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Wang J, Chen S, Xue J. Depressive symptoms mediate the longitudinal relationships between sleep quality and cognitive functions among older adults with mild cognitive impairment: A cross-lagged modeling analysis. Sci Rep 2024; 14:21242. [PMID: 39261558 PMCID: PMC11390960 DOI: 10.1038/s41598-024-72159-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024] Open
Abstract
Although it is generally recognized that sleep quality, depressive symptoms, and cognitive functions are related respectively, the main ambiguity comes from difficulties in determining their cause-effect relationships. The present study aimed to explore the longitudinal causation relationships among sleep quality, depressive symptoms, and cognitive functions in older people with mild cognitive impairment (MCI). A total of 134 patients from 24 communities in Ningbo City, Zhejiang Province, China with MCI were interviewed at baseline, while 124 of them were re-interviewed 2 months later, and 122 were re-interviewed 4 months later. The Patient Health Questionnaire-9, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment Scale were assessed in the interview. Cross-lagged models were tested to disentangle the relationships among sleep quality, depressive symptoms, and cognitive functions using structural equation modeling with latent variables on the four-mouth longitudinal data. The correlation coefficients between sleep quality and depressive symptoms were significant showing the stability across time points of assessment, while the correlation coefficient of cognitive function was not significant (r = 0.159, p > 0.05). The results of index of model fit indicated that the cross-lagged model was acceptable (CFI = 0.934, TLI = 0.899, RMSEA = 0.075, χ2/df = 1.684). The results of cross-lagged model analysis supported the complete mediating role of depressive symptoms in the association between sleep quality and cognitive functions, where worse sleep quality may lead to more severe depressive symptoms, which in turn leads to more severe cognitive decline. In Conclusion, sleep quality is significantly correlated with cognitive functions in patients with mild cognitive impairment, which association is fully mediated by depressive symptoms. Approaches addressing sleep quality and depressive symptoms are recommended and hold promise for the management of mild cognitive impairment.
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Affiliation(s)
- Jiayu Wang
- College of Marxism, Jiaxing University, Jiaxing, China
- Department of Psychology and Behavioral Sciences, Zhejiang University, NO. 866 Yuhangtang Road, Zijingang Campus of Zhejiang University, Hangzhou, Zhejiang, China
| | - Shulin Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, NO. 866 Yuhangtang Road, Zijingang Campus of Zhejiang University, Hangzhou, Zhejiang, China.
| | - Jiang Xue
- The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Songshan Lake Science Park, Dongguan, Guangdong, China.
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Mo W, Liu X, Yamakawa M, Koujiya E, Takeya Y, Shigenobu K, Adachi H, Ikeda M. Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116067. [PMID: 38964141 DOI: 10.1016/j.psychres.2024.116067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/28/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan.
| | - Eriko Koujiya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka, Japan; Asakayama General Hospital, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University
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Borges CR, Poyares DLR, Studart-Neto A, Coutinho AM, Cassimiro L, Avolio I, Piovezan R, Trés ES, Teixeira TBM, Barbosa BJAP, Tufik S, Brucki SMD. Amyloid profile is associated with sleep quality in preclinical but not in prodromal Alzheimer's disease older adults. Sleep Med 2024; 121:359-364. [PMID: 39079370 DOI: 10.1016/j.sleep.2024.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/11/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Few studies have assessed whether neuropathological markers of AD in the preclinical and prodromal stages are associated with polysomnographic changes and obstructive sleep apnea (OSA). METHODS This was a cross-sectional, case-control study of older adults (≥60 years) without relevant clinical and psychiatric comorbidities selected randomly from a cohort of individuals without dementia in a tertiary university hospital in São Paulo, Brazil. They underwent neuropsychological evaluation for clinical diagnosis and were allocated into two samples: cognitively unimpaired (CU) and mild cognitive impairment (MCI). Also, they underwent PET-PiB to determine the amyloid profile and all-night in-lab polysomnography. For each sample, we compared polysomnographic parameters according to the amyloid profile (A+ vs A-). RESULTS We allocated 67 participants (mean age 73 years, SD 10,1), 70 % females, 14 ± 5 years of education, into two samples: CU (n = 28, 42.4 %) and MCI (n = 39, 57.6 %). In the CU sample, the group A+ (n = 9) showed worse sleep parameters than A- (n = 19) (lower total sleep time (p = 0.007), and sleep efficiency (p = 0.005); higher sleep onset latency (p = 0.025), wake time after sleep onset (p = 0.011), and arousal index (AI) (p = 0.007)), and changes in sleep structure: higher %N1 (p = 0.005), and lower %REM (p = 0.006). In the MCI sample, MCI A-had higher AI (p = 0.013), respiratory disturbance index (p = 0.025, controlled for age), and higher rates of severe OSA than A+. DISCUSSION The amyloid profile was associated with polysomnographic markers of worse sleep quality in individuals with preclinical AD but not with prodromal AD, probably due to the higher frequencies of severe OSA.
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Affiliation(s)
- Conrado Regis Borges
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil.
| | - Dalva L R Poyares
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Adalberto Studart-Neto
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Artur M Coutinho
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Luciana Cassimiro
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Isabela Avolio
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Eduardo S Trés
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Thiago B M Teixeira
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Breno J A P Barbosa
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
| | - Sergio Tufik
- Universidade Federal de São Paulo - Escola Paulista de Medicina, R. Botucatu, 862, São Paulo (SP), Brazil
| | - Sonia M D Brucki
- Universidade de São Paulo - Faculdade de Medicina, R. Dr.Enéas de Carvalho Aguiar, 255, São Paulo (SP), Brazil
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Stankeviciute L, Blackman J, Tort-Colet N, Fernández-Arcos A, Sánchez-Benavides G, Suárez-Calvet M, Iranzo Á, Molinuevo JL, Gispert JD, Coulthard E, Grau-Rivera O. Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms. J Sleep Res 2024; 33:e14108. [PMID: 38035770 DOI: 10.1111/jsr.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023]
Abstract
Sleep disturbances are prevalent in Alzheimer's disease (AD), affecting individuals during its early stages. We investigated associations between subjective sleep measures and cerebrospinal fluid (CSF) biomarkers of AD in adults with mild cognitive symptoms from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, considering the influence of memory performance. A total of 442 participants aged >50 years with a Clinical Dementia Rating (CDR) score of 0.5 completed the Pittsburgh Sleep Quality Index questionnaire and underwent neuropsychological assessment, magnetic resonance imaging acquisition, and CSF sampling. We analysed the relationship of sleep quality with CSF AD biomarkers and cognitive performance in separated multivariate linear regression models, adjusting for covariates. Poorer cross-sectional sleep quality was associated with lower CSF levels of phosphorylated tau and total tau alongside better immediate and delayed memory performance. After adjustment for delayed memory scores, associations between CSF biomarkers and sleep quality became non-significant, and further analysis revealed that memory performance mediated this relationship. In post hoc analyses, poorer subjective sleep quality was associated with lesser hippocampal atrophy, with memory performance also mediating this association. In conclusion, worse subjective sleep quality is associated with less altered AD biomarkers in adults with mild cognitive symptoms (CDR score 0.5). These results could be explained by a systematic recall bias affecting subjective sleep assessment in individuals with incipient memory impairment. Caution should therefore be exercised when interpreting subjective sleep quality measures in memory-impaired populations, emphasising the importance of complementing subjective measures with objective assessments.
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Affiliation(s)
- Laura Stankeviciute
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Jonathan Blackman
- North Bristol NHS Trust, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Núria Tort-Colet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Ana Fernández-Arcos
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Álex Iranzo
- Neurology Service, Hospital Clínic de Barcelona and Institut D'Investigacions Biomèdiques, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Elizabeth Coulthard
- North Bristol NHS Trust, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
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5
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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.
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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
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Huang Y, Fleury J. Socially-supported sleep in older adults aged 50 and older: a concept analysis. Front Public Health 2024; 12:1364639. [PMID: 38645458 PMCID: PMC11027164 DOI: 10.3389/fpubh.2024.1364639] [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: 01/02/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The population of older adults is growing disproportionately, constituting 13% of the global population in 2022, and is expected to double by 2050. One of public health's priorities is healthy aging, the maintenance of functional ability aligned with well-being. As many as 50% of older adults report poor sleep quality, leading to an increased risk of morbidity and mortality. The quality and quantity of social relationships may broadly benefit sleep in older adults. However, the concept of socially-supported sleep is underdeveloped as a basis for intervention. Methods Existing literature was searched without time restriction in PubMed, CINAHL, PsycINFO, and Scopus ending in August 2022. Thematic analysis was used to determine the defining attributes, antecedents, and consequences of socially-supported sleep guided by Rodgers' evolutionary concept analysis. Results Twenty-nine articles written in English, peer-reviewed, and examined social support and sleep in participants aged ≥50 were included. The defining attributes reflect dimensions of sleep quality. The antecedents are safe and secure, belonging and connection, and warmth and comfort. The consequences of socially-supported sleep include improved regulatory capabilities, physical and emotional well-being, and quality of life. Conclusion Socially-supported sleep has the potential to inform interventions that promote sleep in older adults. Ongoing research is needed to address the antecedents and mechanisms through which socially-supported sleep may promote sleep quality for healthy aging.
