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Toccaceli Blasi M, Alfano AR, Salzillo M, Buscarnera S, Raparelli V, Cesari M, Bruno G, Canevelli M. Sex-specific clinical and neurobiological correlates of fatigue in older adults. GeroScience 2024:10.1007/s11357-024-01259-0. [PMID: 39129050 DOI: 10.1007/s11357-024-01259-0] [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: 03/21/2024] [Accepted: 06/14/2024] [Indexed: 08/13/2024] Open
Abstract
Fatigue is a common and distressful symptom in older people and has been associated with adverse health outcomes. Nevertheless, its sex-specific pathophysiological underpinnings and clinical correlates have been scarcely investigated. We aimed to comprehensively explore the clinical and neurobiological determinants of fatigue in cognitively unimpaired older adults. A sex-stratified analysis was conducted to look for differences in the clinical expression of fatigue among women and men. Data on cognitively normal individuals were gathered from the Alzheimer's Disease Neuroimaging Initiative (ADNI) 2 study. Fatigue was defined based on self-report at baseline. For each participant, information on sociodemographics, comorbidities, mood, cognitive performance, frailty, and biomarkers of brain pathology was collected. Logistic regression models, stratified by sex, were conducted to explore the factors associated with fatigue. Among the 291 participants selected, 44 subjects (15.1% of the total sample) self-reported fatigue at baseline. Subjects reporting fatigue were more likely women, had higher frailty degrees, and more severe depressive symptoms than those without fatigue. Moreover, they tended to have lower MRI hippocampus volumes. Among women, those reporting fatigue exhibited higher frailty levels, worse depression, and lower MRI hippocampus volumes relative to those without fatigue. Higher frailty degrees were also observed in men reporting vs. non-reporting fatigue. In the adjusted logistic regression model, more severe depression (OR 1.64, 95% CI 1.18-2.28; p < 0.01) and lower MRI hippocampus volumes (OR 0.41, 95% CI 0.19-0.90; p = 0.03) resulted independently associated with fatigue in women, while higher frailty degrees (OR 3.10, 95% CI 1.27-7.54 per 0.1 increase in a 39-item Frailty index; p = 0.01) in men. Fatigue is a complex symptom with a sex-specific pattern of clinical and neurobiological correlates. A better understanding of the underlying mechanisms of these associations is warranted to develop sex-informed approaches for personalized treatments.
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Affiliation(s)
| | - Alba Rosa Alfano
- Department of Internal Medicine and Medical Specialties, UOC Geriatrics, "Sapienza" University, Rome, Italy
| | - Martina Salzillo
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy
| | - Simona Buscarnera
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy
| | - Valeria Raparelli
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Matteo Cesari
- Ageing and Health Unit, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Giuseppe Bruno
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy
- Santa Lucia Foundation IRCCS, Rome, Italy
| | - Marco Canevelli
- Department of Human Neuroscience, "Sapienza" University, Rome, Italy
- National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Andrews MJ, Salat DH, Milberg WP, McGlinchey RE, Fortier CB. Poor sleep and decreased cortical thickness in veterans with mild traumatic brain injury and post-traumatic stress disorder. Mil Med Res 2024; 11:51. [PMID: 39098930 PMCID: PMC11299360 DOI: 10.1186/s40779-024-00557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 07/15/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Poor sleep quality has been associated with changes in brain volume among veterans, particularly those who have experienced mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). This study sought to investigate (1) whether poor sleep quality is associated with decreased cortical thickness in Iraq and Afghanistan war veterans, and (2) whether these associations differ topographically depending on the presence or absence of mTBI and PTSD. METHODS A sample of 440 post-9/11 era U.S. veterans enrolled in the Translational Research Center for Traumatic Brain Injury and Stress Disorders study at VA Boston, MA from 2010 to 2022 was included in the study. We examined the relationship between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and cortical thickness in veterans with mTBI (n = 57), PTSD (n = 110), comorbid mTBI and PTSD (n = 129), and neither PTSD nor mTBI (n = 144). To determine the topographical relationship between subjective sleep quality and cortical thickness in each diagnostic group, we employed a General Linear Model (GLM) at each vertex on the cortical mantle. The extent of topographical overlap between the resulting statistical maps was assessed using Dice coefficients. RESULTS There were no significant associations between PSQI and cortical thickness in the group without PTSD or mTBI (n = 144) or in the PTSD-only group (n = 110). In the mTBI-only group (n = 57), lower sleep quality was significantly associated with reduced thickness bilaterally in frontal, cingulate, and precuneus regions, as well as in the right parietal and temporal regions (β = -0.0137, P < 0.0005). In the comorbid mTBI and PTSD group (n = 129), significant associations were observed bilaterally in frontal, precentral, and precuneus regions, in the left cingulate and the right parietal regions (β = -0.0094, P < 0.0005). Interaction analysis revealed that there was a stronger relationship between poor sleep quality and decreased cortical thickness in individuals with mTBI (n = 186) compared to those without mTBI (n = 254) specifically in the frontal and cingulate regions (β = -0.0077, P < 0.0005). CONCLUSIONS This study demonstrates a significant relationship between poor sleep quality and lower cortical thickness primarily within frontal regions among individuals with both isolated mTBI or comorbid diagnoses of mTBI and PTSD. Thus, if directionality is established in longitudinal and interventional studies, it may be crucial to consider addressing sleep in the treatment of veterans who have sustained mTBI.
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Affiliation(s)
- Murray J Andrews
- Boston University Chobanian and Avedisian School of Medicine, Boston, MA, 02118, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - David H Salat
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02130, USA
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, 02130, USA
- Anthinoula A. Martinos Center for Biomedical Imaging, Boston, MA, 02129, USA
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, 02130, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02138, USA.
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, 02130, USA.
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Brewster G, Yang I, Pelkmans J, Higgins M, Waldrop D, Dunbar SB, Yeager KA. Factors related to cognitive performance among black caregivers of persons living with a chronic illness: An exploratory study. Geriatr Nurs 2024; 59:159-169. [PMID: 39013234 DOI: 10.1016/j.gerinurse.2024.06.035] [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: 01/16/2024] [Revised: 06/05/2024] [Accepted: 06/27/2024] [Indexed: 07/18/2024]
Abstract
This study investigated factors associated with cognitive performance among Black caregivers of persons living with two chronic conditions: dementia or cancer. Fifty-six Black caregivers of people living with dementia or cancer were recruited from clinic and community sources. Variables measured included: depression, anxiety, stress, sleep, fatigue, and caregiver burden. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Descriptive statistics and non-parametric analyses were conducted to identify factors related to MoCA scores. Caregivers were 58.3 years of age and predominantly female. The average MoCA score was 25.23. Gender and education, along with positive appraisal of caregiving were significantly associated with cognitive performance. Several other factors approached significance including cohabitation with the care recipient, fatigue, and stress due to perceived individual and institutional racism. Our findings suggest several factors that warrant further investigation for understanding the relationship between caregiving and cognitive performance in Black caregivers of people living with cancer or dementia.
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Affiliation(s)
- Glenna Brewster
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Irene Yang
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Jordan Pelkmans
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Melinda Higgins
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Drenna Waldrop
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Sandra B Dunbar
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Katherine A Yeager
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
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Hemond CC, Deshpande M, Berrios-Morales I, Zheng S, Meyer JS, Slavich GM, Cole SW. A single-arm, open-label pilot study of neuroimaging, behavioral, and peripheral inflammatory correlates of mindfulness-based stress reduction in multiple sclerosis. Sci Rep 2024; 14:14044. [PMID: 38890336 PMCID: PMC11189512 DOI: 10.1038/s41598-024-62960-w] [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: 02/14/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic neurological disease frequently associated with significant fatigue, anxiety, depression, and stress. These symptoms are difficult to treat, and prominently contribute to the decreases in quality of life observed with MS. The underlying mechanisms of these "silent" symptoms are not well understood and include not just the psychological responses to a chronic disease, but also biological contributions from bidirectional psycho-neuro-immune (dys)regulation of systemic inflammatory biology. To address these issues, we conducted a prospective, observational pilot study to investigate the psychological, biological, and neuroarchitecture changes associated with a mindfulness-based stress reduction (MBSR) program in MS. The overarching hypothesis was that MBSR modulates systemic and central nervous system inflammation via top-down neurocognitive control over forebrain limbic areas responsible for the neurobiological stress response. 23 patients were enrolled in MBSR and assessed pre/post-program with structural 3 T MRI, behavioral measures, hair cortisol, and blood measures of peripheral inflammation, as indexed by the Conserved Transcriptional Response to Adversity (CTRA) profile. MBSR was associated with improvements across a variety of behavioral outcomes, as well as on-study enlargement of the head of the right hippocampus. The CTRA analyses revealed that greater inflammatory gene expression was related to worse patient-reported anxiety, depression, stress, and loneliness, in addition to lower eudaimonic well-being. Hair cortisol did not significantly change from pre- to post-MBSR. These results support the use of MBSR in MS and elucidate inflammatory mechanisms related to key patient-reported outcomes in this population.
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Affiliation(s)
- Christopher C Hemond
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Mugdha Deshpande
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Idanis Berrios-Morales
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Shaokuan Zheng
- Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA
| | - Jerrold S Meyer
- Department of Psychological & Brain Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Steven W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
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Cavaillès C, Letellier N, Berr C, Samieri C, Empana JP, Tzourio C, Dartigues JF, Benmarhnia T, Dauvilliers Y, Jaussent I. The role of cardiovascular health and vascular events in the relationship between excessive daytime sleepiness and dementia risk. J Sleep Res 2024; 33:e14053. [PMID: 37822116 DOI: 10.1111/jsr.14053] [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: 07/12/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023]
Abstract
Many studies suggest a relationship between excessive daytime sleepiness (EDS) and dementia incidence, but the underlying mechanisms remain uncertain. The study aimed to investigate the role of cardiovascular burden in the relationship between EDS and dementia incidence over a 12-year follow-up in community-dwelling older adults. We performed analyses on 6171 subjects (aged ≥65 years) free of dementia and vascular disease at baseline. Participants self-reported EDS at baseline and an expert committee validated both prevalent and incident dementia. We defined cardiovascular burden by a low Cardiovascular Health score, constructed using the American Heart Association metrics, and incident vascular events. To explore the potential role of the cardiovascular burden in the relationship between EDS and dementia, we conducted mediation analyses with inverse odds ratio-weighted estimation, using multivariable-adjusted proportional hazard Cox and logistic regression models. Subjects with EDS had a higher risk of all-cause dementia (hazard ratio [HR] 1.39, 95% confidence interval [CI] 1.13-1.69) and dementia with vascular component (DVC) (HR 2.14, 95% CI 1.30-3.51), but not Alzheimer's disease (HR 1.18, 95% CI 0.93-1.51). Cardiovascular burden explained 5% (95% CI 4.1-5.2) and 11% (95% CI 9.7-11.3) of the relationship between EDS and all-cause dementia and DVC, respectively. These findings confirm that EDS may be implicated in the development of dementia and indicate a weaker than expected role of cardiovascular burden in the relationship between EDS and DVC.
