or a result of poor cognition in advanced age.
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Basta M, Simos P, Bertsias A, Duijker G, Zaganas I, Koutentaki E, Anastasaki M, Mavroidis G, Kalomoiri G, Panagiotakis S, Lionis C, Vgontzas A. Association between insomnia symptoms and cognitive impairment in the Cretan Aging Cohort. Eur Geriatr Med 2018; 9:697-706. [PMID: 34654220 DOI: 10.1007/s41999-018-0086-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 07/19/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Population aging, characteristic of modern Western societies, is associated with various forms of cognitive decline. Insomnia/insomnia-type symptoms have been reported as modifiable risk factors for cognitive decline. The objective of this study was to examine, in a comprehensive way (a) the prevalence and the risk factors associated with insomnia-type symptoms and (b) the association of insomnia-type symptoms with cognitive impairment in a large, homogeneous, community-dwelling population in the island of Crete, Greece. METHODS Our sample consisted of 3066 community-dwelling elders aged 60-100 years participating in the Cretan Aging Cohort. All participants were interviewed with a structured questionnaire assessing demographics, physical and mental health, sleep, lifestyle habits and cognitive function using the Mini Mental State Examination (MMSE). Furthermore, insomnia-type symptom prevalence was estimated in the presence of one or more sleep complaints. Linear and logistic regression analyses examined (a) the association between insomnia-type symptoms and demographics, physical/mental health and lifestyle and (b) the association between cognition and insomnia-type symptoms. RESULTS Prevalence of one or more insomnia-type symptoms was 64.6%. Multivariate analyses showed that female gender, widowhood, benzodiazepine use and physical ailments were significantly associated with insomnia-type symptoms. Multivariate models also showed that insomnia-type symptoms were associated with increased odds of cognitive impairment (p < 0.0001). CONCLUSIONS In a large population of older people in Crete, Greece, insomnia-type symptoms are very prevalent and associated with increased risk for cognitive impairment. Future studies should assess whether treatment of sleep problems improves or delays the deterioration of cognitive function in older adults.
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Affiliation(s)
- Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece.
| | - Panagiotis Simos
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece.,Institute of Computer Science, Foundation for Research and Technology, Heraklion, Crete, Greece
| | - Antonios Bertsias
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - George Duijker
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - Ioannis Zaganas
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Eirini Koutentaki
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece
| | - Maria Anastasaki
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece
| | - Giorgos Mavroidis
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece
| | - Georgia Kalomoiri
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece
| | - Symeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Voutes, 71110, Heraklion, Crete, Greece
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Fang SC, Huang CJ, Wu YL, Wu PY, Tsai PS. Effects of napping on cognitive function modulation in elderly adults with a morning chronotype: A nationwide survey. J Sleep Res 2018; 28:e12724. [PMID: 29984443 DOI: 10.1111/jsr.12724] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/13/2018] [Accepted: 05/28/2018] [Indexed: 11/30/2022]
Abstract
Circadian rhythms and napping habits have been associated with cognitive function; however, little is known about the interaction effects on cognitive function. The present study examined the moderating effects of napping habits on the relationship between chronotypes and cognitive function decline in elderly adults. This cross-sectional study analysed data from the 2009 Taiwan National Health Interview Survey. A total of 1,724 elderly adults (aged ≥65 years) were included. Cognitive function was determined by the Mini-Mental State Examination. Participants' chronotypes were assessed using the midpoint of sleep. Napping habits were assessed by self-report questions. Demographic data, health-related factors and sleep characteristics of the participants were also assessed as potential confounding factors. A hierarchical regression will be used to test the moderating role of napping habits in the relationship between chronotype and cognitive function level after adjustment for potential confounders. A significant interaction effect between chronotype and napping habits was observed with the MMSE score (b = -0.29, SE = 0.14, p = 0.03). Morning-type elderly patients with nap durations >60 min exhibited significantly higher MMSE scores than non-nappers (F = 7.48; p = 0.00). This nationwide survey confirms that in morning-type elderly adults, nap durations >60 min are associated with less cognitive decline; however, napping habits are not associated with cognitive function level in evening-type and intermediate-type elderly adults.
