1
|
Wang X, Luo L, Zhao J, Guo X, Tao L, Zhang F, Liu X, Gao B, Luo Y. Associations between sleep duration trajectories and cognitive decline: A longitudinal cohort study in China. Arch Gerontol Geriatr 2024; 124:105445. [PMID: 38733919 DOI: 10.1016/j.archger.2024.105445] [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: 01/27/2024] [Revised: 03/24/2024] [Accepted: 04/13/2024] [Indexed: 05/13/2024]
Abstract
OBJECT The relationship between sleep duration trajectories and cognitive decline remains uncertain. This study aims to examine the connections between various patterns of sleep duration and cognitive function. METHODS Group-based trajectory modeling (GBTM) was employed to identify longitudinal trajectories of sleep duration over four-year follow-up period, while considering age, sex and nap duration as adjustments. Logistic regression was utilized to analyze the association between sleep trajectories and cognition, with odds ratios (OR) and 95 % confidence intervals (CI) reported. Subgroup analyses based on various demographic characteristics were conducted to explore potential differences in sleep trajectories and cognitive decline across different population subgroups. RESULTS A total of 5061 participants were followed for four years, and three sleep duration trajectories were identified: high increasing (n = 2101, 41.6 %), stable increasing (n = 2087, 40.7 %), and low decreasing (n = 873, 17.7 %). After adjustment for basic demographic information, health status, and baseline cognition, the high increasing trajectory was found to be associated with cognitive decline in terms of global cognition (OR:1.52,95 %CI:1.18-1.96), mental intactness (OR:1.36,95 %CI:1.07-1.73) and episodic memory (OR:1.33, 95 %CI:1.05-1.67), as compared to stable increasing trajectory. These associations were particularly prominent among the non-elderly population (≤65 years) and those without depressive symptoms. CONCLUSION This study suggests that both high increasing and low decreasing sleep duration trajectories are linked to cognitive decline, as compared to the stable increasing trajectory. Long-term attention to changes in sleep duration facilitates early prevention of cognitive decline.
Collapse
Affiliation(s)
- Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lili Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Jianxi Zhao
- School of Applied Science, Beijing Information Science and Technology University, Beijing, 100192, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Bo Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China.
| |
Collapse
|
2
|
Tang S, Liu R, Ren J, Song L, Dong L, Qin Y, Zhao M, Wang Y, Dong Y, Zhao T, Liu C, Hou T, Cong L, Sindi S, Winblad B, Du Y, Qiu C. Association of objective sleep duration with cognition and brain aging biomarkers in older adults. Brain Commun 2024; 6:fcae144. [PMID: 38756537 PMCID: PMC11098043 DOI: 10.1093/braincomms/fcae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/21/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
The neuropathological mechanisms underlying the association between sleep duration and mild cognitive impairment remain poorly understood. This population-based study included 2032 dementia-free people (age ≥ 60 years; 55.1% women) derived from participants in the Multimodal Interventions to Delay Dementia and Disability in Rural China; of these, data were available in 841 participants for Alzheimer's plasma biomarkers (e.g. amyloid-β, total tau and neurofilament light chain), 1044 for serum microvascular biomarkers (e.g. soluble adhesion molecules) and 834 for brain MRI biomarkers (e.g. whiter matter, grey matter, hippocampus, lacunes, enlarged perivascular spaces and white matter hyperintensity WMH). We used electrocardiogram-based cardiopulmonary coupling analysis to measure sleep duration, a neuropsychological test battery to assess cognitive function and the Petersen's criteria to define mild cognitive impairment. Data were analysed with multivariable logistic and general linear models. In the total sample (n = 2032), 510 participants were defined with mild cognitive impairment, including 438 with amnestic mild cognitive impairment and 72 with non-amnestic mild cognitive impairment. Long sleep duration (>8 versus 6-8 h) was significantly associated with increased likelihoods of mild cognitive impairment and non-amnestic mild cognitive impairment and lower scores in global cognition, verbal fluency, attention and executive function (Bonferroni-corrected P < 0.05). In the subsamples, long sleep duration was associated with higher plasma amyloid-β40 and total tau, a lower amyloid-β42/amyloid-β40 ratio and smaller grey matter volume (Bonferroni-corrected P < 0.05). Sleep duration was not significantly associated with serum-soluble adhesion molecules, white matter hyperintensity volume, global enlarged perivascular spaces and lacunes (P > 0.05). Alzheimer's and neurodegenerative pathologies may represent common pathways linking long sleep duration with mild cognitive impairment and low cognition in older adults.