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Affiliation(s)
- Clémence Cavaillès
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Noémie Letellier
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, La Jolla, California, USA
| | - Claudine Berr
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Cecilia Samieri
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Philippe Empana
- Paris Descartes University, Faculty of Medicine, Paris, France; INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France
| | - Christophe Tzourio
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-François Dartigues
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science & Scripps Institution of Oceanography, UC San Diego, La Jolla, California, USA
| | - Yves Dauvilliers
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
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Qi WY, Sun Y, Guo Y, Tan L. Associations of sleep disorders with serum neurofilament light chain levels in Parkinson's disease. BMC Neurol 2024; 24:147. [PMID: 38693483 PMCID: PMC11061948 DOI: 10.1186/s12883-024-03642-y] [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: 01/26/2024] [Accepted: 04/16/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Sleep disorders are a prevalent non-motor symptom of Parkinson's disease (PD), although reliable biological markers are presently lacking. OBJECTIVES To explore the associations between sleep disorders and serum neurofilament light chain (NfL) levels in individuals with prodromal and early PD. METHODS The study contained 1113 participants, including 585 early PD individuals, 353 prodromal PD individuals, and 175 healthy controls (HCs). The correlations between sleep disorders (including rapid eye movement sleep behavior disorder (RBD) and excessive daytime sleepiness (EDS)) and serum NfL levels were researched using multiple linear regression models and linear mixed-effects models. We further investigated the correlations between the rates of changes in daytime sleepiness and serum NfL levels using multiple linear regression models. RESULTS In baseline analysis, early and prodromal PD individuals who manifested specific behaviors of RBD showed significantly higher levels of serum NfL. Specifically, early PD individuals who experienced nocturnal dream behaviors (β = 0.033; P = 0.042) and movements of arms or legs during sleep (β = 0.027; P = 0.049) showed significantly higher serum NfL levels. For prodromal PD individuals, serum NfL levels were significantly higher in individuals suffering from disturbed sleep (β = 0.038; P = 0.026). Our longitudinal findings support these baseline associations. Serum NfL levels showed an upward trend in early PD individuals who had a higher total RBDSQ score (β = 0.002; P = 0.011) or who were considered as probable RBD (β = 0.012; P = 0.009) or who exhibited behaviors on several sub-items of the RBDSQ. In addition, early PD individuals who had a high total ESS score (β = 0.001; P = 0.012) or who were regarded to have EDS (β = 0.013; P = 0.007) or who exhibited daytime sleepiness in several conditions had a trend toward higher serum NfL levels. CONCLUSION Sleep disorders correlate with higher serum NfL, suggesting a link to PD neuronal damage. Early identification of sleep disorders and NfL monitoring are pivotal in detecting at-risk PD patients promptly, allowing for timely intervention. Regular monitoring of NfL levels holds promise for tracking both sleep disorders and disease progression, potentially emerging as a biomarker for evaluating treatment outcomes.
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Affiliation(s)
- Wan-Yi Qi
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, No.5 Donghai Middle Road, Qingdao, China
| | - Yan Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yun Guo
- School of Clinical Medicine, Weifang Medical University, Weifang, 261053, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, No.5 Donghai Middle Road, Qingdao, China.
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
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Okuda M, Noda A, Iwamoto K, Hishikawa N, Miyata S, Yasuma F, Taoka T, Ozaki N, Suhr JA, Miyazaki S. Assessment of cognitive function and sleep-wake rhythms in community-dwelling older adults. Sleep Biol Rhythms 2024; 22:137-145. [PMID: 38476850 PMCID: PMC10899937 DOI: 10.1007/s41105-023-00491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/06/2023] [Indexed: 03/14/2024]
Abstract
Disruption of the circadian rhythm and sleep-wake cycles is a consequence of aging and is associated with the cognitive decline and many neurodegenerative conditions. We investigated the bedtime, wake-up time, sleep timing (midpoint between bedtime and wake-up time), and sleep timing standard deviation (SD) using the actigraphy among 80 consecutive volunteers aged ≥ 60 years. Global cognitive function and executive function of detailed cognitive domains were evaluated using the mini-mental state examination (MMSE) and Wisconsin card sorting test (WCST) and subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The category achievement (CA), total errors (TE), perseverative errors of Nelson (PEN), non-perseverative errors (NPE), and difficulties in maintaining set (DMS) on the WCST were significantly correlated with sleep timing SD (CA: r = - 0.276, p = 0.013, TE: r = 0.311, p = 0.005, PEN: r = 0.241, p = 0.032, NPE: r = 0.250, p = 0.025, DMS: r = 0.235, p = 0.036), but not with the MMSE score. Multiple regression analyses with the stepwise forward selection method including age, ESS score, bedtime, sleep timing, and sleep timing SD, revealed that the ESS score, and sleep timing SD were significant factors related to CA on the WCST (ESS score: β = - 0.322, p = 0.004; sleep timing SD: β = - 0.250, p = 0.022). Assessment of sleep-wake rhythms, daytime sleepiness, and cognitive function using the MMSE and WCST is valuable for the prediction of cognitive decline in the geriatric population.
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Affiliation(s)
- Masato Okuda
- Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, 1200, Matsumoto-cho, Kasugai, Aichi 487-8501 Japan
| | - Akiko Noda
- Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, 1200, Matsumoto-cho, Kasugai, Aichi 487-8501 Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Seiko Miyata
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumihiko Yasuma
- Department of Biomedical Sciences, Chubu University Collage of Life and Health Sciences, Kasugai, Japan
| | - Toshiaki Taoka
- Department of Innovative Biomedical Visualization, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Julie A. Suhr
- Department of Psychology, Ohio University, Athens, OH USA
| | - Soichiro Miyazaki
- Research Institute of Life and Health Sciences, Chubu University, Kasugai, Japan
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Wang Q, Xu S, Liu F, Liu Y, Chen K, Huang L, Xu F, Liu Y. Causal relationship between sleep traits and cognitive impairment: A Mendelian randomization study. J Evid Based Med 2023; 16:485-494. [PMID: 38108111 DOI: 10.1111/jebm.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Observational studies had demonstrated a link between sleep disturbances and cognitive decline. Here, we aimed to investigate the causal association between genetically predicted sleep traits and cognitive impairment using Mendelian randomization (MR). METHODS Using strict criteria, we selected genetic variants from European ancestry Genome-wide association studies (GWAS) from the Sleep Disorders Knowledge Portal and UK Biobank as instrumental variables for several sleep traits, including insomnia, sleep duration, daytime sleepiness, daytime napping, and chronotype. Summary statistics related to cognitive impairment were derived from five different GWAS, including the Social Science Genetic Association Consortium. The role of self-reported sleep trait phenotypes in the etiology of cognitive impairment was explored using inverse-variance weighted (IVW) tests, MR-Egger tests, and weighted medians, and sensitivity analyses were conducted to ensure robustness. RESULTS In the main IVW analysis, sleep duration (reaction time: β = -0.05, 95% CI -0.07 to -0.04, p = 1.93×10-12 ), daytime sleepiness (average cortical thickness: β = -0.12, 95% CI -0.22 to -0.02, p = 0.023), and daytime napping (fluid intelligence: β = -0.47, 95% CI -0.87 to -0.07, p = 0.021; hippocampal volume in Alzheimer's disease: β = -0.99, 95% CI -1.64 to -0.35, p = 0.002) were significantly negatively correlated with cognitive performance. However, any effects of insomnia and chronotype on cognitive impairment were not determined. CONCLUSIONS Our findings highlighted that focusing on sleep behaviors or distinct sleep patterns-particularly sleep duration, daytime sleepiness, and daytime napping, was a promising approach for preventing cognitive impairment. This study also shed light on risk factors for and potential early markers of cognitive impairment risk factors.
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Affiliation(s)
- Qing Wang
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shihan Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fenglan Liu
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yanfei Liu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Keji Chen
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Luqi Huang
- China Evidence-based Medicine Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengqin Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Liu
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Wallensten J, Ljunggren G, Nager A, Wachtler C, Bogdanovic N, Petrovic P, Carlsson AC. Stress, depression, and risk of dementia - a cohort study in the total population between 18 and 65 years old in Region Stockholm. Alzheimers Res Ther 2023; 15:161. [PMID: 37779209 PMCID: PMC10544453 DOI: 10.1186/s13195-023-01308-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/17/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Chronic stress and depression are potential risk factors for mild cognitive impairment and dementia, including Alzheimer disease. The aim was to investigate whether any such risk is additive. METHODS Cohort study including 1 362 548 people (665 997 women, 696 551 men) with records in the Region Stockholm administrative healthcare database (VAL). Exposure was a recorded ICD-10 diagnosis of chronic stress, depression, or both, recorded in 2012 or 2013. Outcome was a diagnosis of Alzheimer disease, other dementia, or mild cognitive impairment recorded from 2014 through 2022. Odds ratios with 99% confidence intervals (CI) adjusted for age, sex, neighborhood socioeconomic status, diabetes, and cardiovascular disorders were calculated. RESULTS During the exposure period, 4 346 patients were diagnosed with chronic stress, 40 101 with depression, and 1 898 with both. The average age at baseline was around 40 years in all groups. In the fully adjusted model, the odds ratio of Alzheimer disease was 2.45 (99% CI 1.22-4.91) in patients with chronic stress, 2.32 (99% CI 1.85-2.90) in patients with depression, and 4.00 (99% CI 1.67-9.58) in patients with chronic stress and depression. The odds ratio of mild cognitive impairment was 1.87 (99% CI 1.20-2.91) in patients with chronic stress, 2.85 (99% CI 2.53-3.22) in patients with depression, and 3.87 (99% CI 2.39-6.27) in patients with both. When other dementia was analyzed, the odds ratio was significant only in patients with depression, 2.39 (99% CI 1.92-2.96). CONCLUSIONS Documented chronic stress increased the risk of mild cognitive impairment and Alzheimer disease. The same was seen with depression. The novel finding is the potential additive effect of chronic stress to depression, on risk of MCI and AD.
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Affiliation(s)
- Johanna Wallensten
- Department of Clinical Sciences, Danderyd Hospital, 18288, Stockholm, Sweden.
- Academic Primary Health Care Centre, Solnavägen 1E, 104 31, Stockholm, Sweden.
| | - Gunnar Ljunggren
- Academic Primary Health Care Centre, Solnavägen 1E, 104 31, Stockholm, Sweden
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Anna Nager
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Caroline Wachtler
- Academic Primary Health Care Centre, Solnavägen 1E, 104 31, Stockholm, Sweden
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Nenad Bogdanovic
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Predrag Petrovic
- Center for Cognitive Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Cognitive and Computational Neurosceince (CCNP), Karolinska Institutet, Stockholm, Sweden
| | - Axel C Carlsson
- Academic Primary Health Care Centre, Solnavägen 1E, 104 31, Stockholm, Sweden
- Division of Family Medicine and Primary Health Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17177, Stockholm, Sweden
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10
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Wang Q, Hu S, Qi L, Wang X, Jin G, Wu D, Wang Y, Ren L. Causal associations between sleep traits and brain structure: a bidirectional Mendelian randomization study. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2023; 19:17. [PMID: 37784181 PMCID: PMC10544625 DOI: 10.1186/s12993-023-00220-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/28/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Emerging evidence suggests bidirectional causal relationships between sleep disturbance and psychiatric disorders, but the underlying mechanisms remain unclear. Understanding the bidirectional causality between sleep traits and brain imaging-derived phenotypes (IDPs) will help elucidate the mechanisms. Although previous studies have identified a range of structural differences in the brains of individuals with sleep disorders, it is still uncertain whether grey matter (GM) volume alterations precede or rather follow from the development of sleep disorders. RESULTS After Bonferroni correction, the forward MR analysis showed that insomnia complaint remained positively associated with the surface area (SA) of medial orbitofrontal cortex (β, 0.26; 95% CI, 0.15-0.37; P = 5.27 × 10-6). In the inverse MR analysis, higher global cortical SA predisposed individuals less prone to suffering insomnia complaint (OR, 0.89; 95%CI, 0.85-0.94; P = 1.51 × 10-5) and short sleep (≤ 6 h; OR, 0.98; 95%CI, 0.97-0.99; P = 1.51 × 10-5), while higher SA in posterior cingulate cortex resulted in a vulnerability to shorter sleep durations (β, - 0.09; 95%CI, - 0.13 to - 0.05; P = 1.21 × 10-5). CONCLUSIONS Sleep habits not only result from but also contribute to alterations in brain structure, which may shed light on the possible mechanisms linking sleep behaviours with neuropsychiatric disorders, and offer new strategies for prevention and intervention in psychiatric disorders and sleep disturbance.