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Affiliation(s)
- Su-Chen Fang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chun-Jen Huang
- Graduate Institute of Clinical Medicine, Collage of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Lin Wu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pei-Yu Wu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Abstract
PURPOSE OF REVIEW Neurologists, along with all health care providers, commonly encounter patients with insomnia, which is a condition that impacts patients' underlying neurologic conditions in a bidirectional manner. While chronic insomnia is one of the most common sleep disturbances, only a small proportion of individuals with this condition discuss their sleep problems with their providers. When insomnia is described, it is more often in relationship to another medical problem, as opposed to an independent condition. In neurology practice, multiple factors including pain, movement disorders, sleep apnea, and medications that act on the central nervous system often contribute to insomnia. An all-inclusive approach is necessary when evaluating sleep problems in patients with insomnia. RECENT FINDINGS The US Food and Drug Administration (FDA) has approved several medications for the treatment of insomnia that target specific receptor systems in the brain and incorporate several unique pharmacodynamic and pharmacokinetic profiles that can represent customized therapy for specific insomnia phenotypes. FDA-approved medications for insomnia include γ-aminobutyric acid (GABA)-modulating benzodiazepine receptor agonists, a melatonin receptor agonist, a histamine receptor antagonist, and the newest approved option, a hypocretin (orexin) receptor antagonist. SUMMARY This article provides an evidence-based multidisciplinary approach to the treatment of insomnia, highlighting the rationale and utility of cognitive-behavioral therapy and pharmacologic interventions. Neurologists should be proactive in assessing the impact of underlying comorbidities on insomnia, particularly in the setting of psychiatric conditions such as depression, sleep disorders such as circadian rhythm disorders, and medical problems such as nocturia.
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Suh SW, Han JW, Lee JR, Byun S, Kwon SJ, Oh SH, Lee KH, Han G, Hong JW, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Seo J, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Sleep and cognitive decline: A prospective nondemented elderly cohort study. Ann Neurol 2018; 83:472-482. [PMID: 29394505 DOI: 10.1002/ana.25166] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate sleep disturbances that induce cognitive changes over 4 years in nondemented elderlies. METHODS Data were acquired from a nationwide, population-based, prospective cohort of Korean elderlies (2,238 normal cognition [NC] and 655 mild cognitive impairment [MCI]). At baseline and 4-year follow-up assessments, sleep-related parameters (midsleep time, sleep duration, sleep latency, subjective sleep quality, sleep efficiency, and daytime dysfunction) and cognitive status were measured using the Pittsburgh Sleep Quality Index and Consortium to Establish a Registry for Alzheimer's Disease Assessment, respectively. We used logistic regression models adjusted for covariates including age, sex, education, apolipoprotein E genotype, Geriatric Depression Scale, Cumulative Illness Rating Scale, and physical activity. RESULTS In participants with NC, long sleep latency (>30 minutes), long sleep duration (≥7.95 hours), and late midsleep time (after 3:00 am) at baseline were related to the risk of cognitive decline at 4-year follow-up assessment; odds ratio (OR) was 1.40 for long sleep latency, 1.67 for long sleep duration, and 0.61 for late midsleep time. These relationships remained significant when these variables maintained their status throughout the follow-up period. Newly developed long sleep latency also doubled the risk of cognitive decline. In those with MCI, however, only long sleep latency reduced the chance of reversion to NC (OR = 0.69). INTERPRETATION As early markers of cognitive decline, long sleep latency can be used for elderlies with NC or MCI, whereas long sleep duration and relatively early sleep time might be used for cognitively normal elderlies only. Ann Neurol 2018;83:472-482.