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Affiliation(s)
- Yingyan Huang
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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Rao S, Cai Y, Zhong Z, Gou T, Wang Y, Liao S, Qiu P, Kuang W. Prevalence, cognitive characteristics, and influencing factors of amnestic mild cognitive impairment among older adults residing in an urban community in Chengdu, China. Front Neurol 2024; 15:1336385. [PMID: 38356893 PMCID: PMC10864602 DOI: 10.3389/fneur.2024.1336385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective Dementia is a significant public health concern, and mild cognitive impairment (MCI) serves as a transitional stage between normal aging and dementia. Among the various types of MCI, amnestic MCI (aMCI) has been identified as having a higher likelihood of progressing to Alzheimer's dimension. However, limited research has been conducted on the prevalence of aMCI in China. Therefore, the objective of this study is to investigate the prevalence of aMCI, examine its cognitive characteristics, and identify associated risk factors. Methods In this cross-sectional study, we investigated a sample of 368 older adults aged 60 years and above in the urban communities of Chengdu, China. The participants underwent a battery of neuropsychological assessments, including the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), Auditory Verbal Learning Test (AVLT), Wechsler's Logical Memory Task (LMT), Boston Naming Test (BNT) and Trail Making Test Part A (TMT-A). Social information was collected by standard questionnaire. Multiple logistic regression analysis was utilized to screen for the risk and protective factors of aMCI. Results The data analysis included 309 subjects with normal cognitive function and 59 with aMCI, resulting in a prevalence of 16.0% for aMCI. The average age of participants was 69.06 ± 7.30 years, with 56.0% being females. After controlling for age, gender and education, the Spearman partial correlation coefficient between various cognitive assessments and aMCI ranged from -0.52 for the long-term delayed recall scores in AVLT to 0.19 for the time-usage scores in TMT-A. The results indicated that all cognitive domains, except for naming scores (after semantic cue of BNT) and error quantity (in TMT-A), showed statistically significant associations with aMCI. Furthermore, the multiple logistic regression analysis revealed that older age (OR = 1.044, 95%CI: 1.002~1.087), lower educational level, and diabetes (OR = 2.450, 95%CI: 1.246~4.818) were risk factors of aMCI. Conclusion This study found a high prevalence of aMCI among older adults in Chengdu, China. Individuals with aMCI exhibited lower cognitive function in memory, language, and executive domains, with long-term delayed recall showing the strongest association. Clinicians should prioritize individuals with verbal learning and memory difficulties, especially long-term delayed recall, in clinical practice.
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Affiliation(s)
- Shan Rao
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yan Cai
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhujun Zhong
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Tianyuan Gou
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yangyang Wang
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Huang H, Zhuang Z, Wan Y, Shi J, Yuan X, Wang D, Chen S. Knowledge Structure and Emerging Trends of Mild Cognitive Impairment with Dyssomnias in Recent 20 Years: A Bibliometric Analysis via CiteSpace and VOSviewer. Behav Neurol 2024; 2024:6622212. [PMID: 38223295 PMCID: PMC10787659 DOI: 10.1155/2024/6622212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
Background Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its heightened propensity for progressing toward dementia. Sleep plays a pivotal role in cognitive function, with dyssomnias not only exacerbating cognitive and affective symptoms associated with neurodegenerative diseases but also contributing to disease progression. Aim This bibliometric analysis investigates the global research on MCI with dyssomnias over the past two decades, aiming to discern key findings, research domains, and emerging trends in this field. Methods In this study, a bibliometric analysis was conducted using the search terms "MCI" and "sleep". Data were extracted from the Web of Science Core Collection database, and visualization and collaborative analysis were performed using CiteSpace and VOSviewer. Results This study encompassed 546 publications from 2003 to 2023. The publication volume and citation rate consistently increased over time. Neurosciences, Clinical Neurology, and Geriatrics Gerontology emerged as the top three research fields. The Journal of Alzheimer's Disease had the highest publication count, while Sleep Medicine received the most citations. USA, China, and Italy led in publication output. Collaborative clusters among authors and institutions were identified, but cooperation between clusters was limited. Active cocited reference clusters included "obstructive sleep apnea", "possible mediating pathways", and "isolated rapid eye movement sleep behaviour disorder". The top frequently mentioned keywords, besides "MCI", were "Alzheimer's disease", "dementia", "risk factor", and "Parkinson's Disease". Notable keyword clusters spanned circadian rhythm, Parkinson's disease, MCI, dementia with Lewy body, subjective cognitive impairment, Lewy body disease, Alzheimer's disease, and dietary patterns. Conclusion The field of MCI with dyssomnias is rapidly expanding, encompassing a wide range of neurodegenerative disorders and sleep disturbances. Current research endeavors are primarily focused on elucidating the underlying pathogenesis, predicting disease progression, and developing innovative treatment strategies for individuals affected by MCI with dyssomnias.
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Affiliation(s)
- Haoyu Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Zesen Zhuang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Yiwen Wan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Jiao Shi
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Xu Yuan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Dan Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Shangjie Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
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9
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Carpi M, Fernandes M, Mercuri NB, Liguori C. Sleep Biomarkers for Predicting Cognitive Decline and Alzheimer's Disease: A Systematic Review of Longitudinal Studies. J Alzheimers Dis 2024; 97:121-143. [PMID: 38043016 DOI: 10.3233/jad-230933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD). OBJECTIVE This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration. METHODS Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility. RESULTS Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies. CONCLUSIONS These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged.
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Affiliation(s)
- Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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10
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Kim SJ, Lee JH, Jang JW, Jung HS, Suh IB. Abnormalities of Rest-Activity and Light Exposure Rhythms Associated with Cognitive Function in Patients with Mild Cognitive Impairment (MCI). J Circadian Rhythms 2023; 21:4. [PMID: 38162255 PMCID: PMC10756154 DOI: 10.5334/jcr.227] [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: 04/04/2023] [Accepted: 10/05/2023] [Indexed: 01/03/2024] Open
Abstract
We aimed to examine the difference in rest-activity rhythm (RAR) and light exposure rhythm (LER) between patients with mild cognitive impairment (MCI) and normal controls (NC), and to verify their relationships with cognitive functions. The neuropsychological battery was administered to participants above 50 years old. The MCI diagnosis was made according to Petersen's criteria. Ten patients with MCI (77.90 ± 6.95 years) and eight NC (74.75 ± 5.06 years) were studied. Actigraphy (Actiwatch 2; Philips Respironics) was recorded at home for 5 days. RAR and LER variables, including interdaily stability (IS), intradaily variability (IV) and relative amplitude, were calculated using nonparametric analyses. The associations between cognitive performance and RAR and LER variables were explored using generalized linear models. There were no significant differences in RAR or LER variables between MCI and NC. There was a significant main effect of RAR-IS on the Stroop Color and Word Test (SCWT), indicating a positive relationship between RAR stability and SCWT performance. There was a significant group by RAR-IS interaction on Trail Making Test-A, indicating a negative relationship in MCI compared to NC. There was a significant group by LER-IV interaction on the Boston Naming Test, indicating a positive relationship in MCI compared to NC. There was no disruption in RAR and LER in patients with MCI. Our study showed that circadian rhythm abnormality was associated with a decline in executive function. However, circadian rhythm abnormality was not associated with declines in processing speed and language function in patients with MCI, implying an altered pathophysiology compared to NC.
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Affiliation(s)
- Seong Jae Kim
- Department of Psychiatry, Chosun University College of Medicine, Gwangju, South Korea
- Department of Psychiatry, Chosun University Hospital, Gwangju, South Korea
| | - Jung Hie Lee
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, South Korea
- Department of Psychiatry, Gwanggyo Good Sleep Clinic, Suwon, South Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Hee Seo Jung
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - In Bum Suh
- Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea
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11
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Mo W, Liu X, Yamakawa M. Prevalence of sleep disturbances in people with mild cognitive impairment: a systematic review protocol. JBI Evid Synth 2023; 21:2211-2217. [PMID: 37338281 DOI: 10.11124/jbies-22-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE This review will determine the prevalence of sleep disturbances in individuals with mild cognitive impairment. INTRODUCTION Mild cognitive impairment is regarded as a transitional state between normal functioning and dementia, and has a high likelihood of conversion to dementia. Individuals with mild cognitive impairment may suffer more severe sleep disturbances compared with normal older people. In some studies, sleep disturbances were associated with significantly higher odds of mild cognitive impairment. There is a need for prevalence estimates of sleep disturbances in people with mild cognitive impairment based on the currently available literature to guide clinical health care professionals and public health policies. INCLUSION CRITERIA The review will consider studies reporting on the prevalence of sleep disturbances in individuals with mild cognitive impairment, using validated instruments, including subjective and/or objective measures. Studies will be excluded if the participants report sleep-related breathing or movement disorders. Studies using only the Mini-Mental State Examination to diagnose mild cognitive impairment will also be excluded. METHODS The review will follow the JBI methodology for systematic reviews of prevalence and incidence. The MEDLINE (Ovid), Embase, Cochrane Library (CDSR and CENTRAL), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection databases will be systematically searched from inception to the present with no language limitations. Analytical observational studies, including prospective and retrospective cohort, case-control, and cross-sectional studies, will be considered. Two reviewers will independently conduct the study selection, critical appraisal, and data extraction. Methodological quality will be evaluated using the JBI critical appraisal checklist for studies reporting prevalence data. A meta-analysis will be conducted to synthesize the prevalence data, where possible. REVIEW REGISTRATION PROSPERO CRD42022366108.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
- The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan
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12
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Gervais NJ, Gravelsins L, Brown A, Reuben R, Perovic M, Karkaby L, Nicoll G, Laird K, Ramana S, Bernardini MQ, Jacobson M, Velsher L, Foulkes W, Rajah MN, Olsen RK, Grady C, Einstein G. Disturbed sleep is associated with reduced verbal episodic memory and entorhinal cortex volume in younger middle-aged women with risk-reducing early ovarian removal. Front Endocrinol (Lausanne) 2023; 14:1265470. [PMID: 37859979 PMCID: PMC10584319 DOI: 10.3389/fendo.2023.1265470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Women with early ovarian removal (<48 years) have an elevated risk for both late-life Alzheimer's disease (AD) and insomnia, a modifiable risk factor. In early midlife, they also show reduced verbal episodic memory and hippocampal volume. Whether these reductions correlate with a sleep phenotype consistent with insomnia risk remains unexplored. Methods We recruited thirty-one younger middleaged women with risk-reducing early bilateral salpingo-oophorectomy (BSO), fifteen of whom were taking estradiol-based hormone replacement therapy (BSO+ERT) and sixteen who were not (BSO). Fourteen age-matched premenopausal (AMC) and seventeen spontaneously peri-postmenopausal (SM) women who were ~10y older and not taking ERT were also enrolled. Overnight polysomnography recordings were collected at participants' home across multiple nights (M=2.38 SEM=0.19), along with subjective sleep quality and hot flash ratings. In addition to group comparisons on sleep measures, associations with verbal episodic memory and medial temporal lobe volume were assessed. Results Increased sleep latency and decreased sleep efficiency were observed on polysomnography recordings of those not taking ERT, consistent with insomnia symptoms. This phenotype was also observed in the older women in SM, implicating ovarian hormone loss. Further, sleep latency was associated with more forgetting on the paragraph recall task, previously shown to be altered in women with early BSO. Both increased sleep latency and reduced sleep efficiency were associated with smaller anterolateral entorhinal cortex volume. Discussion Together, these findings confirm an association between ovarian hormone loss and insomnia symptoms, and importantly, identify an younger onset age in women with early ovarian removal, which may contribute to poorer cognitive and brain outcomes in these women.