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Affiliation(s)
- Qiao Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Lei Qi
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Xiaopeng Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Guangyuan Jin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Di Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Yuke Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Liankun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, NO.45 Changchun Street, Xicheng District, Beijing, China.
- National Center for Neurological Disorders, Beijing, China.
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11
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Dubessy AL, Arnulf I. Sleepiness in neurological disorders. Rev Neurol (Paris) 2023; 179:755-766. [PMID: 37598089 DOI: 10.1016/j.neurol.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/21/2023]
Abstract
Sleepiness is a frequent and underrecognized symptom in neurological disorders, that impacts functional outcomes and quality of life. Multiple and potentially additive factors might contribute to sleepiness in neurological disorders, including sleep quality alterations, circadian rhythm disorders, drugs, and sleep disorders including sleep apnea or central disorders of hypersomnolence. Physician awareness of the possible symptoms of hypersomnolence, and associated causes is of crucial importance to allow proper identification and treatment of underlying causes. This review first provides a brief overview on clinical aspects of excessive daytime sleepiness, and diagnosis tools, then examines its frequency and mechanisms in various neurological disorders, including neurodegenerative disorders, multiple sclerosis, autoimmune encephalitis, epilepsy, and stroke.
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Affiliation(s)
- A-L Dubessy
- Saint Antoine Hospital, Assistance publique des Hôpitaux de Paris (AP-HP), Paris, France.
| | - I Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière Hospital and Sorbonne University, Paris, France; National Reference Network for Orphan Diseases: Narcolepsy and Rare Hypersomnias, Paris, France
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12
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Lim EY, Ho SH, Hong YJ, Jeong JH, Park HK, Park KH, Kim SY, Wang MJ, Choi SH, Shim YS, Cho AH, Yang DW. Clinical Significance of Physical Frailty in Subjects With Subjective Cognitive Decline: A Prospective Study With Amyloid PET Data. J Clin Neurol 2023; 19:447-453. [PMID: 37455506 PMCID: PMC10471550 DOI: 10.3988/jcn.2022.0353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND PURPOSE Physical frailty is known to be closely associated with cognitive impairment and to be an early sign of Alzheimer's disease. We aimed to understand the characteristics of physical frailty and define factors associated with physical frailty in subjects with subjective cognitive decline (SCD) by analyzing amyloid data. METHODS We prospectively enrolled subjects with SCD from a cohort study to identify predictors for the clinical progression to mild cognitive impairment or dementia from SCD (CoSCo). All of the subjects underwent brain magnetic resonance imaging, and brain amyloid positron-emission tomography (PET) to detect amyloid beta plaques. Self-reported exhaustion, handgrip strength, and gait speed were used to measure physical frailty. RESULTS Of 120 subjects with SCD, 26 (21.7%) were amyloid-positive in PET. Female (odds ratio [OR]=3.79, p=0.002) and amyloid-PET-positive (OR=3.80, p=0.008) subjects with SCD were at high risks of self-reported exhaustion. Amyloid PET positivity (OR=3.22, p=0.047) and high burden from periventricular white-matter hyperintensity (OR=3.34, 95% confidence interval=1.18-9.46, p=0.023) were significantly associated with a weaker handgrip. The subjects with SCD with self-reported exhaustion and weaker handgrip presented with lower cognitive performance in neuropsychological tests, especially for information processing speed and executive function. Subjects with a slower gait performed worse in visual memory function tests. CONCLUSIONS Amyloid PET positivity was associated with a higher risk of self-reported exhaustion and weaker handgrip in subjects with SCD. The subjects with SCD and physical frailty also performed worse in neuropsychological tests.
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Affiliation(s)
- Eun Ye Lim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Hee Ho
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Jeong Hong
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee Kyung Park
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Jeong Wang
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Yong Soo Shim
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - A Hyun Cho
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Won Yang
- Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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13
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Fjell AM, Sørensen Ø, Wang Y, Amlien IK, Baaré WFC, Bartrés-Faz D, Boraxbekk CJ, Brandmaier AM, Demuth I, Drevon CA, Ebmeier KP, Ghisletta P, Kievit R, Kühn S, Madsen KS, Nyberg L, Solé-Padullés C, Vidal-Piñeiro D, Wagner G, Watne LO, Walhovd KB. Is Short Sleep Bad for the Brain? Brain Structure and Cognitive Function in Short Sleepers. J Neurosci 2023; 43:5241-5250. [PMID: 37365003 PMCID: PMC10342221 DOI: 10.1523/jneurosci.2330-22.2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023] Open
Abstract
Many sleep less than recommended without experiencing daytime sleepiness. According to prevailing views, short sleep increases risk of lower brain health and cognitive function. Chronic mild sleep deprivation could cause undetected sleep debt, negatively affecting cognitive function and brain health. However, it is possible that some have less sleep need and are more resistant to negative effects of sleep loss. We investigated this using a cross-sectional and longitudinal sample of 47,029 participants of both sexes (20-89 years) from the Lifebrain consortium, Human Connectome project (HCP) and UK Biobank (UKB), with measures of self-reported sleep, including 51,295 MRIs of the brain and cognitive tests. A total of 740 participants who reported to sleep <6 h did not experience daytime sleepiness or sleep problems/disturbances interfering with falling or staying asleep. These short sleepers showed significantly larger regional brain volumes than both short sleepers with daytime sleepiness and sleep problems (n = 1742) and participants sleeping the recommended 7-8 h (n = 3886). However, both groups of short sleepers showed slightly lower general cognitive function (GCA), 0.16 and 0.19 SDs, respectively. Analyses using accelerometer-estimated sleep duration confirmed the findings, and the associations remained after controlling for body mass index, depression symptoms, income, and education. The results suggest that some people can cope with less sleep without obvious negative associations with brain morphometry and that sleepiness and sleep problems may be more related to brain structural differences than duration. However, the slightly lower performance on tests of general cognitive abilities warrants closer examination in natural settings.SIGNIFICANCE STATEMENT Short habitual sleep is prevalent, with unknown consequences for brain health and cognitive performance. Here, we show that daytime sleepiness and sleep problems are more strongly related to regional brain volumes than sleep duration. However, participants sleeping ≤6 h had slightly lower scores on tests of general cognitive function (GCA). This indicates that sleep need is individual and that sleep duration per se is very weakly if at all related brain health, while daytime sleepiness and sleep problems may show somewhat stronger associations. The association between habitual short sleep and lower scores on tests of general cognitive abilities must be further scrutinized in natural settings.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Computational Radiology and Artificial Intelligence, Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Inge K Amlien
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
- Umeå Center for Functional Brain Imaging, Umeå University, 907 36 Umeå, Sweden
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, 907 36 Umeå, Sweden
- Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, 2400 Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, 2020 Copenhagen, Denmark
| | - Andreas M Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Ilja Demuth
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Endocrinology and Metabolic Diseases (including Division of Lipid Metabolism), Biology of Aging working group, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, 10178 Berlin, Germany
- BCRT - Berlin Institute of Health Center for Regenerative Therapies, 13353 Berlin, Germany
| | - Christian A Drevon
- Vitas AS, The Science Park, 0349 Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of 0372 Oslo, Norway
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, 1205 Geneva, Switzerland
- UniDistance Suisse, 3900 Brig, Switzerland
- Swiss National Centre of Competence in Research LIVES, University of Geneva, 1205 Geneva, Switzerland
| | - Rogier Kievit
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Copenhagen, Denmark
- Radiography, Department of Technology, University College Copenhagen, 1799 Copenhagen, Denmark
| | - Lars Nyberg
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Umeå Center for Functional Brain Imaging, Umeå University, 907 36 Umeå, Sweden
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Didac Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Leiv Otto Watne
- Oslo Delirium Research Group, Oslo University Hospital, 0424 Oslo, Norway
- Department of Geriatric Medicine, Akershus University Hospital, 1478 Lørenskog, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, 1478, Lørenskog, Norway
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0373 Oslo, Norway
- Computational Radiology and Artificial Intelligence, Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0424 Oslo, Norway
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14
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AO YAWEN, LI YUSHUANG, ZHAO YILIN, ZHANG LIANG, YANG RENJIE, ZHA YUNFEI. Hippocampal Subfield Volumes in Amateur Marathon Runners. Med Sci Sports Exerc 2023; 55:1208-1217. [PMID: 36878015 PMCID: PMC10241426 DOI: 10.1249/mss.0000000000003144] [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: 03/08/2023]
Abstract
PURPOSE Numerous studies have implicated the involvement of structure and function of the hippocampus in physical exercise, and the larger hippocampal volume is one of the relevant benefits reported in exercise. It remains to be determined how the different subfields of hippocampus respond to physical exercise. METHODS A 3D T1-weighted magnetic resonance imaging was acquired in 73 amateur marathon runners (AMR) and 52 healthy controls (HC) matched with age, sex, and education. The Montreal Cognitive Assessment, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Scale were assessed in all participants. We obtained hippocampal subfield volumes using FreeSurfer 6.0. We compared the volumes of the hippocampal subfield between the two groups and ascertained correlation between the significant subfield metrics and the significant behavioral measure in AMR group. RESULTS The AMR had significantly better sleep than HC, manifested as with lower score of PSQI. Sleep duration in AMR and HC was not significantly different from each other. In the AMR group, the left and right hippocampus, cornu ammonis 1 (CA1), CA4, granule cell and molecular layers of the dentate gyrus, molecular layer, left CA2-3, and left hippocampal-amygdaloid transition area volumes were significantly larger compared with those in the HC group. In AMR group, the correlations between the PSQI and the hippocampal subfield volumes were not significant. No correlations were found between hippocampal subfield volumes and sleep duration in AMR group. CONCLUSIONS We reported larger volumes of specific hippocampal subfields in AMR, which may provide a hippocampal volumetric reserve that protects against age-related hippocampal deterioration. These findings should be further investigated in longitudinal studies.
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15
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Peterson JA, Staud R, Thomas PA, Goodin BR, Fillingim RB, Cruz-Almeida Y. Self-reported pain and fatigue are associated with physical and cognitive function in middle to older-aged adults. Geriatr Nurs 2023; 50:7-14. [PMID: 36640518 PMCID: PMC10316316 DOI: 10.1016/j.gerinurse.2022.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023]
Abstract
Persistent fatigue is often reported in those with chronic musculoskeletal pain. Separately, both chronic pain and chronic fatigue contribute to physical and cognitive decline in older adults. Concurrent pain and fatigue symptoms may increase disability and diminish quality of life, though little data exist to show this. The purpose of this study was to examine associations between self-reported pain and fatigue, both independently and combined, with cognitive and physical function in middle-older-aged adults with chronic knee pain. Using a cross-sectional study design participants (n = 206, age 58.0 ± 8.3) completed questionnaires on pain and fatigue, a physical performance battery to assess physical function, and the Montreal Cognitive Assessment. Hierarchical regressions and moderation analyses were used to assess the relationship between the variables of interest. Pain and fatigue both predicted physical function (β = -0.305, p < 0.001; β = -0.219, p = 0.003, respectively), however only pain significantly predicted cognitive function (β = -0.295, p <0.001). A centered pain*fatigue interaction was a significant predictor of both cognitive function (β = -0.137, p = 0.049) and physical function (β = -0.146, p = 0.048). These findings indicate that self-reported fatigue may contribute primarily to decline in physical function among individuals with chronic pain, and less so to decline in cognitive function. Future studies should examine the impact of both cognitive and physical function decline together on overall disability and health.