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Affiliation(s)
- Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Ju Ri Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Seonjeong Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Soon Jai Kwon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Sang Hoon Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Kyoung Hwan Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Guehee Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Jong Woo Hong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju
| | - Jiyeong Seo
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul.,Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul.,National Institute of Dementia, Seongnam, Korea
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Kocevska D, Rijlaarsdam J, Ghassabian A, Jaddoe VW, Franco OH, Verhulst FC, Tiemeier H. Early Childhood Sleep Patterns and Cognitive Development at Age 6 Years: The Generation R Study. J Pediatr Psychol 2017; 42:260-268. [PMID: 26803843 DOI: 10.1093/jpepsy/jsv168] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 12/10/2015] [Indexed: 12/30/2022] Open
Abstract
Objective To explore the association of sleep duration and awakening frequency with cognitive outcomes in young children. Methods Mothers of 2,800 children from the Generation R cohort reported sleep duration and awakenings at children's age 24 months. At age 6 years, validated Dutch measures were used to assess children's nonverbal intelligence and language comprehension. Results We found a nonlinear association of total sleep time at 24 months with nonverbal intelligence ( p = 0.03) and language comprehension ( p = 0.04) at 6 years. Toddlers sleeping within the recommended 11-14 hr had more favorable cognitive development compared with both extremes. Frequent awakenings were negatively associated with nonverbal intelligence, but not with verbal comprehension. Conclusion Sleep duration in toddlerhood has an inverted-U-shaped relation with childhood cognitive measures. Frequent awakenings are associated with lower nonverbal intelligence. Given the marked decline in sleep duration and awakenings in toddlerhood, developmental changes of sleep patterns might be important for cognitive development.
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Affiliation(s)
- Desana Kocevska
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jolien Rijlaarsdam
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
| | - Akhgar Ghassabian
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
| | - Vincent W Jaddoe
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
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Mokros Ł, Witusik A, Michalska J, Łężak W, Panek M, Nowakowska-Domagała K, Antczak A, Pietras T. Sleep quality, chronotype, temperament and bipolar features as predictors of depressive symptoms among medical students. Chronobiol Int 2017; 34:708-720. [PMID: 28488895 DOI: 10.1080/07420528.2017.1316730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The assessment of risk factors is a crucial step in the prevention and treatment of affective disorders and should encompass personal dispositions. The aim of this study was to assess the value of chronotype and temperament as independent predictors of depressive symptoms among medical students. The study surveyed 140 students of the Faculty of Medicine with a battery of questionnaires: the Beck Depression Index (BDI), Hypomania Checklist 32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), Chronotype Questionnaire and Eysenck Personality Questionnaire Revised. The results were tested using Pearson's correlation quotient and general linear model. Ten percent of the participants demonstrated a BDI score suggestive of clinically significant depressive symptoms. BDI score correlated positively with HCL-32 score. A rise in BDI was independently predicted by elevated Neuroticism and PSQI scores and morningness. Those effects were independent from each other and from other parameters of the model. The presence of depressive symptoms might be associated with bipolar features among medical students. Poor sleep quality predicted depressive symptoms, similarly to Neuroticism and independently of temperament and chronotype. Future studies on the associations between personal dispositions and mood disorders among medical students are required to help identify those at greater risk of developing affective illness. Effective prophylaxis and early intervention are warranted to ensure better treatment results.
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Affiliation(s)
- Łukasz Mokros
- a Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
| | - Andrzej Witusik
- b Department of Psychology , Faculty of Social Sciences, Piotrkow Trybunalski Division, Jan Kochanowski Memorial University of Humanities and Sciences , Piotrkow Trybunalski , Poland
| | - Julia Michalska
- c Clinical Pharmacology Students Scientific Circle, Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
| | - Wojciech Łężak
- d Department of Pharmacology and Toxicology , Medical University of Lodz , Lodz , Poland
| | - Michał Panek
- e Department of Internal Medicine , Asthma and Allergy, Medical University of Lodz , Lodz , Poland
| | - Katarzyna Nowakowska-Domagała
- f Department of Cognitive Science, Institute of Psychology , Faculty of Educational Sciences, University of Lodz , Lodz , Poland
| | - Adam Antczak
- g Department of General and Oncological Pulmonology , Medical University of Lodz , Lodz , Poland
| | - Tadeusz Pietras
- a Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
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Li J, Cacchione PZ, Hodgson N, Riegel B, Keenan BT, Scharf MT, Richards KC, Gooneratne NS. Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment. J Am Geriatr Soc 2017; 65:373-380. [PMID: 27995615 PMCID: PMC6487643 DOI: 10.1111/jgs.14368] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine the cross-sectional associations between self-reported postlunch napping and structured cognitive assessments in Chinese older adults. DESIGN Cross-sectional cohort study. SETTING China. PARTICIPANTS Individuals aged 65 and older from the baseline national wave of the China Health and Retirement Longitudinal Study (CHARLS) (N = 2,974). MEASUREMENTS Interview-based cognitive assessments of orientation and attention, episodic memory, visuospatial abilities, and a combined global cognition score incorporating these assessments. Other self-reported or interview-based assessments included postlunch napping duration, nighttime sleep duration, demographic characteristics, health habits, comorbidities, functional status and social activities. According to reported napping duration, older adults were categorized as non-nappers (0 minutes), short nappers (<30 minutes), moderate nappers (30-90 minutes), and extended nappers (>90 minutes). RESULTS Postlunch napping was reporting in 57.7% of participants for a mean of 63 minutes. Cognitive function was significantly associated with napping (P < .001). Between-group comparisons showed that moderate nappers had better overall cognition than nonnappers (P < .001) or extended nappers (P = .01). Nonnappers also had significantly poorer cognition than short nappers (P = .03). In multiple regression analysis, moderate napping was significantly associated with better cognition than non- (P = .004), short (P = .04), and extended napping (P = .002), after controlling for demographic characteristics, body mass index, depression, instrumental activities of daily living, social activities, and nighttime sleep duration. CONCLUSION A cross-sectional association was found between moderate postlunch napping and better cognition in Chinese older adults. The cross-sectional design and self-reported measures of sleep limited the findings. Longitudinal studies with objective napping measures are needed to further test this hypothesis.