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Affiliation(s)
- Nicole J. Gervais
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, Netherlands
| | - Laura Gravelsins
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Alana Brown
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Rebekah Reuben
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Mateja Perovic
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Laurice Karkaby
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Gina Nicoll
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Kazakao Laird
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shreeyaa Ramana
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Marcus Q. Bernardini
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Michelle Jacobson
- Cancer Clinical Research Unit, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Lea Velsher
- Genetics Program, North York General Hospital, Toronto, ON, Canada
| | - William Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada
- Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada
| | - M. Natasha Rajah
- Departments of Psychiatry and Douglas Research Centre, McGill University, Montreal, QC, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Rosanna K. Olsen
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Cheryl Grady
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Gillian Einstein
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Tema Genus, Linköping University, Linköping, Sweden
- Women’s College Research Institute, Toronto, ON, Canada
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13
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陈 璋, 李 桃, 唐 向. [Application of Polysomnography in Common Neurodegenerative Diseases]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1058-1064. [PMID: 37866969 PMCID: PMC10579074 DOI: 10.12182/20230960304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Indexed: 10/24/2023]
Abstract
At present, the etiology and pathogenesis of most neurodegenerative diseases are still not fully understood, which poses challenges for the prevention, diagnosis, and treatment of these diseases. Sleep disorders are one of the common chief complaints of neurodegenerative diseases. When patients suffer from comorbid sleep disorder and neurodegenerative diseases, the severity of their condition increases, the quality of their life drops further, and the difficulty of treatment increases. A large number of studies have been conducted to monitor the sleep of patients with neurodegenerative diseases, and it has been found that there are significant changes in their polysomnography (PSG) results compared to those of healthy control populations. In addition, there are also significant differences between the PSG findings of patients with different neurodegenerative diseases and the differences are closely associated with the pathogenesis and development of the disease. Herein, we discussed the characteristics of the sleep structure of patients with Parkinson's disease, Alzheimer's disease, Huntington's disease, and dementia with Lewy bodies and provided a brief review of the sleep disorders and the PSG characteristics of these patients. The paper will help improve the understanding of the pathogenesis and pathological changes of neurodegenerative diseases, clarify the relationship between sleep disorders and these diseases, improve clinicians' further understanding of these diseases, and provide a basis for future research.
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Affiliation(s)
- 璋玥 陈
- 四川大学华西医院 睡眠医学中心 (成都 610041)Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 桃美 李
- 四川大学华西医院 睡眠医学中心 (成都 610041)Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - 向东 唐
- 四川大学华西医院 睡眠医学中心 (成都 610041)Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China
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14
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Liang Y, Liu W, Wang M. Characteristics of macroscopic sleep structure in patients with mild cognitive impairment: a systematic review. Front Psychiatry 2023; 14:1212514. [PMID: 37547222 PMCID: PMC10399242 DOI: 10.3389/fpsyt.2023.1212514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Conducting a systematic analysis of objective measurement tools to assess the characteristics of macroscopic sleep architecture in patients with mild cognitive impairment (MCI), amnestic MCI (aMCI), and non-amnestic MCI (naMCI) in order to provide sleep disorder guidance for MCI patients. Methods PubMed, EMbase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP Data were examined to find literature relating to sleep in patients with MCI, aMCI, and naMCI, with a search time frame of build to April 2023. Following independent literature screening, data extraction, and quality evaluation by two researchers, statistical analysis was performed using RevMan 5.4 software. Results Twenty-five papers with 1,165 study subjects were included. Patients with MCI and aMCI were found to have altered total sleep time (TST), reduced sleep efficiency (SE), more wake-time after sleep onset (WASO), longer sleep latency (SL), a higher proportion of N1 stage and a lower proportion of N2 and N3 stage. naMCI was only found to have statistically significant differences in WASO. Conclusions The results of this study provide evidence for macroscopic sleep architecture abnormalities among MCI patients with sleep disorders. Maintaining a normal sleep time, improving SE, and reducing sleep fragmentation may have an association with a slowed development of cognitive impairment. Further exploration is required of the effects each component of macroscopic sleep structure after the intervention has on altered sleep disturbance and cognition in MCI, aMCI, and naMCI. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023401937, identifier: CRD42023401937.
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Affiliation(s)
- Yahui Liang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weihua Liu
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Meizi Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
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15
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You Y, Chen Y, Chen X, Wei M, Yin J, Zhang Q, Cao Q. Threshold effects of the relationship between physical exercise and cognitive function in the short-sleep elder population. Front Aging Neurosci 2023; 15:1214748. [PMID: 37424629 PMCID: PMC10323428 DOI: 10.3389/fnagi.2023.1214748] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background It has been demonstrated that elderly people's cognitive capacities can be improved with exercise, and short sleep is linked to cognitive decline. However, the impact of physical exercise on cognitive performance in seniors who do not get enough sleep is largely unknown. This makes it an intriguing subject to explore further. Methods This study consisted of elders (over 60 years old) who participated throughout the National Health and Nutrition Examination Survey's 2011-2014 cycle (NHANES). Weighted linear regression model and restricted cubic splines analysis were performed to evaluate the association between physical exercise and cognitive function. In the end, 1,615 samples were scrutinized and the total number of weighted respondents was 28,607,569. Results Results showed that in the Animal Fluency test and the Digit Symbol Substitution test, a positive association was found between physical exercise volume and scores in the fully adjusted model. A two-piecewise linear regression model was then applied to explore the threshold effect of exercise on cognitive performance. Before 960 and 800 MET-minutes/week, there were consistent positive relationship between exercise and scores of the Animal Fluency test [ß (95% CI): 0.233 (0.154, 0.312), p < 0.001] and Digit Symbol Substitution test [β (95% CI): 0.555 (0.332, 0.778), p < 0.001], respectively. However, there was a saturation effect where physical exercise volume reached the two inflection points. Conclusion According to our research, the benefit of exercise did not always expand with the exercise volume increment under the short-sleep condition, which challenged existing knowledge. The short-sleep elder group could maintain cognitive performance with no more than 800 MET-minutes/week of physical exercise. Verification of these findings requires further biological investigations.
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Affiliation(s)
- Yanwei You
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Chen
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Mengxian Wei
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qi Zhang
- Undergraduate Department, Taishan University, Tai’an, China
| | - Qiang Cao
- Department of Earth Sciences, Kunming University of Science and Technology, Kunming, China
- School of Pharmacy, Macau University of Science and Technology, Taipa, Macao SAR, China
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16
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Mombelli S, Leitner C, D'Este G, Sforza M, Marelli S, Castelnuovo A, Zucconi M, Casoni F, Fantini ML, Novellino F, Salsone M, Ferini-Strambi L, Galbiati A. A data-driven approach to neuropsychological features in isolated REM behaviour disorder: A latent class analysis. J Neuropsychol 2023; 17:161-179. [PMID: 36192363 DOI: 10.1111/jnp.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
Recent evidence demonstrated that neuropsychological assessment may be considered a valid marker of neurodegeneration in idiopathic REM sleep behaviour disorder (iRBD). However, little is known about the possible neuropsychological heterogeneity within the iRBD population. This retrospective study aimed to identify and describe different neuropsychological phenotypes in iRBD patients by means of a data-driven approach using latent class analysis. A total of 289 iRBD patients underwent a neuropsychological assessment evaluating cognitive domains: global cognition, language, short- and long-term memory, executive functions and visuospatial abilities. The presence of mild cognitive impairment (MCI) was also assessed. Latent class analysis was carried out to identify iRBD subtypes according to neuropsychological scores. The most parsimonious model identified three latent classes. Groups were labelled as follows: Class 2 "severely impaired" (n = 83/289): mean pathological scores in different tests, a high percentage of MCI multiple-domain and impairment in all neuropsychological domains. Class 1 "moderately impaired" (n = 44/289): mean neuropsychological score within the normal value, a high percentage of MCI (high risk to phenoconversion) and great impairment in the visuospatial domain. Class 3 "slightly impaired" (n = 162/289): no deficit worthy of attention except for short- and long-term memory. Our results suggest three different clinical phenotypes within the iRBD population. These findings may be relevant in the future for predicting the clinical trajectories of phenoconversion in iRBD.