Collapse
Affiliation(s)
- Shi Tang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Rui Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lingling Dong
- Department of Neurology, Dongying People’s Hospital, Dongying 257091, China
| | - Yu Qin
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng 252000, China
| | - Mingqing Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tong Zhao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Shireen Sindi
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Neuroepidemiology and Ageing Research Unit (AGE), School of Public Health, Imperial College London, London SW7 2AZ, United Kingdom
| | - Bengt Winblad
- Division of Neurogeriatrics and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
| |
Collapse
|
3
|
Sosnowski DW, Smail EJ, Maher BS, Moore AZ, Kuo PL, Wu MN, Low DV, Stone KL, Simonsick EM, Ferrucci L, Spira AP. Sleep Duration Polygenic Risk and Phenotype: Associations with Biomarkers of Accelerated Aging in the Baltimore Longitudinal Study of Aging. Int J Aging Hum Dev 2024:914150241231192. [PMID: 38347745 DOI: 10.1177/00914150241231192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
We sought to explore whether genetic risk for, and self-reported, short sleep are associated with biological aging and whether age and sex moderate these associations. Participants were a subset of individuals from the Baltimore Longitudinal Study of Aging who had complete data on self-reported sleep (n = 567) or genotype (n = 367). Outcomes included: Intrinsic Horvath age, Hannum age, PhenoAge, GrimAge, and DNAm-based estimates of plasminogen activator inhibitor-1 (PAI-1) and granulocyte count. Results demonstrated that polygenic risk for short sleep was positively associated with granulocyte count; compared to those reporting <6 hr sleep, those reporting >7 hr demonstrated faster PhenoAge and GrimAge acceleration and higher estimated PAI-1. Polygenic risk for short sleep and self-reported sleep duration interacted with age and sex in their associations with some of the outcomes. Findings highlight that polygenic risk for short sleep and self-reported long sleep is associated with variation in the epigenetic landscape and subsequently aging.
Collapse
Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Emily J Smail
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ann Zenobia Moore
- Longitudinal Studies Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Pei-Lun Kuo
- Longitudinal Studies Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Mark N Wu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Dominique V Low
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Eleanor M Simonsick
- Longitudinal Studies Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Adam P Spira
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Services, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| |
Collapse
|
4
|
Leng Y, Knutson K, Carnethon MR, Yaffe K. Association Between Sleep Quantity and Quality in Early Adulthood With Cognitive Function in Midlife. Neurology 2024; 102:e208056. [PMID: 38170947 PMCID: PMC10870739 DOI: 10.1212/wnl.0000000000208056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Growing evidence supports an association between sleep quality and risk of dementia. However, little is known about whether objectively measured sleep duration and quality influence cognition in midlife, a period of importance for understanding the direction of the association between sleep and dementia. We examined the association between sleep duration and quality, measured when participants were in their mid-30s to late 40s, and midlife cognition assessed 11 years later among Black and White adults. METHODS As part of the Coronary Artery Risk Development in Young Adults cohort study, sleep duration and quality were assessed objectively using wrist actigraphy and subjectively by Pittsburgh Sleep Quality Index (PSQI) at 2003-2005. During 2015-2016, we evaluated midlife cognition using the Digit Symbol Substitution Test (DSST), Stroop test, Rey Auditory Verbal Learning Test, Montreal Cognitive Assessment (MoCA), and Letter Fluency and Category Fluency tests. We used multivariable logistic regression to examine the association between sleep parameters and poor cognitive performance, which was defined as a score that was >1 SD below the mean score. RESULTS The 526 participants (58% women and 44% Black) had a mean age of 40.1 ± 3.6 years at baseline, a mean sleep duration of 6.1 ± 1.1 hours, and mean sleep fragmentation index (calculated as the sum of the percentage of time spent moving and the percentage of immobile periods ≤1 minute) of 19.2 ± 8.1%, and 239 (45.6%) participants reported poor sleep as defined by a PSQI global score of >5. After adjustment for demographics, education, smoking, body mass index, depression, physical activity, hypertension, and diabetes, those in the highest vs lowest tertile of sleep fragmentation index had over twice the odds of having poor cognitive performance (>1 SD below the mean) on the DSST (odds ratio [OR] = 2.97; 95% CI 1.34-6.56), fluency (OR = 2.42; 95% CI 1.17-5.02), and MoCA test (OR = 2.29; 95% CI 1.06-4.94). The association between sleep fragmentation and cognitive performance did not differ by race or sex. Objective sleep duration or subjective sleep quality was not associated with cognition in midlife. DISCUSSION Actigraphy-measured high sleep fragmentation rather than sleep duration was associated with worse cognition among middle-aged Black and White men and women. Sleep quality is important for cognitive health even as early as midlife.