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Affiliation(s)
- Junxin Li
- Center for Sleep and Circadian Neurobiology
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | | | - Nancy Hodgson
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Barbara Riegel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Kathy C. Richards
- School of Nursing, College of Health and Human Services, George Mason University, Fairfax, Virginia
| | - Nalaka S. Gooneratne
- Center for Sleep and Circadian Neurobiology
- Division of Geriatric Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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35
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Chiu HY, Lai FC, Chen PY, Tsai PS. Differences Between Men and Women Aged 65 and Older in the Relationship Between Self-Reported Sleep and Cognitive Impairment: A Nationwide Survey in Taiwan. J Am Geriatr Soc 2016; 64:2051-2058. [DOI: 10.1111/jgs.14316] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hsiao-Yean Chiu
- School of Nursing; College of Nursing; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
| | - Fu-Chih Lai
- School of Nursing; College of Nursing; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery; Chang-Gung Memorial Hospital; Taoyuan Taiwan
- School of Medicine; Chang-Gung University; Taoyuan Taiwan
| | - Pei-Shan Tsai
- School of Nursing; College of Nursing; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
- Department of Nursing; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
- Sleep Science Center; Taipei Medical University Hospital; Taipei Medical University; Taipei Taiwan
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36
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Nowakowska-Domagała K, Mokros Ł, Jabłkowska-Górecka K, Grzelińska J, Pietras T. The relationship between chronotype and personality among patients with alcohol dependence syndrome: Pilot study. Chronobiol Int 2016; 33:1351-1358. [DOI: 10.1080/07420528.2016.1213738] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Katarzyna Nowakowska-Domagała
- Department of Cognitive Science, Faculty of Educational Sciences, Institute of Psychology, University of Lodz, Lodz, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | | | - Joanna Grzelińska
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
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Abstract
Sleep disorders are common in neurology practice, but are often undiagnosed and untreated. Specific patient cohorts, such as older adults, patients residing in nursing homes, and patients with underlying chronic neurologic and psychiatric disorders, are at particular risk. If these sleep problems are not properly evaluated and managed the patient may experience exacerbation of the underlying neurologic disorder. This article highlights some of the key sleep disorders relevant to practicing neurologists, emphasizing hypersomnolence, insomnia, and sleep-related movement disorders in the setting of neurologic disorders to enhance the tools available for evaluation, and discusses management strategies.
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Affiliation(s)
- Lori Ani Panossian
- Sleep Laboratory, East Bay Division, Department of Neurology, Veterans Affairs Northern California Health Care System, 150 Muir Road, Martinez, CA 94553, USA
| | - Alon Y Avidan
- Department of Neurology, UCLA Sleep Disorders Center, David Geffen School of Medicine at UCLA, 710 Westwood Boulevard, Room 1-145 RNRC, Los Angeles, CA 90095-1769, USA.