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Affiliation(s)
- Samantha Mombelli
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Leitner
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy
| | - Giada D'Este
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy
| | - Marco Sforza
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy
| | - Sara Marelli
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Castelnuovo
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Zucconi
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Casoni
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Livia Fantini
- Sleep and EEG, Neurophysiology Unit, Clermont-Ferrand University Hospital and UMR 6602 - Université Clermont Auvergne, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Fabiana Novellino
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council, Catanzaro, Italy.,Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Investigación Neuroquímica (IUINQ-UCM), Madrid, Spain.,Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, Spain
| | - Maria Salsone
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy.,Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council, Catanzaro, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy
| | - Andrea Galbiati
- Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.,"Vita-Salute" San Raffaele University, Milan, Italy
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17
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Basta M, Skourti E, Alexopoulou C, Zampetakis A, Ganiaris A, Aligizaki M, Simos P, Vgontzas AN. Cretan Aging Cohort-Phase III: Methodology and Descriptive Characteristics of a Long-Term Longitudinal Study on Predictors of Cognitive Decline in Non-Demented Elderly from Crete, Greece. Healthcare (Basel) 2023; 11:healthcare11050703. [PMID: 36900708 PMCID: PMC10000452 DOI: 10.3390/healthcare11050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Identifying modifiable factors that may predict long-term cognitive decline in the elderly with adequate daily functionality is critical. Such factors may include poor sleep quality and quantity, sleep-related breathing disorders, inflammatory cytokines and stress hormones, as well as mental health problems. This work reports the methodology and descriptive characteristics of a long-term, multidisciplinary study on modifiable risk factors for cognitive status progression, focusing on the 7-year follow-up. Participants were recruited from a large community-dwelling cohort residing in Crete, Greece (CAC; Cretan Aging Cohort). Baseline assessments were conducted in 2013-2014 (Phase I and II, circa 6-month time interval) and follow-up in 2020-2022 (Phase III). In total, 151 individuals completed the Phase III evaluation. Of those, 71 were cognitively non-impaired (CNI group) in Phase II and 80 had been diagnosed with mild cognitive impairment (MCI). In addition to sociodemographic, lifestyle, medical, neuropsychological, and neuropsychiatric data, objective sleep was assessed based on actigraphy (Phase II and III) and home polysomnography (Phase III), while inflammation markers and stress hormones were measured in both phases. Despite the homogeneity of the sample in most sociodemographic indices, MCI persons were significantly older (mean age = 75.03 years, SD = 6.34) and genetically predisposed for cognitive deterioration (APOE ε4 allele carriership). Also, at follow-up, we detected a significant increase in self-reported anxiety symptoms along with a substantial rise in psychotropic medication use and incidence of major medical morbidities. The longitudinal design of the CAC study may provide significant data on possible modifiable factors in the course of cognitive progression in the community-dwelling elderly.
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Affiliation(s)
- Maria Basta
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
- Correspondence: ; Tel.: +30-2810-392-402; Fax: +30-2810-392-859
| | - Eleni Skourti
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Christina Alexopoulou
- Department of Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Alexandros Zampetakis
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Andronikos Ganiaris
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Marina Aligizaki
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Panagiotis Simos
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, 70013 Heraklion, Greece
| | - Alexandros N. Vgontzas
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
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Wang X, Si K, Gu W, Wang X. Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly. Front Aging Neurosci 2023; 14:1028822. [PMID: 36760710 PMCID: PMC9906996 DOI: 10.3389/fnagi.2022.1028822] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.
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Affiliation(s)
- Xin Wang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Keyi Si
- Department of Military Health Statistics, Naval Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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Rosales-Lagarde A, Cubero-Rego L, Menéndez-Conde F, Rodríguez-Torres EE, Itzá-Ortiz B, Martínez-Alcalá C, Vázquez-Tagle G, Vázquez-Mendoza E, Eraña Díaz ML. Dissociation of Arousal Index Between REM and NREM Sleep in Elderly Adults with Cognitive Impairment, No Dementia: A Pilot Study. J Alzheimers Dis 2023; 95:477-491. [PMID: 37574730 DOI: 10.3233/jad-230101] [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: 08/15/2023]
Abstract
BACKGROUND Sleep disruption in elderly has been associated with an increased risk of cognitive impairment and its transition into Alzheimer's disease (AD). High arousal indices (AIs) during sleep may serve as an early-stage biomarker of cognitive impairment non-dementia (CIND). OBJECTIVE Using full-night polysomnography (PSG), we investigated whether CIND is related to different AIs between NREM and REM sleep stages. METHODS Fourteen older adults voluntarily participated in this population-based study that included Mini-Mental State Examination, Neuropsi battery, Katz Index of Independence in Activities of Daily Living, and single-night PSG. Subjects were divided into two groups (n = 7 each) according to their results in Neuropsi memory and attention subtests: cognitively unimpaired (CU), with normal results; and CIND, with -2.5 standard deviations in memory and/or attention subtests. AIs per hour of sleep during N1, N2, N3, and REM stages were obtained and correlated with Neuropsi total score (NTS). RESULTS AI (REM) was significantly higher in CU group than in CIND group. For the total sample, a positive correlation between AI (REM) and NTS was found (r = 0.68, p = 0.006), which remained significant when controlling for the effect of age and education. In CIND group, the AI (N2) was significantly higher than the AI (REM) . CONCLUSION In CIND older adults, this attenuation of normal arousal mechanisms in REM sleep are dissociated from the relative excess of arousals observed in stage N2. We propose as probable etiology an early hypoactivity at the locus coeruleus noradrenergic system, associated to its early pathological damage, present in the AD continuum.
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Affiliation(s)
- Alejandra Rosales-Lagarde
- CONACyT Chairs, National Council of Science and Technology, Mexico
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico
| | - Lourdes Cubero-Rego
- Neurodevelopmental Research Unit, Institute of Neurobiology, National Autonomous University of Mexico, Campus Juriquilla-Queretaro, Querétaro, México
| | | | | | - Benjamín Itzá-Ortiz
- Mathematics Research Center, Autonomous University of the State of Hidalgo, Mexico
| | - Claudia Martínez-Alcalá
- CONACyT Chairs, National Council of Science and Technology, Mexico
- Institute of Health Sciences, Autonomous University of the State of Hidalgo, Mexico
| | | | | | - Marta L Eraña Díaz
- Center for Research in Engineering and Applied Sciences, Autonomous University of the State of Morelos, Mexico
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Distinct sleep disturbance and cognitive dysfunction profiles in oncology outpatients receiving chemotherapy. Support Care Cancer 2022; 30:9243-9254. [PMID: 36066629 DOI: 10.1007/s00520-022-07350-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/24/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Sleep disturbance and cancer-related cognitive impairment (CRCI) are two of the most common symptoms reported by patients undergoing chemotherapy. Less is known about how these symptoms co-occur and their associated risk factors. Study purposes were to identify subgroups of patients with distinct sleep disturbance and CRCI profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, symptom severity scores, and QOL outcomes. METHODS A total of 1,333 oncology outpatients receiving chemotherapy completed self-report questionnaires on sleep disturbance and cognitive dysfunction six times over two cycles of chemotherapy. Latent profile analysis was used to identify distinct sleep disturbance AND cognitive dysfunction profiles. Parametric and non-parametric tests were used to evaluate for differences among the classes. RESULTS Two distinct profiles were identified (i.e., Low = low levels of both sleep disturbance and cognitive dysfunction (53.5%); High = high levels of both sleep disturbance and cognitive dysfunction (45.5%)). Patients in the High class were younger, more likely to be female, had a lower functional status and a higher level of comorbidity. In addition, these patients had a higher symptom burden and a lower quality of life. CONCLUSION Almost half of the patients undergoing chemotherapy experienced clinically meaningful levels of both symptoms. Of note, sleep disturbance is frequently overlooked by both clinicians and patients. Clinicians need to recommend cognitive rehabilitation and physical activity programs to decrease patients' symptom burden.
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Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148457. [PMID: 35886309 PMCID: PMC9325170 DOI: 10.3390/ijerph19148457] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer’s disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8–93.7 healthy participants and 61.8–86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations are associated with cognitive impairment. In conclusion, the frequency and severity of sleep disturbance appear to follow the evolution of cognitive impairment. The overall results of objective measures seem more consistent than those highlighted by subjective measurements.
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Affiliation(s)
- Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Correspondence: (M.C.); (I.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
| | - Francesca Favieri
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
| | - Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
- Correspondence: (M.C.); (I.C.)
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Wei W, Wang K, Shi J, Li Z. The Relationship Between Sleep Disturbance and Apolipoprotein E ε4 in Adults With Mild Cognitive Impairment and Alzheimer's Disease Dementia: An Integrative Review. Biol Res Nurs 2022; 24:327-337. [PMID: 35439097 DOI: 10.1177/10998004221081044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apolipoprotein E ε4 (APOE ε4) was shown to be a risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia. When coupled with sleep disturbance, APOE ε4 posed additional risks to cognitive impairment. But the literature on the association between sleep disturbance and the APOE ε4 status of persons who are cognitively impaired has not yet been systematically examined. OBJECTIVES To explore and synthesize the relationship between sleep disturbance and APOE ε4 status of adults with MCI and AD. METHODS An integrative review was guided by Whittemore and Knafl's methodology. Systematic searches identified studies with multiple sources published before May 20, 2021. A matrix and narrative synthesis was employed to organize and synthesize the findings. Joanna Briggs Institute (JBI) Critical Appraisal tools (2020) were used to evaluate the quality of the selected studies. RESULTS A total of 7 studies were included. APOE ε4 was associated with poor sleep quality in terms of the deterioration of nighttime total sleep time, 24-hour total sleep time, rapid eye movement, sleep efficiency, sleep latency, and wake after sleep onset in a population with MCI or AD. The interacted and adjusted relationship between sleep disturbance and APOE ε4 on the progression of cognitive decline was inconsistent. CONCLUSIONS There is evidence to support an association between sleep disturbance and APOE ε4 in individuals with cognitive impairment, but a further examination of the relationship between sleep parameters and APOE ε4 is warranted, especially as the causal or dose-response relationship remains unclear.
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Affiliation(s)
- Wanrui Wei
- School of Nursing, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kairong Wang
- School of Nursing, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiyuan Shi
- School of Nursing, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zheng Li
- School of Nursing, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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A New Perspective on the Treatment of Alzheimer's Disease and Sleep Deprivation-Related Consequences: Can Curcumin Help? OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6168199. [PMID: 35069976 PMCID: PMC8769857 DOI: 10.1155/2022/6168199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 01/09/2023]
Abstract
Sleep disturbances, as well as sleep-wake rhythm disorders, are characteristic symptoms of Alzheimer's disease (AD) that may head the other clinical signs of this neurodegenerative disease. Age-related structural and physiological changes in the brain lead to changes in sleep patterns. Conditions such as AD affect the cerebral cortex, basal forebrain, locus coeruleus, and the hypothalamus, thus changing the sleep-wake cycle. Sleep disorders likewise adversely affect the course of the disease. Since the sleep quality is important for the proper functioning of the memory, impaired sleep is associated with problems in the related areas of the brain that play a key role in learning and memory functions. In addition to synthetic drugs, utilization of medicinal plants has become popular in the treatment of neurological diseases. Curcuminoids, which are in a diarylheptanoid structure, are the main components of turmeric. Amongst them, curcumin has multiple applications in treatment regimens of various diseases such as cardiovascular diseases, obesity, cancer, inflammatory diseases, and aging. Besides, curcumin has been reported to be effective in different types of neurodegenerative diseases. Scientific studies exclusively showed that curcumin leads significant improvements in the pathological process of AD. Yet, its low solubility hence low bioavailability is the main therapeutic limitation of curcumin. Although previous studies have focused different types of advanced nanoformulations of curcumin, new approaches are needed to solve the solubility problem. This review summarizes the available scientific data, as reported by the most recent studies describing the utilization of curcumin in the treatment of AD and sleep deprivation-related consequences.