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Affiliation(s)
- Jessica A Peterson
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Roland Staud
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Medicine, Rheumatology, University of Florida, Gainesville, FL, USA
| | - Pavithra A Thomas
- College of Arts and Science, Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; School of Medicine, Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- College of Arts and Science, Psychology, University of Alabama at Birmingham, Birmingham, AL, USA; School of Medicine, Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roger B Fillingim
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- College of Dentistry, Pain Research & Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA; College of Dentistry, Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA; Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
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16
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Circadian disruption and sleep disorders in neurodegeneration. Transl Neurodegener 2023; 12:8. [PMID: 36782262 PMCID: PMC9926748 DOI: 10.1186/s40035-023-00340-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
Disruptions of circadian rhythms and sleep cycles are common among neurodegenerative diseases and can occur at multiple levels. Accumulating evidence reveals a bidirectional relationship between disruptions of circadian rhythms and sleep cycles and neurodegenerative diseases. Circadian disruption and sleep disorders aggravate neurodegeneration and neurodegenerative diseases can in turn disrupt circadian rhythms and sleep. Importantly, circadian disruption and various sleep disorders can increase the risk of neurodegenerative diseases. Thus, harnessing the circadian biology findings from preclinical and translational research in neurodegenerative diseases is of importance for reducing risk of neurodegeneration and improving symptoms and quality of life of individuals with neurodegenerative disorders via approaches that normalize circadian in the context of precision medicine. In this review, we discuss the implications of circadian disruption and sleep disorders in neurodegenerative diseases by summarizing evidence from both human and animal studies, focusing on the bidirectional links of sleep and circadian rhythms with prevalent forms of neurodegeneration. These findings provide valuable insights into the pathogenesis of neurodegenerative diseases and suggest a promising role of circadian-based interventions.
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17
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Lin FV. A Multi-Dimensional Model of Fatigue in Old Age: Implications for Brain Aging. Am J Geriatr Psychiatry 2023; 31:152-161. [PMID: 36435711 PMCID: PMC10653728 DOI: 10.1016/j.jagp.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 11/08/2022]
Abstract
As the most reported symptom in old age, fatigue is understudied in terms of both mechanisms and measures. Population heterogeneity and methodological inconsistency makes understanding the relationship between fatigue and brain aging challenging. The present article comprehensively reviews existing conceptual and operational frameworks of fatigue, as well as mechanistic heterogeneities of fatigue that exist in the aging literature. Then, I propose a Multi-Dimensional Model of fatigue to provide theoretical cohesion to the study of fatigue in old age, along with a "fatigue circuit" addressing brain profiles across dimensions of fatigue. The potential relationships between fatigue dimensions, the fatigue circuit, and brain aging are discussed to inform the direction of future research.
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Affiliation(s)
- Feng V Lin
- Department of Psychiatry and Behavioral Sciences(FVL), Stanford University, Palo Alto, CA, 94304; Wu Tsai Neuroscience Institute, Stanford University(FVL), Palo Alto, CA, 94304.
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18
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Namsrai T, Ambikairajah A, Cherbuin N. Poorer sleep impairs brain health at midlife. Sci Rep 2023; 13:1874. [PMID: 36725955 PMCID: PMC9892039 DOI: 10.1038/s41598-023-27913-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
Sleep is an emerging risk factor for dementia but its association with brain health remains unclear. This study included UK Biobank (n = 29,545; mean age = 54.65) participants at imaging visit with sleep measures and brain scans, and a subset (n = 14,206) with cognitive measures. Multiple linear regression analyses were conducted to study the associations between sleep and brain health. Every additional hour of sleep above 7 h/day was associated with 0.10-0.25% lower brain volumes. In contrast, a negative non-linear association was observed between sleep duration, grey matter, and hippocampal volume. Both longer (> 9 h/day) and shorter sleep (< 6 h/day) durations were associated with lower brain volumes and cognitive measures (memory, reaction time, fluid intelligence). Additionally, daytime dozing was associated with lower brain volumes (grey matter and left hippocampus volume) and lower cognitive measures (reaction time and fluid intelligence). Poor sleep (< 6 h/day, > 9 h/day, daytime dozing) at midlife was associated with lower brain health. Sleep may be an important target to improve brain health into old age and delay the onset of dementia.
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Affiliation(s)
- Tergel Namsrai
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
| | - Ananthan Ambikairajah
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.,Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.
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19
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Li Y, Wang J, Ji L, Cheng C, Su T, Wu S, Han F, Cox DJ, Wang E, Chen R. Cortical thinning in male obstructive sleep apnoea patients with excessive daytime sleepiness. Front Neurol 2023; 14:1019457. [PMID: 37034093 PMCID: PMC10076663 DOI: 10.3389/fneur.2023.1019457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Background and purpose Obstructive sleep apnoea is associated with excessive daytime sleepiness due to sleep fragmentation and hypoxemia, both of which can lead to abnormal brain morphology. However, the pattern of brain structural changes associated with excessive daytime sleepiness is still unclear. This study aims to investigate the effects of excessive daytime sleepiness on cortical thickness in patients with obstructive sleep apnoea. Materials and methods 61 male patients with newly diagnosed obstructive sleep apnoea were included in the present study. Polysomnography and structural MRI were performed for each participant. Subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale score. Surface-based morphometric analysis was performed using Statistical Parametric Mapping 12 and Computational Anatomy 12 toolboxes to extract cortical thickness. Results Using the median Epworth Sleepiness Scale score, patients were divided into the non-sleepiness group and the sleepiness group. The cortical thickness was markedly thinner in the sleepiness group in the left temporal, frontal, and parietal lobe and bilateral pre- and postcentral gyri (pFWE < 0.05). There was a significant negative correlation between the cortical thickness and the Epworth Sleepiness Scale score. After adjusting for age, body mass index, and obstructive sleep apnoea severity, the Epworth Sleepiness Scale score remained an independent factor affecting the cortical thickness of the left middle temporal lobe, transverse temporal and temporal pole. Conclusion Subjective daytime sleepiness is associated with decreased cortical thickness, and the Epworth Sleepiness Scale score may be of utility as a clinical marker of brain injury in patients with obstructive sleep apnoea.
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Affiliation(s)
- Yezhou Li
- School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Jing Wang
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Lirong Ji
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chaohong Cheng
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Tong Su
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuqing Wu
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei Han
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Daniel J. Cox
- Division of Psychology, Communication, and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Erlei Wang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Erlei Wang,
| | - Rui Chen
- Department of Respiratory and Critical Care, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Centre, The Second Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Rui Chen,
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20
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Cavaillès C, Berr C, Helmer C, Gabelle A, Jaussent I, Dauvilliers Y. Complaints of daytime sleepiness, insomnia, hypnotic use, and risk of dementia: a prospective cohort study in the elderly. Alzheimers Res Ther 2022; 14:12. [PMID: 35057850 PMCID: PMC8780361 DOI: 10.1186/s13195-021-00952-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/20/2021] [Indexed: 01/13/2023]
Abstract
Abstract
Background
Sleep disturbances are common in elderly and occur frequently in dementia. The impact of excessive daytime sleepiness (EDS), insomnia complaints, sleep quality, and hypnotics on the risk of all-cause dementia, Alzheimer disease (AD), and dementia with vascular component (DVC) remains unclear, as does the association between sleep profile and plasma β-amyloid levels.
Methods
Analyses were carried out on 6851 participants aged 65 years and over randomly recruited from three French cities and free of dementia at baseline. A structured interview and self-questionnaire assessed sleep complaints (EDS, insomnia complaints, sleep quality) and medications at baseline. Incident cases of dementia were diagnosed systematically over a 12-year period. Multivariate Cox models were used to estimate the risk of dementia associated with the sleep complaints considered individually and globally. Plasma β-amyloid levels were measured by an xMAP-based assay technology in 984 subjects.
Results
After adjustment for socio-demographic characteristics, lifestyle, APOE-ε4, cardiovascular factors, and depressive status, EDS had a higher risk of all-cause dementia (HR = 1.21; 95%CI = [1.01–1.46]) and DVC (HR = 1.58; 95%CI = [1.07–2.32]) but not AD. Persistent use of hypnotics increased the risk for all-cause dementia, specifically AD (HR = 1.28; 95%CI = [1.04–1.58]), but not DVC. No association was found for insomnia complaints and sleep quality taken as individual factors or combined with EDS on the risk of dementia. No association was found between β-amyloid, sleep complaints, and incident dementia.
Conclusions
The results suggest a deleterious role of EDS and hypnotics on dementia. Further studies are required to elucidate the mechanisms involved in these associations and whether its management can prevent the risk of dementia.
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21
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Chylinski D, Narbutas J, Balteau E, Collette F, Bastin C, Berthomier C, Salmon E, Maquet P, Carrier J, Phillips C, Lina JM, Vandewalle G, Van Egroo M. Frontal grey matter microstructure is associated with sleep slow waves characteristics in late midlife. Sleep 2022; 45:zsac178. [PMID: 35869626 PMCID: PMC9644125 DOI: 10.1093/sleep/zsac178] [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: 03/24/2022] [Revised: 07/13/2022] [Indexed: 07/25/2023] Open
Abstract
STUDY OBJECTIVES The ability to generate slow waves (SW) during non-rapid eye movement (NREM) sleep decreases as early as the 5th decade of life, predominantly over frontal regions. This decrease may concern prominently SW characterized by a fast switch from hyperpolarized to depolarized, or down-to-up, state. Yet, the relationship between these fast and slow switcher SW and cerebral microstructure in ageing is not established. METHODS We recorded habitual sleep under EEG in 99 healthy late midlife individuals (mean age = 59.3 ± 5.3 years; 68 women) and extracted SW parameters (density, amplitude, frequency) for all SW as well as according to their switcher type (slow vs. fast). We further used neurite orientation dispersion and density imaging (NODDI) to assess microstructural integrity over a frontal grey matter region of interest (ROI). RESULTS In statistical models adjusted for age, sex, and sleep duration, we found that a lower SW density, particularly for fast switcher SW, was associated with a reduced orientation dispersion of neurites in the frontal ROI (p = 0.018, R2β* = 0.06). In addition, overall SW frequency was positively associated with neurite density (p = 0.03, R2β* = 0.05). By contrast, we found no significant relationships between SW amplitude and NODDI metrics. CONCLUSIONS Our findings suggest that the complexity of neurite organization contributes specifically to the rate of fast switcher SW occurrence in healthy middle-aged individuals, corroborating slow and fast switcher SW as distinct types of SW. They further suggest that the density of frontal neurites plays a key role for neural synchronization during sleep. TRIAL REGISTRATION NUMBER EudraCT 2016-001436-35.
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Affiliation(s)
- Daphne Chylinski
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | - Christine Bastin
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
| | | | - Eric Salmon
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium
- Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - Julie Carrier
- CARSM, CIUSSS of Nord-de l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, University of Montreal, Canada
| | - Christophe Phillips
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
- GIGA-In Silico Medicine, University of Liège, Liège, Belgium
| | - Jean-Marc Lina
- CARSM, CIUSSS of Nord-de l’Île-de-Montréal, Montreal, Canada
- Department of Psychology, University of Montreal, Canada
| | - Gilles Vandewalle
- Corresponding authors. Gilles Vandewalle, GIGA-Cyclotron Research Centre-In Vivo Imaging, Bâtiment B30, Université de Liège, Allée du Six Août, 8, 4000 Liège, Belgium.
| | - Maxime Van Egroo
- Maxime Van Egroo, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, Maastricht, The Netherlands.