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38
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Lo JC, Groeger JA, Cheng GH, Dijk DJ, Chee MWL. Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Med 2016; 17:87-98. [PMID: 26847980 DOI: 10.1016/j.sleep.2015.08.021] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/13/2015] [Accepted: 08/08/2015] [Indexed: 12/19/2022]
Affiliation(s)
- June C Lo
- Centre for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-NUS Graduate Medical School, Singapore.
| | - John A Groeger
- Department of Psychology, University of Hull, Hull, United Kingdom
| | - Grand H Cheng
- Counselling & Psychology Department, Hong Kong Shue Yan University, Hong Kong
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, United Kingdom
| | - Michael W L Chee
- Centre for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-NUS Graduate Medical School, Singapore.
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39
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Brewster GS, Varrasse M, Rowe M. Sleep and Cognition in Community-Dwelling Older Adults: A Review of Literature. Healthcare (Basel) 2015; 3:1243-70. [PMID: 27066397 PMCID: PMC4822499 DOI: 10.3390/healthcare3041243] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/24/2015] [Indexed: 12/12/2022] Open
Abstract
Changes in sleep and cognition occur with advancing age. While both may occur independently of each other, it is possible that alterations in sleep parameters may increase the risk of age-related cognitive changes. This review aimed to understand the relationship between sleep parameters (sleep latency, wake after sleep onset, sleep efficiency, sleep duration, general sleep complaints) and cognition in community-dwelling adults aged 60 years and older without sleep disorders. Systematic, computer-aided searches were conducted using multiple sleep and cognition-related search terms in PubMed, PsycINFO, and CINAHL. Twenty-nine manuscripts met the inclusion criteria. Results suggest an inconsistent relationship between sleep parameters and cognition in older adults and modifiers such as depressive symptoms, undiagnosed sleep apnea and other medical conditions may influence their association. Measures of sleep and cognition were heterogeneous. Future studies should aim to further clarify the association between sleep parameters and cognitive domains by simultaneously using both objective and subjective measures of sleep parameters. Identifying which sleep parameters to target may lead to the development of novel targets for interventions and reduce the risk of cognitive changes with aging.
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Affiliation(s)
- Glenna S. Brewster
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd., MDC Box 22, Tampa, FL 33612, USA; E-Mail:
- School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA
| | - Miranda Varrasse
- School of Nursing, University of Pennsylvania, Claire M. Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104, USA; E-Mail:
| | - Meredeth Rowe
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd., MDC Box 22, Tampa, FL 33612, USA; E-Mail:
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Fan LY, Sun Y, Lee HJ, Yang SC, Chen TF, Lin KN, Lin CC, Wang PN, Tang LY, Chiu MJ. Marital Status, Lifestyle and Dementia: A Nationwide Survey in Taiwan. PLoS One 2015; 10:e0139154. [PMID: 26413719 PMCID: PMC4587383 DOI: 10.1371/journal.pone.0139154] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 09/08/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evidence of an association between lifestyle and marital status and risk of dementia is limited in Asia. METHODS In this nationwide population-based cross-sectional survey, participants were selected by computerized random sampling from all 19 counties in Taiwan. A total of 10432 residents were assessed by a door-to-door in-person survey, among whom 7035 were normal and 929 were diagnosed with dementia using the criteria recommended by National Institute on Aging-Alzheimer's Association. Premorbid lifestyle habits and demographic data including marital status were compared between normal subjects and participants with dementia. RESULTS After adjustment for age, gender, education, body mass index, smoking, drinking, marital status, sleep habits, exercise, social engagement and co-morbidities including hypertension, diabetes and cerebrovascular diseases, an increased risk for dementia was found in people with widow or widower status (OR 1.42, 95% CI 1.15-1.77) and people who used to take a nap in the afternoon (OR 1.33, 95% CI 1.02-1.72). Decreased risk was found in people with the habit of regular exercise (OR 0.12, 95% CI 0.09-0.16), adequate night sleep (OR 0.55, 95% CI 0.39-0.76) and regular social engagement (OR 0.53, 95% CI 0.36-0.77). CONCLUSIONS Our results provide preliminary evidence of possible risk-reduction effects for dementia, including regular exercise even in modest amounts, social engagement and adequate night sleep, whereas people with the widow/widower status or who used to take an afternoon nap might have increased risk of dementia.