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Temporal dynamics of depression, cognitive performance and sleep in older persons with depressive symptoms and cognitive impairments: a series of eight single-subject studies. Int Psychogeriatr 2022; 34:47-59. [PMID: 33715659 DOI: 10.1017/s1041610221000065] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To investigate the presence, nature and direction of the daily temporal association between depressive symptoms, cognitive performance and sleep in older individuals. DESIGN, SETTING, PARTICIPANTS Single-subject study design in eight older adults with cognitive impairments and depressive symptoms. MEASUREMENTS For 63 consecutive days, depressive symptoms, working memory performance and night-time sleep duration were daily assessed with an electronic diary and actigraphy. The temporal associations of depressive symptoms, working memory and total sleep time were evaluated for each participant separately with time-series analysis (vector autoregressive modeling). RESULTS For seven out of eight participants we found a temporal association between depressive symptoms and/or sleep and/or working memory performance. More depressive symptoms were preceded by longer sleep duration in one person (r = 0.39; p < .001), by longer or shorter sleep duration than usual in one other person (B = 0.49; p < .001), by worse working memory in one person (B = -0.45; p = .007), and by better working memory performance in one other person (B = 0.35; p = .009). Worse working memory performance was preceded by longer sleep duration (r = -.35; p = .005) in one person, by shorter or longer sleep duration in three other persons (B = -0.76; p = .005, B = -0.61; p < .001; B = -0.34; p = .002), and by more depressive symptoms in one person (B = -0.25; p = .009). CONCLUSION The presence, nature and direction of the temporal associations between depressive symptoms, cognitive performance and sleep differed between individuals. Knowledge of personal temporal associations may be valuable for the development of personalized intervention strategies in order to maintain their health, quality of life, functional outcomes and independence.
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Arapova Y, Popov I, Shikhliarova A, Rostorguev E, Kuznetsova N, Protasova T. The study of cognitive functions and the brain electrical activity in wakefulness and night sleep in patients with lobe tumors. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:106-111. [DOI: 10.17116/jnevro2022122031106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Grässler B, Dordevic M, Herold F, Darius S, Langhans C, Halfpaap N, Labott BK, Müller P, Ammar A, Thielmann B, Böckelmann I, Müller NG, Hökelmann A. Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13321. [PMID: 34948937 PMCID: PMC8703743 DOI: 10.3390/ijerph182413321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022]
Abstract
Sleep problems can be caused by psychological stress but are also related to cardiovascular and neurodegenerative diseases. Improving lifestyle behaviors, such as good sleep hygiene, can help to counteract the negative effects of neurodegenerative diseases and to improve quality of life. The purpose of this cross-sectional study was to investigate the relationship between subjectively reported measures of sleep quality (via Pittsburgh Sleep Quality Index (PSQI)) and objective measures of cardiac autonomic control (via resting state heart rate variability (HRV)) among individuals with mild cognitive impairment (MCI). The PSQI and resting state HRV data of 42 MCI participants (69.0 ± 5.5; 56-80 years) were analyzed. Nineteen of the participants reported poor sleep quality (PSQI score > 5). Good sleepers showed higher resting heart rate than bad sleepers (p = 0.037; ES = 0.670). Correlation analysis showed a significant correlation between the parameter HF nu and sleep efficiency, contrasting the expected positive association between reduced HRV and poor sleep quality in healthy and individuals with specific diseases. Otherwise, there were no significances, indicating that measures of subjective sleep quality and resting HRV were not related in the present sample of MCI participants. Further research is needed to better understand the complex relationship between HRV and lifestyle factors (e.g., sleep) in MCI.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
| | - Milos Dordevic
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (M.D.); (F.H.); (P.M.); (N.G.M.)
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, 14469 Potsdam, Germany
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (M.D.); (F.H.); (P.M.); (N.G.M.)
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, 14469 Potsdam, Germany
| | - Sabine Darius
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (S.D.); (B.T.); (I.B.)
| | - Corinna Langhans
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
| | - Nicole Halfpaap
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
| | - Berit K. Labott
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
| | - Patrick Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (M.D.); (F.H.); (P.M.); (N.G.M.)
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany
| | - Achraf Ammar
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (S.D.); (B.T.); (I.B.)
| | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (S.D.); (B.T.); (I.B.)
| | - Notger G. Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (M.D.); (F.H.); (P.M.); (N.G.M.)
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences, University of Potsdam, 14469 Potsdam, Germany
- Center for Behavioral Brain Sciences (CBBS), Brenneckestraße 6, 39118 Magdeburg, Germany
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany; (C.L.); (N.H.); (B.K.L.); (A.A.); (A.H.)
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Wang R, Zhu J, Zhang J, Ma Y, Jiang H. Psychological assessments of a senile patient with tetraplegia who received brain-computer interface implantation: a case report. Neurol Sci 2021; 43:1427-1430. [PMID: 34812967 DOI: 10.1007/s10072-021-05393-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/07/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Research on individuals with brain-computer interface (BCI) presents not only technological challenges but ethical challenges (e.g., psychological aspects) as well. We assessed the mental health of a senile patient with tetraplegia after an invasive implantation of BCI and a long-term daily training, in order to provide new experience about the ethical impact of BCI on users and inform future clinical applications of such devices. METHODS This case was a 71-year-old man with tetraplegia for 2 years. Prior to the implant surgery of BCI, and 1 month, 2 months, 3 months, and 9 months after training, a series of tests for cognition, emotion, social support, sleep, and quality of life were performed to evaluate the patient's mental health. RESULTS Compared with baseline before surgery, the patients' cognition, emotion, social support, sleep, and quality of life improved after the surgery and the long-term daily training. At 3 months post-training, the patient's cognitive score measured by Mini-mental State Examination reached the cutoff point for cognitive impairment in the elderly. Subjective well-being and quality of life showed a slight decline at 9 months post-training compared with that 3 months post-training but remained above the baseline. CONCLUSION This study shows the psychological benefits in a senile patient after an invasive BCI implantation and a long-term daily training. BCI ethics is still in its early stages, and further research is needed to understand emerging psychological states of this specific population.
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Affiliation(s)
- Rui Wang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Junming Zhu
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Ying Ma
- Department of Psychiatry, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Hongjie Jiang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China.
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Smith L, Shin JI, Jacob L, Carmichael C, López Sánchez GF, Oh H, Butler LT, Barnett Y, Pizzol D, Tully MA, Soysal P, Veronese N, Koyanagi A. Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries. Exp Gerontol 2021; 154:111513. [PMID: 34384889 DOI: 10.1016/j.exger.2021.111513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings. OBJECTIVE To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs). DESIGN Cross-sectional. SETTING Study on Global Ageing and Adult Health (SAGE). SUBJECTS 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50-114 years; 51.7% females]. METHODS MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question "Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?" and categorized as "None", "Mild", "Moderate", "Severe/Extreme". Multivariable logistic regression analysis and meta-analysis were conducted. RESULTS Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50-2.16), and a low level of between-country heterogeneity was observed (I2 = 28.2%). CONCLUSIONS Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Christina Carmichael
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Laurie T Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation - Khartoum, Sudan
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Northern Ireland, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093 Fatih, İstanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain
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Hu M, Shu X, Feng H, Xiao LD. Sleep, inflammation and cognitive function in middle-aged and older adults: A population-based study. J Affect Disord 2021; 284:120-125. [PMID: 33592430 DOI: 10.1016/j.jad.2021.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/13/2021] [Accepted: 02/01/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Sleep plays a key role in preserving cognitive function. However, the optimal strategies of sleep for cognition and the underlying mechanism are not well-established. METHODS A cross-sectional study was performed using the China Health and Retirement Longitudinal Study (CHARLS), 2011-2012 survey. Self-reported nighttime sleep and afternoon napping data were collected. Fasting blood collected was analyzed for the high-sensitivity C-reactive protein (CRP) and white blood cell. RESULTS Both nighttime sleep and afternoon napping were significantly associated with cognition after adjusting for confounders (p < 0.05). Precisely, participants with nighttime sleep of 6.1-7h had the highest cognition scores (p < 0.05). Participants with less than 30 min afternoon napping had the highest cognition scores (p < 0.05). The synergistic effect of nighttime sleep and afternoon napping was not significant (p > 0.05). Nighttime sleep and afternoon napping were significantly related to the white blood cell, but not the high-sensitivity CRP. The white blood cell mediated the association between sleep and cognition (p < 0.05). CONCLUSION Nighttime sleep of six to seven hours and afternoon napping of less than 30 minutes are associated with optimal cognitive function in middle-aged and older people, respectively. Sleep influences cognition partly via the inflammatory profile.
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Affiliation(s)
- Mingyue Hu
- Xiangya Nursing School, Central South University, Changsha 410000, China
| | - Xinhui Shu
- Department of Hematology, Henan Cancer Hospital, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha 410000, China; Oceanwide Health management institute, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
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Torossian M, Fiske SM, Jacelon CS. Sleep, Mild Cognitive Impairment, and Interventions for Sleep Improvement: An Integrative Review. West J Nurs Res 2021:193945920986907. [PMID: 33455559 PMCID: PMC8282804 DOI: 10.1177/0193945920986907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbance in mild cognitive impairment (MCI) is associated with progression to Alzheimer's disease (AD), more severe AD symptoms, and worse health outcomes. The aim of this review was to examine the relationship between sleep and MCI, and the effectiveness of sleep improvement interventions for older adults with MCI or AD. An integrative review was conducted using four databases, and findings were analyzed using an iterative process. Findings from 24 studies showed that alterations in sleep increased the risk of MCI and that the sleep quality of individuals with MCI or AD was poorer than healthy controls. Changes in brain anatomy were also observed in healthy older adults with sleep disturbances. Examined interventions were shown to be effective in improving sleep. Screening for sleep disturbances in individuals with MCI/AD is crucial to mitigate neurodegenerative or neurobehavioral risks in this population.