Collapse
Affiliation(s)
- Yue Leng
- From the Department of Psychiatry and Behavioral Sciences (Y.L., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Departments of Neurology (K.K.) and Preventive Medicine (M.R.C.), Northwestern University Feinberg School of Medicine, Chicago, IL; and VA Medical Center (K.Y.), San Francisco, CA
| | - Kristen Knutson
- From the Department of Psychiatry and Behavioral Sciences (Y.L., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Departments of Neurology (K.K.) and Preventive Medicine (M.R.C.), Northwestern University Feinberg School of Medicine, Chicago, IL; and VA Medical Center (K.Y.), San Francisco, CA
| | - Mercedes R Carnethon
- From the Department of Psychiatry and Behavioral Sciences (Y.L., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Departments of Neurology (K.K.) and Preventive Medicine (M.R.C.), Northwestern University Feinberg School of Medicine, Chicago, IL; and VA Medical Center (K.Y.), San Francisco, CA
| | - Kristine Yaffe
- From the Department of Psychiatry and Behavioral Sciences (Y.L., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Departments of Neurology (K.K.) and Preventive Medicine (M.R.C.), Northwestern University Feinberg School of Medicine, Chicago, IL; and VA Medical Center (K.Y.), San Francisco, CA
| |
Collapse
|
5
|
Zhang H, Zhang L, Chen C, Zhong X. Association between daytime napping and cognitive impairment among Chinese older population: a cross-sectional study. Environ Health Prev Med 2023; 28:72. [PMID: 37989282 PMCID: PMC10685077 DOI: 10.1265/ehpm.23-00031] [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: 02/09/2023] [Accepted: 09/30/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Both napping and nighttime sleep duration have been reported to be associated with cognitive function in older adults, whereas little is known about the association between daytime napping and cognitive impairment in different nighttime sleep duration subgroups. This study aimed to explore the correlation between daytime napping and cognitive impairment across nighttime sleep duration subgroups. METHODS A cross-sectional study was conducted by using the fourth survey of China Health and Retirement Longitudinal Study (CHARLS). We utilized the Mini-Mental State Examination (MMSE) scale to define cognitive impairment, and the daytime napping and nighttime sleep duration was self-reported by individuals. We applied the Restricted Cubic Spline (RCS) to analysis the dose-response relationships between daytime napping and cognitive impairment. And the multivariate Logistic Regression Model (LRM) was performed to evaluate the association of daytime napping and cognitive impairment. RESULTS A total of 3,052 individuals were included, of which 769 were cognitive impairment. The RCS showed there were non-linear association between daytime napping and cognitive impairment in all participants group and longer nighttime sleep duration subgroup (PNon-linear < 0.05, PDaytime napping < 0.05). The LRM revealed no napping (OR = 1.62, 95%CI 1.14-2.30) and excessive napping (1.64 95%CI 1.09-2.48) were related to cognitive impairment in longer nighttime sleep duration subgroup. CONCLUSIONS Daytime napping had nonlinear association with cognitive impairment in Chinese elderly population. No napping and excessive daytime napping (>90 minutes) were related to cognitive impairment in participants with 7 and more hours nighttime sleep duration.
Collapse
Affiliation(s)
- Hong Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Lijuan Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Chen Chen
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Xiaoni Zhong
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| |
Collapse
|
6
|
Costello MM, Mc Carthy CE, Bosch J, Robinson S, McDermott C, Canavan MD, O'Donnell MJ. Are clinical trials randomising households to lifestyle interventions to delay cognitive decline feasible? A pilot study to determine the beliefs, preferences, and deterrents for households impacted by dementia based on semi-structured interviews. BMC Geriatr 2022; 22:322. [PMID: 35418013 PMCID: PMC9005908 DOI: 10.1186/s12877-022-02941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction While lifestyle risk factors are implicated in the development and progression of cognitive impairment, interventional trials of individual participants have yielded unconvincing evidence. We sought to explore the development of lifestyle interventions targeting the household-unit. Methods Semi-structured interviews were carried out among eight households affected by cognitive impairment (i.e. member of the household had cognitive impairment). Interviews took place online using a secure, web-based video platform recommended for patient clinician interaction. Interview content was analysed, and important themes identified. Results Eighteen participants were interviewed within households, of which eight (one per household) had cognitive impairment and others were spouses or first-degree relatives living in the same home. Several themes emerged; 1) household members without cognitive impairment were more likely to report poor sleep habits, and sleep was perceived to be the hardest behaviour to change; 2) diet generated most interest as a potential lifestyle intervention target as most participants believed there is a strong link with nutrition and cognition; 3) physical activity is challenging to adapt due to lack of motivation and focus when individuals are cognitively impaired. Barriers to study participation, including risk of harm, complexity of intervention and deviation from routine emerged during discussions. Conclusions This study identified beliefs and preferences of households towards lifestyle intervention trials. Findings from this study may be used to inform future clinical trial protocols and future qualitative studies should explore acceptability and feasibility of digital intervention applications.