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22
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Ren L, Liang J, Wan F, Wang Y, Dai XJ. Development of a Clinical Risk Score Prediction Tool for 5-, 9-, and 13-Year Risk of Dementia. JAMA Netw Open 2022; 5:e2242596. [PMID: 36394871 PMCID: PMC9672974 DOI: 10.1001/jamanetworkopen.2022.42596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Although researchers have devoted substantial efforts, money, and time to studying the causes of dementia and the means to prevent it, no effective treatment exists yet. Identifying preclinical risk factors of dementia could help prevent or delay its progression. OBJECTIVE To develop a point risk score prediction model of dementia. DESIGN, SETTING, AND PARTICIPANTS This study used a large UK population-based prospective cohort study conducted between March 13, 2006, and October 1, 2010. Data analysis was performed from June 7 to September 15, 2021. Individual analyses of time end points were concluded at the first dementia diagnosis during the follow-up period. The data were split into training and testing data sets to separately establish and validate a prediction model. MAIN OUTCOMES AND MEASURES Outcomes of interest included 5-, 9-, and 13-year dementia risk. Least absolute shrinkage and selection operator and multivariate Cox proportional hazards regression models were used to identify available and practical dementia predictors. A point risk score model was developed for the individual prediction of 5-, 9-, and 13-year dementia risk. RESULTS A total of 502 505 participants were selected; the population after exclusions for missing data and dementia diagnosis at baseline was 444 695 (205 187 men; mean [SD] age, 56.74 [8.18] years; 239 508 women; mean [SD] age, 56.20 [8.01] years). Dementia occurrence during the 13 years of follow-up was 0.7% for men and 0.5% for women. The C statistic of the final multivariate Cox proportional hazards regression model was 0.86 for men and 0.85 for women in the training data set, and 0.85 for men and 0.87 for women in the testing data set. Men and women shared some modifiable risk and protective factors, but they also presented independent risk factors that accounted for 31.7% of men developing dementia and 53.35% of women developing dementia according to the weighted population-attributable fraction. The total point score of the risk score model ranged from -18 to 30 in men and -17 to 30 in women. The risk score model yielded nearly 100% prediction accuracy of 13-year dementia risk both in men and women. CONCLUSIONS AND RELEVANCE In this diagnostic study, a practical risk score tool was developed for individual prediction of dementia risk, which may help individuals identify their potential risk profile and provide guidance on precise and timely actions to promote dementia delay or prevention.
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Affiliation(s)
- Lina Ren
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
| | - Junxian Liang
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau, China
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Taipa, Macau, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau, China
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Taipa, Macau, China
| | - Yongjun Wang
- Shenzhen Mental Health Centre, Shenzhen Kangning Hospital, Shenzhen, China
- College of Mental Health and Psychological Science, Anhui Medical University, Hefei, China
| | - Xi-jian Dai
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macau, China
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Taipa, Macau, China
- Department of Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
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23
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Baril AA, Beiser AS, DeCarli C, Himali D, Sanchez E, Cavuoto M, Redline S, Gottlieb DJ, Seshadri S, Pase MP, Himali JJ. Self-reported sleepiness associates with greater brain and cortical volume and lower prevalence of ischemic covert brain infarcts in a community sample. Sleep 2022; 45:zsac185. [PMID: 35917199 PMCID: PMC9548673 DOI: 10.1093/sleep/zsac185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES We evaluated if self-reported sleepiness was associated with neuroimaging markers of brain aging and ischemic damage in a large community-based sample. METHODS Participants from the Framingham Heart Study Offspring cohort (n = 468, 62.5 ± 8.7 years old, 49.6%M) free of dementia, stroke, and neurological diseases, completed sleep questionnaires and polysomnography followed by magnetic resonance imaging (MRI), 3 years later on average. We used linear and logistic regression models to evaluate the associations between Epworth Sleepiness Scale (ESS) scores and total brain, cortical and subcortical gray matter, and white matter hyperintensities volumes, and the presence of covert brain infarcts. RESULTS Higher sleepiness scores were associated with larger total brain volume, greater cortical gray matter volume, and a lower prevalence of covert brain infarcts, even when adjusting for a large array of potential confounders, including demographics, sleep profiles and disorders, organic health diseases, and proxies for daytime cognitive and physical activities. Interactions indicated that more sleepiness was associated with larger cortical gray matter volume in men only and in APOE ε4 noncarriers, whereas a trend for smaller cortical gray matter volume was observed in carriers. In longitudinal analyses, those with stable excessive daytime sleepiness over time had greater total brain and cortical gray matter volumes, whereas baseline sleepiness scores were not associated with subsequent atrophy or cognitive decline. CONCLUSION Our findings suggest that sleepiness is not necessarily a marker of poor brain health when not explained by diseases or sleep debt and sleep disorders. Rather, sleepiness could be a marker of preserved sleep-regulatory processes and brain health in some cases.
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Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Framingham, MA, USA
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Alexa S Beiser
- The Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, CA, USA
| | | | - Erlan Sanchez
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Marina Cavuoto
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - Matthew P Pase
- The Framingham Heart Study, Framingham, MA, USA
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, VIC, Australia
- Harvard T.H. Chan School of Public Health, MA, USA
| | - Jayandra J Himali
- The Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX, USA
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24
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Liu H, Badawy M, Sun S, Cruz G, Ge S, Xiong Q. Microglial repopulation alleviates age-related decline of stable wakefulness in mice. Front Aging Neurosci 2022; 14:988166. [PMID: 36262885 PMCID: PMC9574185 DOI: 10.3389/fnagi.2022.988166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/06/2022] [Indexed: 12/04/2022] Open
Abstract
Changes in wake/sleep architecture have been observed in both aged human and animal models, presumably due to various functional decay throughout the aging body particularly in the brain. Microglia have emerged as a modulator for wake/sleep architecture in the adult brain, and displayed distinct morphology and activity in the aging brain. However, the link between microglia and age-related wake/sleep changes remains elusive. In this study, we systematically examined the brain vigilance and microglia morphology in aging mice (3, 6, 12, and 18 months old), and determined how microglia affect the aging-related wake/sleep alterations in mice. We found that from young adult to aged mice there was a clear decline in stable wakefulness at nighttime, and a decrease of microglial processes length in various brain regions involved in wake/sleep regulation. The decreased stable wakefulness can be restored following the time course of microglia depletion and repopulation in the adult brain. Microglia repopulation in the aging brain restored age-related decline in stable wakefulness. Taken together, our findings suggest a link between aged microglia and deteriorated stable wakefulness in aged brains.
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25
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Polat F, Karasu F. Effect of sleep hygiene training given to elderly individuals on daytime sleepiness and fatigue: A randomized controlled trial. Perspect Psychiatr Care 2022; 58:2161-2169. [PMID: 35124807 DOI: 10.1111/ppc.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study was conducted to determine the effect of sleep hygiene training given to elderly individuals on daytime sleepiness and fatigue. DESIGN AND METHODS The sample size was calculated by G. Power and determined as 134 elderly individuals. The experimental group was trained in sleep, two sessions a week for a total of 2 weeks. FINDINGS The difference between Epworth Sleepiness Scale and Fatigue Severity Scale posttest mean scores of the elderly individuals in the experimental and control groups were found to be statistically significant (p < 0.05). PRACTICE IMPLICATIONS Sleep hygiene training reduced daytime sleepiness and fatigue in older adults.
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Affiliation(s)
- Filiz Polat
- Department of Midwifery, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Fatma Karasu
- Department of Nursing, Yusuf Şerefoğlu Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey
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26
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Angioni D, Cesari M, Raffin J, Virecoulon Giudici K, Mangin JF, Bouyahia A, Chupin M, Fischer C, Gourieux E, Rolland Y, De Breucker S, Vellas B, de Souto Barreto P. Neuroimaging correlates of persistent fatigue in older adults: A secondary analysis from the Multidomain Alzheimer Preventive Trial (MAPT) trial. Aging Ment Health 2022; 26:1654-1660. [PMID: 34082625 DOI: 10.1080/13607863.2021.1932737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Fatigue has been suggested as a marker of biological aging. It seems plausible that this symptom might be associated with changes in brain health. The objective of this study was to examine the associations between persistent fatigue and neuroimaging correlates in a non-disease-specific population of community-dwelling older adults. METHODS We performed a cross-sectional analysis using data from The Multidomain Alzheimer Preventive Trial (MAPT). We included 458 subjects. Persistent fatigue was defined as meeting exhaustion criterion of Fried frailty phenotype in two consecutive clinical visits six months apart between study baseline and one year. Brain imaging correlates, assessed by magnetic resonance imaging (MRI), were the outcomes. The associations between persistent fatigue and brain correlates were explored using mixed model linear regressions with random effect at the center level. RESULTS The mean age of the participants was 74.8 ± 4 years old, and 63% of the subjects were women. Forty-seven participants (10%) exhibited a persistent fatigue profile. People with persistent fatigue were older compared to subjects without persistent fatigue (76.2 years ± 4.3 vs.74.7 ± 3.9 p = 0.009). Persistent fatigue was associated with higher white matter hyperintensity volume in the fully adjusted analysis. We did not find any cross-sectional association between persistent fatigue and sub-cortical volumes and global and regional cortical thickness. CONCLUSION Persistent fatigue was cross-sectionnally associated with higher white matter hyperintensity volume in older adults. Further longitudinal studies, using an assessment tool specifically designed and validated for measuring fatigue, are needed to confirm our findings.
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Affiliation(s)
- Davide Angioni
- Gerontopole of Toulouse, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Matteo Cesari
- IRCCS Istituti Clinici Scientifici Maugeri, Università degli Studi di Milano, Milan, Italy
| | - Jeremy Raffin
- Gerontopole of Toulouse, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | | | - Jean François Mangin
- CATI Multicenter Neuroimaging Platform, Neurospin, CEA, CNRS, Université Paris-Saclay, Gif sur Yvette, France
| | - Ali Bouyahia
- CATI, ICM, CNRS, Sorbonne Université, Paris, France
| | - Marie Chupin
- CATI, ICM, CNRS, Sorbonne Université, Paris, France
| | - Clara Fischer
- CATI Multicenter Neuroimaging Platform, Neurospin, CEA, CNRS, Université Paris-Saclay, Gif sur Yvette, France
| | - Emmanuelle Gourieux
- CATI Multicenter Neuroimaging Platform, Neurospin, CEA, CNRS, Université Paris-Saclay, Gif sur Yvette, France
| | - Yves Rolland
- Gerontopole of Toulouse, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
| | - Sandra De Breucker
- Erasmus Hospital, Geriatric Unit, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Bruno Vellas
- Gerontopole of Toulouse, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Toulouse University Hospital (CHU Toulouse), Toulouse, France.,UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
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27
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Liu C, Lee SH, Loewenstein DA, Galvin JE, Camargo CJ, Alperin N. Poor sleep accelerates hippocampal and posterior cingulate volume loss in cognitively normal healthy older adults. J Sleep Res 2022; 31:e13538. [PMID: 34927298 PMCID: PMC10731580 DOI: 10.1111/jsr.13538] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 01/05/2023]
Abstract
Poor sleep quality is a known risk factor for Alzheimer's disease. This longitudinal imaging study aimed to determine the acceleration in the rates of tissue loss in cognitively critical brain regions due to poor sleep in healthy elderly individuals. Cognitively-normal healthy individuals, aged ≥60 years, reported Pittsburgh Sleep Quality Index (PSQI) and underwent baseline and 2-year follow-up magnetic resonance imaging brain scans. The links between self-reported sleep quality, rates of tissue loss in cognitively-critical brain regions, and white matter hyperintensity load were assessed. A total of 48 subjects were classified into normal (n = 23; PSQI score <5) and poor sleepers (n = 25; PSQI score ≥5). The two groups were not significantly different in terms of age, gender, years of education, ethnicity, handedness, body mass index, and cognitive performance. Compared to normal sleepers, poor sleepers exhibited much faster rates of volume loss, over threefold in the right hippocampus and fivefold in the right posterior cingulate over 2 years. In contrast, there were no significant differences in the rates of volume loss in the cerebral and cerebellar grey and white matter between the two groups. Rates of volume loss in the right posterior cingulate were negatively associated with global PSQI scores. Poor sleep significantly accelerates volume loss in the right hippocampus and the right posterior cingulate cortex. These findings demonstrate that self-reported sleep quality explains inter-individual differences in the rates of volume loss in cognitively-critical brain regions in healthy older adults and provide a strong impetus to offer sleep interventions to cognitively normal older adults who are poor sleepers.