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Cai S, Li T, Zhang L, Shi L, Liao J, Li W, Cheng G, Tan W, Rong S. Characteristics of Sleep Structure Assessed by Objective Measurements in Patients With Amnestic Mild Cognitive Impairment: A Meta-Analysis. Front Neurol 2020; 11:577126. [PMID: 33281712 PMCID: PMC7689212 DOI: 10.3389/fneur.2020.577126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023] Open
Abstract
Objectives: This study aims to explore the differences of sleep structure between patients with amnestic mild cognitive impairment (aMCI) and elderly people with normal cognition, which will help to provide evidence for the relationship between sleep disturbances and cognitive impairment. Methods: A systematic review and meta-analysis were conducted on the literature on sleep parameters obtained by polysomnography or actigraphy in patients with aMCI. The PubMed and EMBASE databases were searched up to April 2020. Inclusion and exclusion criteria were established according to evidence-based medicine methods, and data of all eligible studies were meta-analyzed using the Review Manager 5.3 software. Results: Among the 1,171 literature articles on sleep structure of patients with MCI, eight case-control studies met the inclusion criteria and were included in this meta-analysis. A total of 278 subjects were included, of which 103 were patients with aMCI and 175 were elderly people with normal cognition. The results showed that sleep efficiency (SE) and slow wave sleep (SWS) of patients with aMCI were significantly lower than those of healthy elderly people. Compared with the control group, the percentage of stage 1 of non-rapid eye movement (N1%) in the aMCI patients group increased, and the percentage of stage 2 of non-rapid eye movement (N2%) decreased. Conclusions: Patients with aMCI may experience more severe sleep disturbances than normal cognitive elderly people. There were specific changes, especially in SE and SWS, in the sleep structure of patients with aMCI when compared to those with normal cognition.
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Affiliation(s)
- Sijie Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Tingting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Li Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, China
| | - Longhua Shi
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Wenfang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Guangwen Cheng
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Community Health Service Center of Qingling, Wuhan, China
- Hospital of Wuhan University of Science and Technology, Wuhan, China
- Wei Tan
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Shuang Rong
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Chou CA, Toedebusch CD, Redrick T, Freund D, McLeland JS, Morris JC, Holtzman DM, Lucey BP. Comparison of single-channel EEG, actigraphy, and sleep diary in cognitively normal and mildly impaired older adults. ACTA ACUST UNITED AC 2020; 1:zpaa006. [PMID: 33644758 PMCID: PMC7898727 DOI: 10.1093/sleepadvances/zpaa006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/12/2020] [Indexed: 12/12/2022]
Abstract
Study Objectives Multiple methods for monitoring sleep-wake activity have identified sleep disturbances as risk factors for Alzheimer disease (AD). In order to identify the level of agreement between different methods, we compared sleep parameters derived from single-channel EEG (scEEG), actigraphy, and sleep diaries in cognitively normal and mildly impaired older adults. Methods Two hundred ninety-three participants were monitored at home for up to six nights with scEEG, actigraphy, and sleep diaries. Total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) were calculated using each of these methods. In 109 of the 293 participants, the ratio of cerebrospinal fluid concentrations of phosphorylated tau (p-tau) and amyloid-β-42 (Aβ42) was used as a biomarker for AD pathology. Results Agreement was highest for TST across instruments, especially in cognitively normal older adults. Overall, scEEG and actigraphy appeared to have greater agreement for multiple sleep parameters than for scEEG and diary or actigraphy and diary. Levels of agreement between scEEG and actigraphy overall decreased in mildly impaired participants and those with biomarker evidence of AD pathology, especially for measurements of TST. Conclusions Caution should be exercised when comparing scEEG and actigraphy in individuals with mild cognitive impairment or with AD pathology. Sleep diaries may capture different aspects of sleep compared to scEEG and actigraphy. Additional studies comparing different methods of measuring sleep-wake activity in older adults are necessary to allow for comparison between studies using different methods.
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Affiliation(s)
- Chris A Chou
- Department of Neurology, Washington University School of Medicine, St Louis, MO
| | | | - Tiara Redrick
- Department of Neurology, Washington University School of Medicine, St Louis, MO
| | - David Freund
- Department of Neurology, Washington University School of Medicine, St Louis, MO
| | - Jennifer S McLeland
- Department of Neurology, Washington University School of Medicine, St Louis, MO
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO.,Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, MO.,Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO.,Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO
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Hu M, Shu X, Wu X, Chen F, Hu H, Zhang J, Yan P, Feng H. Neuropsychiatric symptoms as prognostic makers for the elderly with mild cognitive impairment: a meta-analysis. J Affect Disord 2020; 271:185-192. [PMID: 32479315 DOI: 10.1016/j.jad.2020.03.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/11/2020] [Accepted: 03/22/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Although several neuropsychiatric symptoms (NPSs) have been demonstrated to have value in the prediction of the progression of mild cognitive impairment (MCI) to dementia, these symptoms are less studied for the prediction of the transition from normal cognition (NC) to MCI. METHODS Prospective cohort studies were included if they reported on at least one NPS at baseline and had MCI as the outcome. RESULTS We obtained 13 cohort studies with a total population of 33,066. Depression was the most common neuropsychiatric symptom and could significantly predict transition to MCI (RR = 1.49, 95% CI: 1.13-1.86). However, depression was more capable of predicting amnestic MCI (RR=1.43, 95% CI: 1.04-1.83) than non-aMCI (RR= 0.96, 95% CI 95% CI: 0.60-1.33). Subgroup analysis suggested that the association between depression and MCI changed with depression severity, depression criteria, apolipoprotein-E-adjusted status, age, the percentage of females, and follow-up times, but some data were too sparse for a reliable estimate. Regarding other NPSs, there were insufficient data to assess their effect on the development of MCI. However, apathy, anxiety, sleep disturbances, irritability, and agitation might be risk factors for the prediction of NC-MCI transition with strong predictive value. CONCLUSIONS Depression was associated with an approximately 1.5-fold sincreased risk of the progression to MCI in the population with normal cognition. Other NPSs with underlying predictive value deserve more attention.
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Affiliation(s)
- Mingyue Hu
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China
| | - Xinhui Shu
- Department of Hematology, Tumor Hospital of Henan Province, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyin Wu
- Department of Public Health, XiangYa School of Medicine, Central South University, Changsha, China
| | - Fenghui Chen
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China; Department of Nursing, Xinjiang Medical University, Xinjiang, China
| | - Hengyu Hu
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China
| | - Junmei Zhang
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Ping Yan
- Department of Nursing, Xinjiang Medical University, Xinjiang, China
| | - Hui Feng
- Department of Nursing, XiangYa School of Medicine, Central South University, Changsha, China; Oceanwide Health management institute, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University, Changsha, China.
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Borges CR, Poyares D, Piovezan R, Nitrini R, Brucki S. Alzheimer's disease and sleep disturbances: a review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 77:815-824. [PMID: 31826138 DOI: 10.1590/0004-282x20190149] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/23/2019] [Indexed: 01/19/2023]
Abstract
The association between Alzheimer's disease (AD) and sleep disturbances has received increasing scientific attention in the last decades. However, little is known about the impact of sleep and its disturbances on the development of preclinical AD stages, such as mild cognitive impairment. This review describes the evolution of knowledge about the potential bidirectional relationships between AD and sleep disturbances exploring recent large prospective studies and meta-analyses and studies of the possible mechanisms through which sleep and the neurodegenerative process could be associated. The review also makes a comprehensive exploration of the sleep characteristics of older people, ranging from cognitively normal individuals, through patients with mild cognitive impairment, up to the those with dementia with AD.
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Affiliation(s)
- Conrado Regis Borges
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
| | - Dalva Poyares
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Instituto do Sono, São Paulo SP, Brasil
| | - Ronaldo Piovezan
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Instituto do Sono, São Paulo SP, Brasil
| | - Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
| | - Sonia Brucki
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brasil
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Riba-Llena I, Álvarez-Sabin J, Romero O, Santamarina E, Sampol G, Maisterra O, Ferré Á, Montaner J, Quintana M, Delgado P. Nighttime hypoxia affects global cognition, memory, and executive function in community-dwelling individuals with hypertension. J Clin Sleep Med 2020; 16:243-250. [PMID: 31992414 DOI: 10.5664/jcsm.8174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The objective of this study was to determine which respiratory and architectural sleep parameters are related to cognitive function and cognitive status (mild cognitive impairment [MCI] versus normal cognitive aging [NCA]) in community-dwelling individuals with hypertension. Additionally, it aimed to determine whether the results changed in the presence or absence of vascular brain lesions (silent brain infarcts and extensive white matter hyperintensities [WMHs]). METHODS In a cohort of individuals with hypertension and without previous stroke or dementia, we conducted in-hospital polysomnography including electroencephalography, electro-oculography, electromyography, and magnetic resonance imaging to assess silent brain infarcts and WMHs. Cognitive testing was carried out with a screening test (Dementia Rating Scale version 2 [DRS-2]) and a complete cognitive visit. RESULTS This study included 158 participants with a median age of 65.0 years; 32.3% were females, and the median apnea-hypopnea index was 22.3 events/h. MCI was diagnosed in 24 study participants, and the rest had NCA. Regarding respiratory parameters, total DRS-2 scores (β; 95% CI) 0.121; 0.026, 0.215 were positively associated with mean O₂ saturation, whereas total (-0.022; -0.036, -0.009), executive function (-0.016; -0.026, -0.006) and memory (-0.017; -0.029, -0.004) DRS-2 scores were all negatively associated with the percent of time with oxygen saturation < 90% after correcting for education, vascular risk factors, and magnetic resonance imaging lesions. Regarding sleep architecture, Attention DRS-2 scores (0.0153; 0.001, 0.306) were independently associated with total sleep time. Similar results were obtained in the absence of silent brain infarcts or WMHs in the stratified analysis. None of the sleep parameters were associated with cognitive status. CONCLUSIONS Low oxygen saturation contributes to cognitive performance, and this effect appears even in the absence of vascular brain lesions in individuals with hypertension.