Collapse
Affiliation(s)
- Maria M Costello
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland. .,University Hospital Galway, Newcastle Road, Galway, Ireland.
| | - Christine E Mc Carthy
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Jackie Bosch
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Stephanie Robinson
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Clodagh McDermott
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Michelle D Canavan
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| | - Martin J O'Donnell
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, H91YR71, Ireland.,University Hospital Galway, Newcastle Road, Galway, Ireland
| |
Collapse
|
7
|
Balouch S, Dijk DA, Rusted J, Skene SS, Tabet N, Dijk D. Night‐to‐night variation in sleep associates with day‐to‐day variation in vigilance, cognition, memory, and behavioral problems in Alzheimer's disease. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12303. [PMID: 35603140 PMCID: PMC9109375 DOI: 10.1002/dad2.12303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 11/05/2022]
Abstract
Introduction Sleep disturbances are commonly reported in people living with Alzheimer's disease (AD), but it is currently unknown whether night‐to‐night variation in sleep predicts day‐to‐day variation in vigilance, cognition, mood, and behavior (daytime measures). Methods Subjective and objective sleep and daytime measures were collected daily for 2 weeks in 15 participants with mild AD, eight participants with mild cognitive impairment (MCI), and 22 participants with no cognitive impairment (NCI). Associations between daytime measures and four principal components of sleep (duration, quality, continuity, and latency) were quantified using mixed‐model regression. Results Sleepiness, alertness, contentedness, everyday memory errors, serial subtraction, and behavioral problems were predicted by at least one of the components of sleep, and in particular sleep duration and continuity. Associations between variations in sleep and daytime measures were linear or quadratic and often different between participants with AD and those with NCI. Discussion These findings imply that daytime functioning in people with AD may be improved by interventions that target sleep continuity.
Collapse
Affiliation(s)
- Sara Balouch
- Centre for Dementia Studies Brighton & Sussex Medical School Brighton UK
- School of Humanities and Social Science University of Brighton Brighton UK
| | - Dylan A.D. Dijk
- Surrey Clinical Trials Unit Department of Clinical and Experimental Medicine University of Surrey Guildford UK
| | | | - Simon S. Skene
- Surrey Clinical Trials Unit Department of Clinical and Experimental Medicine University of Surrey Guildford UK
| | - Naji Tabet
- Centre for Dementia Studies Brighton & Sussex Medical School Brighton UK
| | - Derk‐Jan Dijk
- Surrey Sleep Research Centre Department of Clinical and Experimental Medicine University of Surrey Guildford UK
- UK Dementia Research Institute Care Research and Technology Centre Imperial College London and the University of Surrey Guildford UK
| |
Collapse
|
8
|
Huang D, Wang S. Association Between the Anti-Aging Protein Klotho and Sleep Duration in General Population. Int J Gen Med 2021; 14:10023-10030. [PMID: 34955652 PMCID: PMC8694114 DOI: 10.2147/ijgm.s345927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Sleep duration is associated with aging. However, the relationship between sleep duration and the concentration of the protein klotho in the serum remains unknown in the general population of the United States. Hence, this study aimed at exploring the association between them. Methods Participants whose data included klotho protein and sleep duration variables in the National Health and Nutrition Examination Survey data from 2007 to 2016 were utilized for this analysis. Results Sleep duration was non-linearly associated with the level of klotho protein in the serum, with a negative association between sleep duration and serum klotho concentration after adjusting for confounding variables (β = −7.6; 95% CI: −11.3, −4.0; P < 0.001). The conversion of the sleep duration from a continuous variable to a categorical variable (tertile: T1: <5.5 hours; T2: 5.5–7.5 hours; T3: >7.5 hours) revealed that the serum klotho of the participants in the highest tertile (>7.5 hours) was 21.9 pg/mL lower (95% CI: −38.6, −5.2; P = 0.01) than those in the lowest tertile (<5.5 hours). Conclusion Our results revealed that people who sleep more than 7.5 hours per night have decreased levels of the anti-aging protein klotho in their serum, thus being more at risk of aging-related syndromes.