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Affiliation(s)
- Ling-Yun Fan
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Huey-Jane Lee
- Taiwan Alzheimer’s Disease Association, Taipei, Taiwan
| | | | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ker-Neng Lin
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Chi Lin
- Department of Computer Science and Information Engineering, Chung Gung University, Tao-Yuan, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Yu Tang
- Taiwan Alzheimer’s Disease Association, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Engineering and Bioinformatics, College of Electric Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
- * E-mail:
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41
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Chen PY, Chiu HT, Chiu HY. Daytime sleepiness is independently associated with falls in older adults with dementia. Geriatr Gerontol Int 2015; 16:850-5. [PMID: 26245804 DOI: 10.1111/ggi.12567] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 11/29/2022]
Abstract
AIM To examine whether elderly people with dementia have a higher prevalence of falls and sleep disturbances than those without dementia, and to determine the subjective sleep characteristics associated with falls in older adults with dementia. METHODS This was a cross-sectional, population-based study derived from the data in the 2009 Taiwan National Health Interview Survey. A total of 123 older adults with dementia (aged 65 years or older), and 246 older adults without dementia who were randomly selected from the database were included. The occurrence of falls and subjective sleep characteristics (e.g. sleep hours, insomnia symptoms, daytime sleepiness, difficulty in breathing during sleep and daytime naps) were evaluated using the responses to the survey questions. RESULTS The prevalence of falls in older adults with dementia were approximately twofold higher than that for those without dementia (27.6% vs 15.3%, P = 0.006). Older adults with dementia had longer sleep hours, and increased daytime sleepiness, daytime naps and difficulty in breathing during sleep (all P < 0.05) than those without dementia. Among older adults with dementia, daytime sleepiness was the only sleep characteristic that was significantly correlated to an increased risk of falls (adjusted odds ratio 5.56, 95% confidence interval 1.95-15.91) despite controlling for possible risk factors. CONCLUSIONS Older adults with dementia had a higher prevalence of falls and sleep disturbances than that observed for those without dementia. Daytime sleepiness was an independent risk factor of falls in elderly people, with dementia after accounting for a range of covariates. Geriatr Gerontol Int 2016; 16: 850-855.
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Affiliation(s)
- Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,School of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Hsiao-Ting Chiu
- Department of Rehabilitation, Sinwu branch, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Hsiao-Yean Chiu
- Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Auyeung TW, Kwok T, Leung J, Lee JSW, Ohlsson C, Vandenput L, Wing YK, Woo J. Sleep Duration and Disturbances Were Associated With Testosterone Level, Muscle Mass, and Muscle Strength—A Cross-Sectional Study in 1274 Older Men. J Am Med Dir Assoc 2015; 16:630.e1-6. [DOI: 10.1016/j.jamda.2015.04.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 01/18/2023]
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Pace-Schott EF, Spencer RMC. Sleep-dependent memory consolidation in healthy aging and mild cognitive impairment. Curr Top Behav Neurosci 2015; 25:307-330. [PMID: 24652608 DOI: 10.1007/7854_2014_300] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sleep quality and architecture as well as sleep's homeostatic and circadian controls change with healthy aging. Changes include reductions in slow-wave sleep's (SWS) percent and spectral power in the sleep electroencephalogram (EEG), number and amplitude of sleep spindles, rapid eye movement (REM) density and the amplitude of circadian rhythms, as well as a phase advance (moved earlier in time) of the brain's circadian clock. With mild cognitive impairment (MCI) there are further reductions of sleep quality, SWS, spindles, and percent REM, all of which further diminish, along with a profound disruption of circadian rhythmicity, with the conversion to Alzheimer's disease (AD). Sleep disorders may represent risk factors for dementias (e.g., REM Behavior Disorder presages Parkinson's disease) and sleep disorders are themselves extremely prevalent in neurodegenerative diseases. Working memory , formation of new episodic memories, and processing speed all decline with healthy aging whereas semantic, recognition, and emotional declarative memory are spared. In MCI, episodic and working memory further decline along with declines in semantic memory. In young adults, sleep-dependent memory consolidation (SDC) is widely observed for both declarative and procedural memory tasks. However, with healthy aging, although SDC for declarative memory is preserved, certain procedural tasks, such as motor-sequence learning, do not show SDC. In younger adults, fragmentation of sleep can reduce SDC, and a normative increase in sleep fragmentation may account for reduced SDC with healthy aging. Whereas sleep disorders such as insomnia, obstructive sleep apnea, and narcolepsy can impair SDC in the absence of neurodegenerative changes, the incidence of sleep disorders increases both with normal aging and, further, with neurodegenerative disease. Specific features of sleep architecture, such as sleep spindles and SWS are strongly linked to SDC. Diminution of these features with healthy aging and their further decline with MCI may account for concomitant declines in SDC. Notably these same sleep features further markedly decline, in concert with declining cognitive function, with the progression to AD. Therefore, progressive changes in sleep quality, architecture, and neural regulation may constitute a contributing factor to cognitive decline that is seen both with healthy aging and, to a much greater extent, with neurodegenerative disease.