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Affiliation(s)
- Iolanda Riba-Llena
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Álvarez-Sabin
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Odile Romero
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Estevo Santamarina
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Sampol
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Multidisciplinary Sleep Unit, Respiratory Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Maisterra
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Álex Ferré
- Multidisciplinary Sleep Unit, Department of Neurophysiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manuel Quintana
- Neurology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Li L, Li L, Chai JX, Xiao L, Ng CH, Ungvari GS, Xiang YT. Prevalence of Poor Sleep Quality in Patients With Hypertension in China: A Meta-analysis of Comparative Studies and Epidemiological Surveys. Front Psychiatry 2020; 11:591. [PMID: 32695027 PMCID: PMC7338685 DOI: 10.3389/fpsyt.2020.00591] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/08/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE This meta-analysis examined the prevalence of poor sleep quality and its associated factors in patients with hypertension in China. METHODS Both English (PubMed, PsycINFO, EMBASE) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched. The random-effects model was used to estimate the prevalence of poor sleep quality in Chinese patients with hypertension. The funnel plot and Egger's tests were used to assess publication bias. RESULTS The prevalence of poor sleep quality in 24 studies with 13,920 hypertensive patients was 52.5% (95% confidence interval [CI]: 46.1-58.9%). In contrast, the prevalence of poor sleep quality in six studies with 5,610 healthy control subjects was 32.5% (95% CI: 19.0-49.7%). In these studies, compared to healthy controls, the pooled odds ratio (OR) of poor sleep quality was 2.66 (95% CI: 1.80-3.93) for hypertensive patients. Subgroup and meta-regression analyses revealed that patients in hospitals were more likely to have poor sleep quality than patients in the community. Studies with smaller sample size, studies using convenience or consecutive sampling and those published in Chinese reported higher prevalence of poor sleep quality. Furthermore, poor sleep quality was more common in older and male hypertensive patients, while the proportion of poor sleep quality was negatively associated with survey year. CONCLUSION Appropriate strategies for screening, prevention, and treatment of poor sleep quality in this population should be developed.
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Affiliation(s)
- Lin Li
- Department of Pharmacy, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Lu Li
- Department of Pharmacy, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jing-Xin Chai
- Beijing Centers for Disease Prevention and Control, Beijing, China.,Beijing Centers for Disease Preventive Medical Research, Beijing, China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,Department of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macau, China.,Center for Cognition and Brain Sciences, University of Macau, Macau, Macau
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Sleep disturbances in HIV-HCV coinfected patients: indications for clinical management in the HCV cure era (ANRS CO13 HEPAVIH cohort). Eur J Gastroenterol Hepatol 2019; 31:1508-1517. [PMID: 31094856 DOI: 10.1097/meg.0000000000001441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Although common among patients coinfected with HIV and hepatitis C virus (HCV), sleep disturbances (SD) are still poorly documented in this population in the HCV cure era. This longitudinal study aimed at analysing SD in HIV-HCV coinfected patients and identifying their clinical and sociobehavioural correlates. METHODS We used 5-year annual follow-up data from 1047 participants in the French National Agency for Research on Aids and Viral Hepatitis Cohort 13 'Hépatite et VIH' (ANRS CO13 HEPAVIH) cohort of HIV-HCV coinfected patients to identify clinical (medical records) and behavioural (self-administered questionnaires) correlates of SD (mixed-effects logistic regression). SD were identified using one item documenting the occurrence of insomnia or difficulty falling asleep (ANRS 'Action Coordonnée 24' self-reported symptoms checklist), and two items documenting perceived sleep quality (Center for Epidemiologic Studies Depression and WHO Quality of Life HIV-specific brief scales). RESULTS Seven hundred and sixteen (68.4%) patients with completed self-administered questionnaires reported SD at their most recent follow-up visit. In the multivariable model, hazardous alcohol consumption (Alcohol Use Disorders Identification Test-Consumption score ≥ 4 for men, ≥ 3 for women) (adjusted odds ratio = 1.61; 95% confidence interval: 1.09-2.36), depressive symptoms (6.78; 4.36-10.55) and the number of other physical and psychological self-reported symptoms (1.10; 1.07-1.13) were associated independently with SD after adjustment for sex, age and employment status. HCV cure was not associated significantly with SD. CONCLUSION SD remain frequent in HIV-HCV coinfected patients and are associated with a series of modifiable behavioural risk factors. Independent of HCV cure, improved screening and comprehensive management of alcohol use, physical and psychological self-reported symptoms and depression are essential in this population. Closer investigation of these risk factors of SDs may both increase sleep quality and indirectly improve patients' clinical outcomes.
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Liu S, Pan J, Tang K, Lei Q, He L, Meng Y, Cai X, Li Z. Sleep spindles, K-complexes, limb movements and sleep stage proportions may be biomarkers for amnestic mild cognitive impairment and Alzheimer's disease. Sleep Breath 2019; 24:637-651. [PMID: 31786748 DOI: 10.1007/s11325-019-01970-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/05/2019] [Accepted: 11/02/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Sleep disturbances are common in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients. Non-rapid eye movement stage 3 (N3), rapid eye movement stage (REM), spindle density, and K-complex (KC) density are decreased in MCI and AD patients. Periodic limb movements in sleep (PLMS) are increased in other neurodegenerative diseases. We aimed to distinguish amnestic mild cognitive impairment (aMCI) patients from the overall population of MCI patients by comparing the N3 and REM proportions, the morphological characteristics of spindles and KCs and the periodic limb movement index (PLMI) among control, aMCI and AD subjects. METHODS In 92 subjects (30 controls, 32 aMCI and 30 AD), sleep stages, spindles, KCs and PLMS were recorded during the second of two nights of polysomnography (PSG). We compared the above parameters among the three groups. RESULTS AD and aMCI subjects had lower proportions of N3 and REM, poorer spindle and KC activities and more frequent PLMS than controls. These alterations were associated with decreased Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. We determined cut-off values for distinguishing aMCI and AD using logistic regression and receiver operating characteristic (ROC) analyses. CONCLUSIONS AD and aMCI patients have abnormal sleep stage proportions, spindles, KCs and PLMS. The combination of the above alterations may distinguish aMCI and AD patients from controls with high specificity and sensitivity.
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Affiliation(s)
- Shunjie Liu
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Junhao Pan
- Department of Psychology, Sun Yat-sen University, Guangzhou, 510006, China
| | - Ke Tang
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Qingfeng Lei
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Lu He
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Yangyang Meng
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Xiaodong Cai
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Zhong Li
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China.
- Shenzhen Research Institute, Sun Yat-Sen University, Shenzhen, China.
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, 510080, China.
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Liu S, Pan J, Lei Q, He L, Zhong B, Meng Y, Li Z. Spontaneous K-Complexes may be biomarkers of the progression of amnestic mild cognitive impairment. Sleep Med 2019; 67:99-109. [PMID: 31918124 DOI: 10.1016/j.sleep.2019.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/04/2019] [Accepted: 10/18/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Spontaneous K-complexes (SKCs), a hallmark of stage 2 sleep, have been reported to decrease in density in Alzheimer's disease (AD) patients. However, few former studies have explored the alterations in SKC characteristics in the pre-clinical phase of AD-amnestic mild cognitive impairment (aMCI). The aim of our prospective cohort study was to investigate the changing trend in SKC characteristics during the progression of aMCI. METHODS SKC density, amplitude and duration were measured in aMCI subjects and normal controls (NC) at two-year follow-up assessments by polysomnography (PSG). In sum, 22 NCs, 25 stable aMCI (sMCI) subjects and 20 progressive aMCI (pMCI) subjects finished the four follow-up PSG assessments, and their data were used for analysis. RESULTS SKC density and amplitude, but not duration, decreased during the follow-up assessments in both NCs and aMCI subjects, but the rate of decrease of these parameters was greater in aMCI subjects. With the progression of aMCI, significant differences in SKC density and amplitude among the three groups were observed, whereas SKC density showed no difference at the early stage of aMCI. The receiver operating characteristic (ROC) curve results demonstrated that SKC density and amplitude could distinguish aMCI subjects from NCs with high specificity and sensitivity. CONCLUSION Our results suggest that SKCs decrease with ageing and the progression of aMCI, and SKC characteristics may be potential biomarkers for diagnosing aMCI.
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Affiliation(s)
- Shunjie Liu
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Junhao Pan
- Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, China
| | - Qingfeng Lei
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Lu He
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Bingting Zhong
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Yangyang Meng
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Zhong Li
- Department of Neurology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China; Shenzhen Research Institute of Sun Yat-Sen University, China; Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangzhou, 510080, China.
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Taillard J, Sagaspe P, Berthomier C, Brandewinder M, Amieva H, Dartigues JF, Rainfray M, Harston S, Micoulaud-Franchi JA, Philip P. Non-REM Sleep Characteristics Predict Early Cognitive Impairment in an Aging Population. Front Neurol 2019; 10:197. [PMID: 30918496 PMCID: PMC6424890 DOI: 10.3389/fneur.2019.00197] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/15/2019] [Indexed: 12/13/2022] Open
Abstract
Objective: Recent research suggests that sleep disorders or changes in sleep stages or EEG waveform precede over time the onset of the clinical signs of pathological cognitive impairment (e.g., Alzheimer's disease). The aim of this study was to identify biomarkers based on EEG power values and spindle characteristics during sleep that occur in the early stages of mild cognitive impairment (MCI) in older adults. Methods: This study was a case-control cross-sectional study with 1-year follow-up of cases. Patients with isolated subjective cognitive complaints (SCC) or MCI were recruited in the Bordeaux Memory Clinic (MEMENTO cohort). Cognitively normal controls were recruited. All participants were recorded with two successive polysomnography 1 year apart. Delta, theta, and sigma absolute spectral power and spindle characteristics (frequency, density, and amplitude) were analyzed from purified EEG during NREM and REM sleep periods during the entire second night. Results: Twenty-nine patients (8 males, age = 71 ± 7 years) and 29 controls were recruited at T0. Logistic regression analyses demonstrated that age-related cognitive impairment were associated with a reduced delta power (odds ratio (OR) 0.072, P < 0.05), theta power (OR 0.018, P < 0.01), sigma power (OR 0.033, P < 0.05), and spindle maximal amplitude (OR 0.002, P < 0.05) during NREM sleep. Variables were adjusted on age, gender, body mass index, educational level, and medication use. Seventeen patients were evaluated at 1-year follow-up. Correlations showed that changes in self-reported sleep complaints, sleep consolidation, and spindle characteristics (spectral power, maximal amplitude, duration, and frequency) were associated with cognitive impairment (P < 0.05). Conclusion: A reduction in slow-wave, theta and sigma activities, and a modification in spindle characteristics during NREM sleep are associated very early with a greater risk of the occurrence of cognitive impairment. Poor sleep consolidation, lower amplitude, and faster frequency of spindles may be early sleep biomarkers of worsening cognitive decline in older adults.