Collapse
Affiliation(s)
- Dongdong Huang
- Department of Respiratory and Critical Care Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, Zhejiang, People's Republic of China
| | - Saibin Wang
- Department of Respiratory Medicine, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital, Jinhua, 321000, Zhejiang, People's Republic of China
| |
Collapse
|
9
|
Zhu Q, You Y, Fan L, Fan H. Associations between sleep duration patterns and cognitive decline trajectories in older Chinese adults. Aging Clin Exp Res 2021; 33:3057-3063. [PMID: 33837933 DOI: 10.1007/s40520-021-01851-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Abnormal sleep duration has been identified as a risk factor for cognitive decline. However, most studies have measured sleep duration and cognitive function at a single time point, while both tend to decrease with age. AIMS This study aimed to investigate the association between changes in sleep duration patterns and cognitive trajectories in older adults. METHODS Using longitudinal data (2005-2014) from the Chinese Longitudinal Healthy Longevity Survey, a total of 4347 subjects were included in this study. Cognitive function was measured with the Chinese version of the Mini-Mental State Examination. Group-based trajectory models were used to identify the trajectories of sleep duration and cognitive decline within the study sample as the participants aged. Furthermore, the association between sleep duration patterns and cognitive trajectories was examined by multinomial logistic regression analysis. RESULTS Using the medium-stable sleep duration pattern as a reference, the trajectory with a long and increased sleep duration pattern was more likely to be associated with the slight cognitive decline trajectory (OR = 1.80; 95% CI 1.31-2.44). Persistent short sleep was associated with a decreased likelihood of having a rapid cognitive decline trajectory (OR = 0.32; 95% CI 0.12-0.75). DISCUSSION Changes in sleep duration over time were independently associated with cognitive decline and may be a marker of cognitive decline. CONCLUSIONS Tracking of sleep duration over time in older adults may provide a useful insight for prevention of cognitive decline, and the increased sleep duration should be noticed with greater vigilance.
Collapse
Affiliation(s)
- Qi Zhu
- Department of Preventive Medicine, North Sichuan Medical College, Fujiang Road, Shunqing, Nanchong, 234, Sichuan, China.
| | - Yueyue You
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Lin Fan
- Department of Indoor Environment and Health Monitoring, China CDC Key Laboratory of Environment and Population Health, Chinese Center for Disease Control and Prevention, National Institute of Environmental Health, Beijing, China
| | - Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Fujiang Road, Shunqing, Nanchong, 234, Sichuan, China.
| |
Collapse
|
10
|
Hua J, Zhuang S, Shen Y, Tang X, Sun H, Fang Q. Exploring the Bidirectional Associations Between Short or Long Sleep Duration and Lower Cognitive Function: A 7-Year Cohort Study in China. Front Aging Neurosci 2021; 13:727763. [PMID: 34690740 PMCID: PMC8528020 DOI: 10.3389/fnagi.2021.727763] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/14/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Sleep duration is linked to cognitive function, but whether short or prolonged sleep duration results from impaired cognition or vice versa has been controversial in previous studies. We aimed to investigate the bidirectional association between sleep duration and cognitive function in older Chinese participants. Methods: Data were obtained from a nationally representative study conducted in China. A total of 7984 participants aged 45 years or older were assessed at baseline between June 2011 and March 2012 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Nocturnal sleep duration was evaluated using interviews. Cognitive function was examined via assessments of global cognition, including episodic memory, visuospatial construction, calculation, orientation and attention capacity. Latent growth models and cross-lagged models were used to assess the bidirectional association between sleep duration and cognitive function. Results: Among the 7,984 participants who were followed in the four waves of the study, the baseline mean (SD) age was 64.7 (8.4) years, 3862 (48.4%) were male, and 6453 (80.7%) lived in rural areas. Latent growth models showed that both sleep duration and global cognition worsened over time. Cross-lagged models indicated that short or long sleep duration in the previous wave was associated with lower global cognition in the subsequent wave (standardized β = −0.066; 95% CI: −0.073, −0.059; P < 0.001; Wave 1 to 2) and that lower global cognition in the previous wave was associated with short or long sleep duration in the subsequent wave (standardized β = −0.106; 95% CI: −0.116, −0.096; P < 0.001; Wave 1 to 2). Conclusion: There was a bidirectional association between sleep duration and cognitive function, with lower cognitive function having a stronger association with long or short sleep duration than the reverse relationship. Global cognition was likely the major driver in these reciprocal associations.
Collapse
Affiliation(s)
- Jianian Hua
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Medical College of Soochow University, Suzhou, China
| | - Sheng Zhuang
- Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xiang Tang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongpeng Sun
- Department of Child Health, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|