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Affiliation(s)
- Edward F Pace-Schott
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA,
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Scullin MK, Bliwise DL. Sleep, cognition, and normal aging: integrating a half century of multidisciplinary research. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 10:97-137. [PMID: 25620997 PMCID: PMC4302758 DOI: 10.1177/1745691614556680] [Citation(s) in RCA: 286] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Sleep is implicated in cognitive functioning in young adults. With increasing age, there are substantial changes to sleep quantity and quality, including changes to slow-wave sleep, spindle density, and sleep continuity/fragmentation. A provocative question for the field of cognitive aging is whether such changes in sleep physiology affect cognition (e.g., memory consolidation). We review nearly a half century of research across seven diverse correlational and experimental domains that historically have had little crosstalk. Broadly speaking, sleep and cognitive functions are often related in advancing age, though the prevalence of null effects in healthy older adults (including correlations in the unexpected, negative direction) indicates that age may be an effect modifier of these associations. We interpret the literature as suggesting that maintaining good sleep quality, at least in young adulthood and middle age, promotes better cognitive functioning and serves to protect against age-related cognitive declines.
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Affiliation(s)
- Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University Department of Neurology, Emory University School of Medicine
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Xu L, Jiang CQ, Lam TH, Zhang WS, Cherny SS, Thomas GN, Cheng KK. Sleep duration and memory in the elderly Chinese: longitudinal analysis of the Guangzhou Biobank Cohort Study. Sleep 2014; 37:1737-44. [PMID: 25364069 PMCID: PMC4196057 DOI: 10.5665/sleep.4162] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Previous cross-sectional studies showed that short or long sleep duration was associated with memory impairment (MI), but longitudinal studies are scarce. We examined whether sleep duration was associated with memory decline or development of MI. DESIGN SETTING PARTICIPANTS We conducted a prospective analysis based on the Guangzhou Biobank Cohort Study on 13,888 participants aged 50+ years without MI at baseline and with a follow-up for a mean of 4.1 years. MEASURES AND RESULTS Memory decline was assessed using the Delayed 10-Word Recall Test (DWRT), and in a subset (n = 6,020) with the Mini-Mental State Examination (MMSE). Short and long sleep duration was defined as ≤ 5 hours/day and ≥ 9 hours/day, respectively. Data were analyzed both continuously for memory decline and dichotomously for MI (independently defined as DWRT, < 4; MMSE, < 25). After adjusting for multiple potential confounders, both short and long sleep durations were associated with memory decline using DWRT or MMSE score changes (all P < 0.001). Seven percent (n = 980) developed DWRT-defined MI and 4.0% (n = 194) MMSE-defined MI during the follow-up. Only those with a short (≤ 5 h/day) sleep duration had a significantly increased risk of DWRT-defined MI (odds ratio = 1.53 (95% confidence interval; 1.21-1.93); P < 0.001) relative to normal sleepers (7 h/day). The association remained significant after excluding those with poor self-reported health. No associations were observed with MMSE-defined MI for both long and short sleep durations. CONCLUSIONS This is the largest study to date addressing the association between extremes of sleep duration and memory decline. The observed adverse relationships provide support for an intervention study to examine the potential benefits of normalizing sleep duration in attenuating memory decline.