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Affiliation(s)
- Jacques Taillard
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France.,SANPSY, USR 3413, Université Bordeaux, Bordeaux, France
| | - Patricia Sagaspe
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France.,SANPSY, USR 3413, Université Bordeaux, Bordeaux, France.,CHU de Bordeaux, Pôle Neurosciences Cliniques, Bordeaux, France
| | | | | | - Hélène Amieva
- CMRR, CHU Bordeaux, Bordeaux, France.,Bordeaux Population Health Center, INSERM U1219, Université de Bordeaux, Bordeaux, France
| | - Jean-François Dartigues
- CMRR, CHU Bordeaux, Bordeaux, France.,Bordeaux Population Health Center, INSERM U1219, Université de Bordeaux, Bordeaux, France
| | | | | | - Jean-Arthur Micoulaud-Franchi
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France.,SANPSY, USR 3413, Université Bordeaux, Bordeaux, France.,CHU de Bordeaux, Pôle Neurosciences Cliniques, Bordeaux, France
| | - Pierre Philip
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France.,SANPSY, USR 3413, Université Bordeaux, Bordeaux, France.,CHU de Bordeaux, Pôle Neurosciences Cliniques, Bordeaux, France
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Multi-angles of smoking and mild cognitive impairment: is the association mediated by sleep duration? Neurol Sci 2019; 40:1019-1027. [PMID: 30778881 DOI: 10.1007/s10072-019-03750-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/02/2019] [Indexed: 01/09/2023]
Abstract
Although the association between cigarette smoking and risk of mild cognitive impairment (MCI) is controversial, most recent studies have shown that this influence is negative. However, it is unknown how multiple factors of smoking affect MCI, and the mechanisms of different smoking factors are not yet clarified. This study will examine the impact of various angles of smoking on MCI and the potential mediating effects of sleep duration on smoking MCI association in the elderly. In the case group, 109 elderly people who met the inclusion criteria were selected, and 123 were selected in the control group. Participant characteristics include sleep duration and a detailed lifetime history of smoking. After adjusting the relevant covariates, higher odds of MCI occurrence were found in ex-smokers/current smokers; moderate/heavy smokers; smokers for 30-44, 45-59 and more than 60 years; smokers with cumulative smoking duration of 30-44 or more than 60 years and smokers with cumulative dose smoking intensity of 200-399 or 400-599 cigarettes monthly. Elderly subjects who had quit smoking for 21 years or longer were found to have lower odds of MCI occurrence. The indirect effects of smoking on MCI via sleep duration were statistically significant, as the ratio of indirect effect to total effect ranged from 0.14 to 0.29. Smoking affects cognitive function through multi-angles of smoking and influences the cognitive function partly via the duration of sleep.
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Carnicelli L, Maestri M, Di Coscio E, Tognoni G, Fabbrini M, Schirru A, Giorgi FS, Siciliano G, Bonuccelli U, Bonanni E. A longitudinal study of polysomnographic variables in patients with mild cognitive impairment converting to Alzheimer's disease. J Sleep Res 2019; 28:e12821. [DOI: 10.1111/jsr.12821] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Luca Carnicelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Michelangelo Maestri
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Elisa Di Coscio
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gloria Tognoni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Monica Fabbrini
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Alessandro Schirru
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Filippo S. Giorgi
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Gabriele Siciliano
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Ubaldo Bonuccelli
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
| | - Enrica Bonanni
- Section of Neurology Department of Clinical and Experimental Medicine University of Pisa and Pisa University Hospital Pisa Italy
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Gagnon JF, Lafrenière A, Rauchs G, Petit D, Carrier J. Sleep in Normal Aging, Alzheimer's Disease, and Mild Cognitive Impairment. HANDBOOK OF SLEEP RESEARCH 2019. [DOI: 10.1016/b978-0-12-813743-7.00045-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Burke SL, Hu T, Spadola CE, Li T, Naseh M, Burgess A, Cadet T. Mild cognitive impairment: associations with sleep disturbance, apolipoprotein e4, and sleep medications. Sleep Med 2018; 52:168-176. [PMID: 30359892 PMCID: PMC6800075 DOI: 10.1016/j.sleep.2018.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/22/2018] [Accepted: 09/04/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Mild cognitive impairment (MCI) is associated with increased memory problems although the ability to complete daily life activities remains relatively intact. This study examined: (1) if sleep disturbance increased the hazard of MCI; (2) if APOE e4 carriers with sleep disturbance experience an increased risk of MCI; and, (3) if prescription sleep medications provide a protective effect against MCI. We hypothesized that sleep disturbance increases the hazard of MCI, this relationship is stronger among APOE e4 carriers reporting a sleep disturbance. Furthermore, we hypothesized that sleep medications decrease the hazard of MCI. METHODS To determine whether sleep medication mediates the risk of developing MCI for individuals with sleep disturbance and/or APOE e4, we analyzed the National Alzheimer's Coordinating Center Uniform Data Set. We selected participants with normal cognition at baseline (n = 6798), and conduced survival analyses. RESULTS Our main findings indicated that the hazard of MCI was significantly associated with sleep disturbance. The hazard remained among those who did not use sleep medication. Trazodone and zolpidem users did not have a significant hazard of MCI, but the significant hazard remained for those who did not use these medications. APOE e4 carriers had a significantly higher hazard of MCI. Among e4 carriers who used trazodone or zolpidem, there was not a statistically significant risk of MCI. CONCLUSION This study demonstrated the potential utilization of trazodone and zolpidem in the treatment of sleep disturbance while potentially mitigating the risk of MCI. While trazodone and zolpidem have been shown to positively impact sleep disturbance in individuals with normal cognition, further research should explore these findings given that these medications are potentially inappropriate for older adults.
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Affiliation(s)
- Shanna L Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5 585, Miami, FL, 33199, USA.
| | - Tianyan Hu
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, 11200 S.W. 8th Street, AHC5 452, Miami, FL, 33199, USA.
| | - Christine E Spadola
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, 777 Glades Road SO303 Boca Raton, FL, 33431-0991, USA.
| | - Tan Li
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Biostatistics, 11200 S.W. 8th Street, AHC5464 Miami, FL, 33199, USA.
| | - Mitra Naseh
- Florida International University, Robert Stempel College of Public Health & Social Work, School of Social Work, Miami, FL, 33199, USA.
| | - Aaron Burgess
- Florida International University, Robert Stempel College of Public Health & Social Work, School of Social Work, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
| | - Tamara Cadet
- Simmons University, School of Social Work, Harvard School of Dental Medicine, Oral Health Policy and Epidemiology, Boston, MA 02115 USA.
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Della Monica C, Johnsen S, Atzori G, Groeger JA, Dijk DJ. Rapid Eye Movement Sleep, Sleep Continuity and Slow Wave Sleep as Predictors of Cognition, Mood, and Subjective Sleep Quality in Healthy Men and Women, Aged 20-84 Years. Front Psychiatry 2018; 9:255. [PMID: 29988413 PMCID: PMC6024010 DOI: 10.3389/fpsyt.2018.00255] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/24/2018] [Indexed: 12/16/2022] Open
Abstract
Sleep and its sub-states are assumed to be important for brain function across the lifespan but which aspects of sleep associate with various aspects of cognition, mood and self-reported sleep quality has not yet been established in detail. Sleep was quantified by polysomnography, quantitative Electroencephalogram (EEG) analysis and self-report in 206 healthy men and women, aged 20-84 years, without sleep complaints. Waking brain function was quantified by five assessments scheduled across the day covering objectively assessed performance across cognitive domains including sustained attention and arousal, decision and response time, motor and sequence control, working memory, and executive function as well as self-reports of alertness, mood and affect. Controlled for age and sex, self-reported sleep quality was negatively associated with number of awakenings and positively associated with the duration of Rapid Eye Movement (REM) sleep, but no significant associations with Slow Wave Sleep (SWS) measures were observed. Controlling only for age showed that associations between objective and subjective sleep quality were much stronger in women than in men. Analysis of 51 performance measures demonstrated that, after controlling for age and sex, fewer awakenings and more REM sleep were associated significantly with better performance on the Goal Neglect task, which is a test of executive function. Factor analysis of the individual performance measures identified four latent variables labeled Mood/Arousal, Response Time, Accuracy, and Visual Perceptual Sensitivity. Whereas Mood/Arousal improved with age, Response Times became slower, while Accuracy and Visual perceptual sensitivity showed little change with age. After controlling for sex and age, nominally significant association between sleep and factor scores were observed such that Response Times were faster with more SWS, and Accuracy was reduced where individuals woke more often or had less REM sleep. These data identify a positive contribution of SWS to processing speed and in particular highlight the importance of sleep continuity and REM sleep for subjective sleep quality and performance accuracy across the adult lifespan. These findings warrant further investigation of the contribution of sleep continuity and REM sleep to brain function.
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Affiliation(s)
- Ciro Della Monica
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sigurd Johnsen
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Giuseppe Atzori
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - John A Groeger
- Division of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Derk-Jan Dijk
- Surrey Clinical Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.,Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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