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Affiliation(s)
- Che Liu
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Miami, FL, USA
| | - Sang H. Lee
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
| | - David A. Loewenstein
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James E. Galvin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christian J. Camargo
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Noam Alperin
- Department of Radiology, University of Miami Miller School of Medicine, University of Miami, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Miami, FL, USA
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28
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Carvalho DZ, St. Louis EK, Przybelski SA, Morgenthaler TI, Machulda MM, Boeve BF, Petersen RC, Jack CR, Graff-Radford J, Vemuri P, Mielke MM. Sleepiness in Cognitively Unimpaired Older Adults Is Associated With CSF Biomarkers of Inflammation and Axonal Integrity. Front Aging Neurosci 2022; 14:930315. [PMID: 35898322 PMCID: PMC9309557 DOI: 10.3389/fnagi.2022.930315] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Sleepiness has been associated with cognitive decline and dementia in the elderly. Older adults with excessive daytime sleepiness appear to be more vulnerable to longitudinal amyloid PET accumulation before the onset of the dementia. However, it remains unclear whether sleepiness is similarly associated with other biomarkers of Alzheimer's disease (AD), axonal integrity, and inflammation, which may also contribute to neurodegeneration and cognitive decline. Methods In this cross-sectional analysis, we identified 260 cognitively unimpaired adults (>60 years) from the Mayo Clinic Study of Aging, a population-based cohort from Olmsted County (MN), who underwent CSF quantification of AD biomarkers (Aβ42, p-tau, p-tau/Aβ42) in addition to at least one of the following biomarkers [neurofilament light chain (NfL) interleukin-6 (IL-6), IL-10, and tumor necrosis factor-α (TNF-α)]. We fit linear regression models to assess associations between sleepiness, as measured by the Epworth Sleepiness Scale (ESS), and CSF biomarkers, controlling for age, sex, APOε4 status, body mass index, hypertension, dyslipidemia, and prior diagnosis of obstructive sleep apnea. Results Higher ESS scores were associated with higher CSF IL-6 and NfL, but not with the other CSF biomarkers. For every ESS score point increase, there was a 0.009 ([95% CI 0.001-0.016], p = 0.033) increase in the log of IL-6 and 0.01 ([95% CI 0.002-0.018], p = 0.016) increase in the log of NfL. A sensitivity analysis showed an association between ESS scores and log of p-tau/Aβ42 only in participants with an abnormal ratio (>0.023), highly predictive of amyloid positivity. For every ESS score point increase, there was a 0.006 ([95% CI 0.001-0.012], p = 0.021) increase in the log of CSF p-tau/Aβ42. Conclusion Sleepiness was associated with greater CSF IL-6 and NfL levels, which could contribute to neurodegeneration or alternatively cause sleepiness. Higher NfL levels may result from sleep disruption and/or contribute to sleepiness via disturbed connectivity or damage to wake-promoting centers. Associations between sleepiness and p-tau/Aβ42 in participants with abnormal ratio suggest that amyloid positivity contributes to vulnerability to sleep disturbance, which may further amyloid accumulation in a feed-forward loop process. Prospective studies of these markers are needed to determine cause-effect relationships between these associations.
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Affiliation(s)
- Diego Z. Carvalho
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Erik K. St. Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Timothy I. Morgenthaler
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Mary M. Machulda
- Department of Psychology, Mayo Clinic, Rochester, MN, United States
| | - Bradley F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Clifford R. Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | | | | | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Sleep habits are associated with cognition decline in physically robust, but not in frail participants: a longitudinal observational study. Sci Rep 2022; 12:11595. [PMID: 35804185 PMCID: PMC9270465 DOI: 10.1038/s41598-022-15915-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
Frail older adults are vulnerable to stressors; thus, sleep related cognition impairment might more greatly affect frail than healthy older adults. In the present study, we investigated whether the association between sleep problems and cognition varies with physical frailty status (modified from Fried et al.). Participants 55 years and older who completed a baseline and follow-up questionnaire (median follow-up: 5.5 years), were included in the analysis. Sleep parameters were evaluated in an interview at the baseline. Cognitive decline was defined as a loss of 3 or more points on the Mini-Mental State Examination (MMSE) at follow-up. Associations between sleep problems and cognitive decline were examined using logistic regression and were stratified by baseline physical frailty status, adjusted for potential confounders. A short total sleep duration (< 5 vs. 7-9 h, odds ratio (OR) = 1.88, 95% confidence interval (CI) 1.18-3.00), excessive daytime sleepiness (OR = 1.49, 95% CI 1.04-2.13), low sleep efficiency (< 65% vs. ≥ 85%, OR = 1.62, 95% CI 1.07-2.46), and insomnia complaints (OR = 2.34, 95% CI 1.23-4.43) were associated with MMSE decline in physically robust. The association was stronger for the sleep summary score, which summarized abnormal sleep duration, excessive daytime sleepiness, and insomnia complaints ([Formula: see text] 2 vs. 0, OR = 3.79, 95% CI 2.10-6.85, p < 0.0001). Due to the low prevalence of frailty in this community-dwelling population, the statistical power to detect an association was low. More evidence is needed to clarify the role of sleep in the progression of cognitive decline in frail individuals.
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Lin C, Glynn NW, Gmelin T, Wei YC, Chen YL, Huang CM, Shyu YC, Chen CK. Validation of the Traditional Chinese Version of the Pittsburgh Fatigability Scale for Older Adults. Clin Gerontol 2022; 45:606-618. [PMID: 33934690 PMCID: PMC10155380 DOI: 10.1080/07317115.2021.1914258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The Pittsburgh Fatigability Scale (PFS) is a self-administered 10-item tool to measure physical and mental fatigability in older adults. The aim of the current study was to validate the psychometric properties of the traditional Chinese version of PFS (TC-PFS). METHODS We recruited 114 community-dwellingolder adults, where 35 were diagnosed with late-life depression (LLD), 26 with mild cognitive impairment (MCI), and 53 were cognitively normal (CN) from a larger community study of older adults. Statistical analyses were done separately for TC-PFS Physical and Mental subscales. Factor analysis was used for reliability, Cronbach's alpha for internal consistency, Pearson's correlation for construct validity, and group comparison for discriminative validity. RESULTS Factor analysis revealed a two-factor structure for both the TC-PFS Physical and Mental subscales with high reliability (α = 0.89 and 0.89, respectively). Patients with LLD had the highest PFS scores, with 80.0% and 82.9% classified as having greater physical and mental fatigability. For concurrent validity, we found moderate associations with the vitality and physical functioning subscales of the 36-Item Short Form Health Survey. For convergent validity, TC-PFS showed moderate association with emotional-related psychometrics, particularly for the Physical subscale in those with LLD. In contrast, TC-PFS Mental subscale showed correlations with cognitive function, particularly in the MCI group. CONCLUSIONS Our results indicate that the TC-PFS is a valid instrument to measure perceived physical and mental fatigability in older Taiwanese adults.Clinical implications: Perceived fatigability reflects the underlying physical, mental or cognitive function in older adults with or without depression.
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Affiliation(s)
- Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Nancy W Glynn
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Theresa Gmelin
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yi-Chia Wei
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
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31
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Gan J, Wang XD, Shi Z, Yuan J, Zhang M, Liu S, Wang F, You Y, Jia P, Feng L, Xu J, Zhang J, Hu W, Chen Z, Ji Y. The Impact of Rotating Night Shift Work and Daytime Recharge on Cognitive Performance Among Retired Nurses. Front Aging Neurosci 2022; 13:827772. [PMID: 35145395 PMCID: PMC8821912 DOI: 10.3389/fnagi.2021.827772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe exact relationship between long-term shift work (SW) and cognitive impairment (CI) has been poorly understood. The effects of the long-term rotating night SW (RNSW) combining daytime recharge (DTR) on cognitive function were investigated.MethodsA total 920 retired nurses and 656 retired female teachers aged ≥50 years were analyzed. Participants who worked at least once per week for 8 hat night for more than 1 year were defined as the SW group, and those without a regular nighttime shift were defined as the control group. The associations among duration, frequency, and DTR of RNSW, and neuropsychological assessments were ascertained by regression models.ResultsParticipants with RNSW had a significantly higher proportion of mild CI (MCI), both amnestic MCI (aMCI) (14.4% in 11–20 years, p < 0.05, and 17.8% in > 20 years, p < 0.001) and non-amnestic MCI (naMCI) (8.1% in 11–20 years, p < 0.05), as well as dementia (1.5% in 1–10 years, and 11.7% in > 20 years, p < 0.05) compared to controls (8.4% with aMCI, 4.4% with naMCI, and 7.0% with dementia, respectively). There were significant negative relationships between general times of night SW and scores of Mini-Mental State Examination (MMSE) (R squared = 0.01, p = 0.0014) and Montreal Cognitive Assessment (MoCA) (R squared = 0.01, p = 0.0054). Participants with ≥1 h of DTR and ≥ 11 years of RNSW were about 2-fold more likely to experience MCI compared with the subjects in the control group, especially with 3–5 h (odds ratio [OR]: 2.35; 95% confidence interval: 1.49–3.68, p < 0.001).ConclusionThe long-term RNSW was associated with a higher risk of CI, especially aMCI and dementia, and the problem cannot be improved by DTR.
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Affiliation(s)
- Jinghuan Gan
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Zhihong Shi
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Junliang Yuan
- NHC Key Laboratory of Mental Health (Peking University), Department of Neurology, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Meiyun Zhang
- Department of Neurology, Tianjin People’s Hospital, Tianjin, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
| | - Fei Wang
- Department of Neurology, Yuncheng Central Hospital of Shanxi Province, Yuncheng, China
| | - Yong You
- Department of Neurology, Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Peifei Jia
- Department of Neurology, The Second Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Lisha Feng
- Department of Encephalopathy, Research Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junying Xu
- Department of Neurology, Tianjin Baodi People’s Hospital, Tianjin, China
| | - Jinhong Zhang
- Department of Neurology, Cangzhou People’s Hospital, Cangzhou, China
| | - Wenzheng Hu
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhichao Chen
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Ji
- Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Tianjin Key Laboratory of Cerebrovascular and of Neurodegenerative Diseases, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Dementia Institute, Tianjin, China
- *Correspondence: Yong Ji,
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Price CC. The New Frontier of Perioperative Cognitive Medicine for Alzheimer's Disease and Related Dementias. Neurotherapeutics 2022; 19:132-142. [PMID: 35084722 PMCID: PMC9130373 DOI: 10.1007/s13311-021-01180-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 01/03/2023] Open
Abstract
This is a review of preoperative cognitive assessment and other healthcare gaps in the care of older adults at risk for Alzheimer's disease and related dementias (ADRD) who have elected surgery with anesthesia. It summarizes concerns regarding ADRD perioperative healthcare, perioperative cognitive, and neuronal domains of vulnerability. It also offers a plan for phased preoperative cognitive screening and perioperative cognitive intervention opportunities. An argument is made for why medical professionals in the perioperative setting need fundamental training in cognitive-behavioral principles, an understanding of neurodegenerative diseases of aging, and an appreciation of the immediate and long-term medical risks for such patients undergoing anesthesia. The author's goal is to encourage readers to consider perioperative cognitive medicine as a new frontier for generating evidence-based care approaches for at-risk older adults with neurodegenerative disorders who require procedures with anesthesia.