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Affiliation(s)
- Lin Xu
- School of Public Health, University of Hong Kong, Hong Kong
| | | | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong
| | | | | | - G. Neil Thomas
- Public Health, Epidemiology, and Biostatistics, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Public Health, Epidemiology, and Biostatistics, University of Birmingham, Birmingham, UK
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Lee JS, Auyeung T, Leung J, Chan D, Kwok T, Woo J, Wing Y. Long Sleep Duration Is Associated With Higher Mortality in Older People Independent of Frailty: A 5-Year Cohort Study. J Am Med Dir Assoc 2014; 15:649-54. [DOI: 10.1016/j.jamda.2014.05.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/04/2014] [Accepted: 05/08/2014] [Indexed: 12/18/2022]
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Devore EE, Grodstein F, Duffy JF, Stampfer MJ, Czeisler CA, Schernhammer ES. Sleep duration in midlife and later life in relation to cognition. J Am Geriatr Soc 2014; 62:1073-81. [PMID: 24786726 DOI: 10.1111/jgs.12790] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate associations between sleep duration at midlife and later life and change in sleep duration over time and cognition in older women. DESIGN Participants reported sleep duration in 1986 and 2000, and a subgroup of older participants began cognitive testing in 1995 to 2001; follow-up testing was conducted three times, at 2-year intervals. SETTING Prospective Nurses' Health Study cohort. PARTICIPANTS Female nurses aged 70 and older free of stroke and depression at the initial cognitive assessment (N = 15,385). MEASUREMENTS Validated, telephone-based cognitive battery to measure cognitive function; four repeated assessments over 6 years were averaged to estimate overall cognition at older ages, and trajectories of cognitive change were evaluated over follow up. RESULTS Extreme sleep durations in later life were associated with worse average cognition (P < .001 for the quadratic term for a global score averaging all six cognitive tests). For example, women sleeping 5 h/d or less had worse global cognition than those sleeping 7 h/d, as did women sleeping 9 h/d or more; differences were equivalent to nearly 2 additional years of age. Associations were similar, although slightly attenuated, for sleep duration in midlife. Women whose sleep duration changed by 2 h/d or more over time had worse cognition than women with no change in sleep duration (e.g., for the global score, P < .001 for the quadratic term). Sleep duration was not associated with trajectories of cognitive function over 6 years, which might be attributable to short follow-up for detecting cognitive decline. CONCLUSION Extreme sleep durations at midlife and later life and extreme changes in sleep duration over time appear to be associated with poor cognition in older women.
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Affiliation(s)
- Elizabeth E Devore
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Benito-León J, Louis ED, Bermejo-Pareja F. Cognitive decline in short and long sleepers: a prospective population-based study (NEDICES). J Psychiatr Res 2013; 47:1998-2003. [PMID: 24094933 PMCID: PMC3839098 DOI: 10.1016/j.jpsychires.2013.09.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is not clear whether cognitive decline progresses more quickly in long sleepers than in short sleepers or than in participants with usual sleep duration. We assessed cognitive decline as a function of self-reported sleep duration in a prospective population-based cohort (NEDICES). METHODS Participants were evaluated at baseline and 3 years later. Baseline demographic variables were recorded and participants indicated their daily sleep usual duration as the sum of nighttime sleep and daytime napping. The average daily total usual sleep duration was grouped into three categories: ≤ 5 h (short sleepers), 6-8 h (reference category), and ≥ 9 h (long sleepers). At baseline and at follow-up, a 37-item version of the Mini-Mental State Examination (37-MMSE) was administered. RESULTS The final sample, 2715 participants (72.9 ± 6.1 years), comprised 298 (11%) short sleepers, 1086 (40%) long sleepers, and 1331 (49%) in the reference group (6-8 h). During the three year follow-up period, the 37-MMSE declined by 0.5 ± 4.0 points in short sleepers, 0.6 ± 4.3 points in long sleepers, and 0.2 ± 3.8 points in the reference group (p = 0.08). The difference between short sleepers and the reference group was not significant (p = 0.142); however, the difference between long sleepers and the reference group was significant (p = 0.040). In analyses adjusted for baseline age and other potential confounders, this difference remained robust. CONCLUSIONS In this study, cognitive test scores among long sleepers declined more rapidly than observed in a reference group. Additional studies are needed to confirm these results.
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Affiliation(s)
- Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain.
| | - Elan D. Louis
- G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA,Department of Epidemiology, Mailman School of Public Health, Columbia; University, New York, NY, USA
| | - Félix Bermejo-Pareja
- Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain,Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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