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Affiliation(s)
- Catherine C Price
- Clinical and Health Psychology, Anesthesiology, University of Florida, Gainesville, FL, USA.
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33
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Kokošová V, Filip P, Kec D, Baláž M. Bidirectional Association Between Sleep and Brain Atrophy in Aging. Front Aging Neurosci 2021; 13:726662. [PMID: 34955805 PMCID: PMC8693777 DOI: 10.3389/fnagi.2021.726662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/29/2021] [Indexed: 11/23/2022] Open
Abstract
Human brain aging is characterized by the gradual deterioration of its function and structure, affected by the interplay of a multitude of causal factors. The sleep, a periodically repeating state of reversible unconsciousness characterized by distinct electrical brain activity, is crucial for maintaining brain homeostasis. Indeed, insufficient sleep was associated with accelerated brain atrophy and impaired brain functional connectivity. Concurrently, alteration of sleep-related transient electrical events in senescence was correlated with structural and functional deterioration of brain regions responsible for their generation, implying the interconnectedness of sleep and brain structure. This review discusses currently available data on the link between human brain aging and sleep derived from various neuroimaging and neurophysiological methods. We advocate the notion of a mutual relationship between the sleep structure and age-related alterations of functional and structural brain integrity, pointing out the position of high-quality sleep as a potent preventive factor of early brain aging and neurodegeneration. However, further studies are needed to reveal the causality of the relationship between sleep and brain aging.
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Affiliation(s)
- Viktória Kokošová
- Department of Neurology, Faculty of Medicine, University Hospital Brno and Masaryk University, Brno, Czechia
| | - Pavel Filip
- Department of Neurology, First Faculty of Medicine, General University Hospital Prague and Charles University, Prague, Czechia.,Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States
| | - David Kec
- Department of Neurology, Faculty of Medicine, University Hospital Brno and Masaryk University, Brno, Czechia
| | - Marek Baláž
- First Department of Neurology, Faculty of Medicine, University Hospital of St. Anne and Masaryk University, Brno, Czechia
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Su Y, Cochrane BB, Yu SY, Reding K, Herting JR, Zaslavsky O. Fatigue in community-dwelling older adults: A review of definitions, measures, and related factors. Geriatr Nurs 2021; 43:266-279. [PMID: 34963072 DOI: 10.1016/j.gerinurse.2021.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/04/2022]
Abstract
Fatigue is a common age-related symptom among community-dwelling adults aged 65 years and older. Yet, a systematic approach has rarely been applied to review definitions, measures, related factors, and consequences of fatigue in this population. A scoping review was conducted in December 2020 to fill the gap, and 36 articles met the inclusion criteria. Definitions, albeit diverse, included at least one of the following attributes: an early indicator of disablement, subjective, a lack of energy, multidimensional, impaired daily activities, and temporal. A summary of fatigue measures used in this population was provided, including a brief overview, number of items, reliability, and validity. In general, different measures were used with considerable variability in the content. Additionally, most measures had limited information on test-retest reliability and validity. Fatigue-related factors mapped into biological, psychological, social, and behavioral factors. Fatigue consequences were primarily declines in physical and cognitive functions. (100-150 words).
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Affiliation(s)
- Yan Su
- School of Nursing, University of Washington, Seattle, WA, United States.
| | - Barbara B Cochrane
- School of Nursing, University of Washington, Seattle, WA, United States; Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA, United States
| | - Shih-Yin Yu
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Kerryn Reding
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Jerald R Herting
- Department of Sociology, University of Washington, Seattle, WA, United States
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA, United States
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35
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Hjort Telhede E, Arvidsson S, Karlsson S. Nursing staff's experiences of how weighted blankets influence resident's in nursing homes expressions of health. Int J Qual Stud Health Well-being 2021; 17:2009203. [PMID: 34904541 PMCID: PMC8740773 DOI: 10.1080/17482631.2021.2009203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The most common treatment for resident’s health problems is pharmacological. Little research has been done on how an intervention with a non-pharmacological method, such as a weighted blanket, Through the nursing staff view, we can learn how weighted blankets influence resident’s health in nursing homes. The aim of this study was to explore nursing staff’s experiences of how an intervention with weighted blankets influenced resident’s expressions of health. Methods The study had a descriptive qualitative design with semi-structured interviews with 20 nursing staff working in nursing homes, and an inductive content analysis was applied. Results The nursing staff expressed that the weighted blanket positively influenced resident’s health in the areas of sleep, physical activity, and psychological behaviour. The weighted blanket made them fall asleep faster, sleep was uninterrupted andthey felt more rested in the morning. The nursing staff observed an increased level of activity as the resident became more energetic . The nursing staff also experienced reduced negative psychological behaviours like anxiety and worrying. Conclusion This study indicated that the weighted blanket changed the health expression of resident in several crucial areas. Deep pressure treatment indicates an alternative health-improved treatment for resident in nursing homes.
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Affiliation(s)
| | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Staffan Karlsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Sakalauskaitė-Juodeikienė E, Eling P. Hildegard of Bingen (c. 1098-1179) on sleep and dreams in her Causae et curae and Physica: a historical perspective. Sleep Med 2021; 88:7-12. [PMID: 34715528 DOI: 10.1016/j.sleep.2021.09.018] [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: 07/12/2021] [Revised: 08/13/2021] [Accepted: 09/28/2021] [Indexed: 11/19/2022]
Abstract
Saint Hildegard of Bingen (c. 1098-1179) was a 12th century Benedictine abbess, a visionary, a composer, a poet, a healer, and one of few medieval women who produced treatises on medicine. In her medical writings, Causae et curae and Physica, the abbess described, among other topics, physical functions and mechanisms of sleep, dreams and waking, emphasizing the importance of sleep for the human body. She regarded sleep as both a passive and an active process. Hildegard warned her readers about sleeping too little or too much, evaluated possible causes of insomnia and nightmares, and discussed potential treatments for these sleep disorders. In this paper, we analyze Hildegard's writings in the context of Greco-Roman physiological theories, which were held to the end of the Middle Ages and later. We also discuss questions concerning the abbess's putative education, the originality of her works, and the significance of her writings in the context of current knowledge on sleep medicine.
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Affiliation(s)
- Eglė Sakalauskaitė-Juodeikienė
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
| | - Paul Eling
- Radboud University, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, Netherlands
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37
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Sang F, Chen Y, Chen K, Dang M, Gao S, Zhang Z. Sex Differences in Cortical Morphometry and White Matter Microstructure During Brain Aging and Their Relationships to Cognition. Cereb Cortex 2021; 31:5253-5262. [PMID: 34148074 DOI: 10.1093/cercor/bhab155] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/16/2021] [Accepted: 05/10/2021] [Indexed: 01/02/2023] Open
Abstract
Changes in brain structure are associated with aging, and accompanied by the gradual deterioration of cognitive functions, which manifests differently in males and females. Here, we quantify the age-related spatial aging patterns of brain gray and white matter structures, their volume reduction rate, their relationships with specific cognitive functions, as well as differences between males and females in a cross-sectional nondementia dataset. We found that both males and females showed extensive age-related decreases in the volumes of most gray matter and white matter regions. Females have larger regions where the volume decreases with age and a greater slope (females: 0.199%, males: 0.183%) of volume decrease in gray matter. For white matter, no significant sex differences were found in age-related regions, and the slope of volume decrease. More significant associations were identified between brain structures and cognition in males during aging than females. This study explored the age-related regional variations in gray matter and white matter, as well as the sex differences in a nondemented elderly population. This study helps to further understand the aging of the brain structure and sex differences in the aging of brain structures and provides new evidence for the aging of nondemented individuals.
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Affiliation(s)
- Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ 85006, USA
| | - Mingxi Dang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Shudan Gao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
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38
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Angioni D, Virecoulon Giudici K, Montoya Martinez M, Rolland Y, Vellas B, de Souto Barreto P. Neuroimaging markers of chronic fatigue in older people: a narrative review. Aging Clin Exp Res 2021; 33:1487-1492. [PMID: 32734575 DOI: 10.1007/s40520-020-01666-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Chronic fatigue is a common symptom in older adults. Although some studies have attempted to identify the neuronal correlates of fatigue associated with chronic diseases, the scientific evidence is scarce regarding fatigue in older people not suffering from a specific disease. AIMS To gather available evidence of neuroimaging studies investigating the associations between fatigue and brain health in older adults out of the context of a specific disease, and to identify potential brain structures associated with this symptom. METHODS Studies considering exclusively patients with a specific disease and/or studies focusing on physiological mechanisms of acute fatigue induced by the realization of cognitive and physical tasks were excluded. RESULTS Very few studies on the associations of fatigue with neuroimaging markers are currently available. Fatigue was associated with reduced hippocampus volumes and with hippocampal amyloid deposition. Regarding the association between fatigue and the circuit of basal ganglia, putamen and thalamus were associated with physical fatigability, whereas amygdala and thalamus with mental fatigability. Very limited evidence about white matter integrity found that healthy individuals with high levels of fatigue had a greater total volume of leukoaraiosis. CONCLUSION This review suggests that hippocampus damage and potentially loss of function in basal ganglia networks could play a role on chronic fatigue during aging. Further studies are needed to assess the associations of fatigue with white matter alterations.
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Tian Q, Ehrenkranz R, Rosso AL, Glynn NW, Chahine LM, Hengenius J, Zhu X, Rosano C. Mild parkinsonian signs, energy decline, and striatal volume in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 77:800-806. [PMID: 34049395 DOI: 10.1093/gerona/glab150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mild Parkinsonian Signs (MPS), highly prevalent in older adults, predict disability. It is unknown whether energy decline, a predictor of mobility disability, is also associated with MPS. We hypothesized that those with MPS had greater decline in self-reported energy levels (SEL) than those without MPS, and that SEL decline and MPS share neural substrates. METHODS Using data from the Health, Aging and Body Composition Study, we analyzed 293 Parkinson's Disease-free participants (83±3 years old, 39% Black, 58% women) with neuroimaging data, MPS evaluation by Unified Parkinson Disease Rating Scale in 2006-2008, and ≥ 3 measures of SEL since 1999-2000. Individual SEL slopes were computed via linear mixed models. Associations of SEL slopes with MPS were tested using logistic regression models. Association of SEL slope with volume of striatum, sensorimotor, and cognitive regions were examined using linear regression models adjusted for normalized total gray matter volume. Models were adjusted for baseline SEL, mobility, demographics, and comorbidities. RESULTS Compared to those without MPS (n=165), those with MPS (n=128) had 37% greater SEL decline in the prior eight years (p=0.001). Greater SEL decline was associated with smaller right striatal volume (adjusted standardized β=0.126, p=0.029). SEL decline was not associated with volumes in other regions. The association of SEL decline with MPS remained similar after adjustment for right striatal volume (adjusted OR=2.03, 95% CI: 1.16 - 3.54). CONCLUSION SEL decline may be faster in those with MPS. Striatal atrophy may be important for declining energy but does not explain the association with MPS.
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Affiliation(s)
- Qu Tian
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland
| | - Rebecca Ehrenkranz
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lana M Chahine
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James Hengenius
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Xiaonan Zhu
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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40
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Liu C, Lee SH, Hernandez-Cardenache R, Loewenstein D, Kather J, Alperin N. Poor sleep is associated with small hippocampal subfields in cognitively normal elderly individuals. J Sleep Res 2021; 30:e13362. [PMID: 33949039 DOI: 10.1111/jsr.13362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/21/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022]
Abstract
Recent studies demonstrated reduced hippocampal volumes in elderly healthy individuals who are cognitively normal but poor sleepers. The association between sleep quality and the pattern of volume loss across hippocampal subfields (HSs) is not well known. Thus, it is the focus of the present study. Sleep quality was self-assessed using the Pittsburgh Sleep Quality Index (PSQI). The HS volumes were measured using sub-millimetre in-plane resolution T2-weighted magnetic resonance imaging data. A total of 67 cognitively normal elderly individuals aged 60-83 years were classified into 30 normal sleepers with a PSQI <5 and 37 poor sleepers with a PSQI ≥5. The two groups were equivalent in age, gender distribution, ethnicity, education attainment, handedness and cognitive performance. Compared to normal sleepers, poor sleepers exhibited significantly lower normalised volumes in the left cornu ammonis field 1 (CA1), dentate gyrus (DG) and subiculum. In contrast, there were no significant differences in normalised grey and white matter volumes between the two groups. The global PSQI was negatively associated with the normalised volumes of the left CA1, DG and subiculum. Sleep duration was associated with the normalised volumes of the bilateral CA1, DG, left CA2 and subiculum. Verbal memory scores were associated with the left CA1 volume. In conclusion, poor sleep quality, especially insufficient sleep duration, was associated with volume loss in several HSs that are involved in specific learning and memory tasks. As the hippocampus does not regulate sleep, it is more likely that poor sleep leads to small hippocampi. Thus, based on this assumption, improving sleep quality of poor sleeper elderly individuals could benefit hippocampal health.
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Affiliation(s)
- Che Liu
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Sang H Lee
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rene Hernandez-Cardenache
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David Loewenstein
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Josefina Kather
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Noam Alperin
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
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41
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Fjell AM, Sørensen Ø, Amlien IK, Bartrés-Faz D, Bros DM, Buchmann N, Demuth I, Drevon CA, Düzel S, Ebmeier KP, Idland AV, Kietzmann TC, Kievit R, Kühn S, Lindenberger U, Mowinckel AM, Nyberg L, Price D, Sexton CE, Solé-Padullés C, Pudas S, Sederevicius D, Suri S, Wagner G, Watne LO, Westerhausen R, Zsoldos E, Walhovd KB. Self-reported sleep relates to hippocampal atrophy across the adult lifespan: results from the Lifebrain consortium. Sleep 2021; 43:5628807. [PMID: 31738420 PMCID: PMC7215271 DOI: 10.1093/sleep/zsz280] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/25/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives Poor sleep is associated with multiple age-related neurodegenerative and neuropsychiatric conditions. The hippocampus plays a special role in sleep and sleep-dependent cognition, and accelerated hippocampal atrophy is typically seen with higher age. Hence, it is critical to establish how the relationship between sleep and hippocampal volume loss unfolds across the adult lifespan. Methods Self-reported sleep measures and MRI-derived hippocampal volumes were obtained from 3105 cognitively normal participants (18–90 years) from major European brain studies in the Lifebrain consortium. Hippocampal volume change was estimated from 5116 MRIs from 1299 participants for whom longitudinal MRIs were available, followed up to 11 years with a mean interval of 3.3 years. Cross-sectional analyses were repeated in a sample of 21,390 participants from the UK Biobank. Results No cross-sectional sleep—hippocampal volume relationships were found. However, worse sleep quality, efficiency, problems, and daytime tiredness were related to greater hippocampal volume loss over time, with high scorers showing 0.22% greater annual loss than low scorers. The relationship between sleep and hippocampal atrophy did not vary across age. Simulations showed that the observed longitudinal effects were too small to be detected as age-interactions in the cross-sectional analyses. Conclusions Worse self-reported sleep is associated with higher rates of hippocampal volume decline across the adult lifespan. This suggests that sleep is relevant to understand individual differences in hippocampal atrophy, but limited effect sizes call for cautious interpretation.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway
| | - Inge K Amlien
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Spain
| | - Didac Maciá Bros
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Spain
| | - Nikolaus Buchmann
- Department of Cardiology, Charité - University Medicine Berlin Campus Benjamin Franklin, Berlin, Germany
| | - Ilja Demuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Germany
| | - Christian A Drevon
- Vitas AS, Research Park, Gaustadalleen 21, 0349, Oslo and 6 University of Oslo, Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, Medicine/University of Oslo, Norway
| | - Sandra Düzel
- Max Planck Institute for Human Development, Germany
| | | | - Ane-Victoria Idland
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway.,Oslo Delirium Research Group, Department of Geriatric Medicine, University of Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Tim C Kietzmann
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Simone Kühn
- Max Planck Institute for Human Development, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | | | | | - Lars Nyberg
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Darren Price
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Claire E Sexton
- Department of Psychiatry, University of Oxford, UK.,Global Brain Health Institute, Department of Neurology, University of California San Francisco, CA.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and Institut de Neurociències, Universitat de Barcelona, Spain
| | - Sara Pudas
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | | | - Sana Suri
- Department of Psychiatry, University of Oxford, UK.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Gerd Wagner
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Leiv Otto Watne
- Oslo Delirium Research Group, Department of Geriatric Medicine, University of Oslo, Norway
| | - René Westerhausen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, UK.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
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42
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André C, Laniepce A, Chételat G, Rauchs G. Brain changes associated with sleep disruption in cognitively unimpaired older adults: A short review of neuroimaging studies. Ageing Res Rev 2021; 66:101252. [PMID: 33418092 DOI: 10.1016/j.arr.2020.101252] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
Ageing is characterized by a progressive decline of sleep quality. Sleep difficulties are increasingly recognized as a risk factor for Alzheimer's disease (AD), and have been associated with cognitive decline. However, the brain substrates underlying this association remain unclear. In this review, our objective was to provide a comprehensive overview of the relationships between sleep changes and brain structural, functional and molecular integrity, including amyloid and tau pathologies in cognitively unimpaired older adults. We especially discuss the topography and causality of these associations, as well as the potential underlying mechanisms. Taken together, current findings converge to a link between several sleep parameters, amyloid and tau levels in the CSF, and neurodegeneration in diffuse frontal, temporal and parietal areas. However, the existing literature remains heterogeneous, and the specific sleep changes associated with early AD pathological changes, in terms of topography and neuroimaging modality, is not clearly established yet. Notably, if slow wave sleep disruption seems to be related to frontal amyloid deposition, the brain correlates of sleep-disordered breathing and REM sleep disruption remain unclear. Moreover, sleep parameters associated with tau- and FDG-PET imaging are largely unexplored. Lastly, whether sleep disruption is a cause or a consequence of brain alterations remains an open question.
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43
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Wan M, Ye Y, Lin H, Xu Y, Liang S, Xia R, He J, Qiu P, Huang C, Tao J, Chen L, Zheng G. Deviations in Hippocampal Subregion in Older Adults With Cognitive Frailty. Front Aging Neurosci 2021; 12:615852. [PMID: 33519422 PMCID: PMC7838368 DOI: 10.3389/fnagi.2020.615852] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/15/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Cognitive frailty is a particular state of cognitive vulnerability toward dementia with neuropathological hallmarks. The hippocampus is a complex, heterogeneous structure closely relates to the cognitive impairment in elderly which is composed of 12 subregions. Atrophy of these subregions has been implicated in a variety of neurodegenerative diseases. The aim of this study was to explore the changes in hippocampal subregions in older adults with cognitive frailty and the relationship between subregions and cognitive impairment as well as physical frailty. METHODS Twenty-six older adults with cognitive frailty and 26 matched healthy controls were included in this study. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA) scale (Fuzhou version) and Wechsler Memory Scale-Revised Chinese version (WMS-RC), while physical frailty was tested with the Chinese version of the Edmonton Frailty Scale (EFS) and grip strength. The volume of the hippocampal subregions was measured with structural brain magnetic resonance imaging. Partial correlation analysis was carried out between the volumes of hippocampal subregions and MoCA scores, Wechsler's Memory Quotient and physical frailty indexes. RESULTS A significant volume decrease was found in six hippocampal subregions, including the bilateral presubiculum, the left parasubiculum, molecular layer of the hippocampus proper (molecular layer of the HP), and hippocampal amygdala transition area (HATA), and the right cornu ammonis subfield 1 (CA1) area, in older adults with cognitive frailty, while the proportion of brain parenchyma and total number of white matter fibers were lower than those in the healthy controls. Positive correlations were found between Wechsler's Memory Quotient and the size of the left molecular layer of the HP and HATA and the right presubiculum. The sizes of the left presubiculum, molecular of the layer HP, and HATA and right CA1 and presubiculum were found to be positively correlated with MoCA score. The sizes of the left parasubiculum, molecular layer of the HP and HATA were found to be negatively correlated with the physical frailty index. CONCLUSION Significant volume decrease occurs in hippocampal subregions of older adults with cognitive frailty, and these changes are correlated with cognitive impairment and physical frailty. Therefore, the atrophy of hippocampal subregions could participate in the pathological progression of cognitive frailty.
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Affiliation(s)
- Mingyue Wan
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yu Ye
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huiying Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ying Xu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengxiang Liang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rui Xia
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianquan He
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Pingting Qiu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Chengwu Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
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44
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Ji X, Fu Y. The role of sleep disturbances in cognitive function and depressive symptoms among community-dwelling elderly with sleep complaints. Int J Geriatr Psychiatry 2021; 36:96-105. [PMID: 33411399 DOI: 10.1002/gps.5401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/28/2020] [Accepted: 08/08/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The relationships between sleep problems, cognitive impairments, and depression have been established in the aging population. However, less is known about the role of late-life onset insomnia and sex involved in these dyad or tripartite relationships. This study aimed to consider onset age of insomnia and sex in the relationship between sleep parameters, cognition and depression among older adults with current insomnia complaints. METHOD A multistep sampling method was adopted to recruit participants with current insomnia complaints in China in 2018. Sleep measures include onset age of insomnia (64 years old or before vs during/after 65), three factors from insomnia severity index (ISI; nighttime, daytime, and perception), excessive daytime sleepiness, and sleep duration. Outcome measures were mini-mental state examination (MMSE) and center for epidemiologic studies depression scale (CESD). RESULTS The average age of older adults was 75 (SD = 7.1). Among them, 62% participants are female. In general, older aged, female, late-life onset insomnia as well as interaction of sex * onset age of insomnia were significantly associated with poorer cognition. Yet, age, sex, and onset age of insomnia were not significant indicators for depression. For female participants, later onset of insomnia, nighttime symptoms of insomnia, excessive daytime sleepiness and depression were risk factors for cognitive decline. Nevertheless, only daytime sleepiness, together with depression, were found positively associated with male participants' cognitive decline. CONCLUSIONS There were robust associations between daytime sleepiness, depressive symptoms, and poor cognitive performance. More importantly, late-life onset insomnia was particularly indicative for poor cognitive performance among female older adults. Future study should emphasize the specific mechanism involved in changes of sleep patterns in the development of cognitive impairment among older adults. Sex differences in the relationship between onset age of insomnia and cognition also require further attention.
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Affiliation(s)
- Xiaowen Ji
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA
| | - Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
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45
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Djonlagic I, Mariani S, Fitzpatrick AL, Van Der Klei VMGTH, Johnson DA, Wood AC, Seeman T, Nguyen HT, Prerau MJ, Luchsinger JA, Dzierzewski JM, Rapp SR, Tranah GJ, Yaffe K, Burdick KE, Stone KL, Redline S, Purcell SM. Macro and micro sleep architecture and cognitive performance in older adults. Nat Hum Behav 2021; 5:123-145. [PMID: 33199858 PMCID: PMC9881675 DOI: 10.1038/s41562-020-00964-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/15/2020] [Indexed: 01/31/2023]
Abstract
We sought to determine which facets of sleep neurophysiology were most strongly linked to cognitive performance in 3,819 older adults from two independent cohorts, using whole-night electroencephalography. From over 150 objective sleep metrics, we identified 23 that predicted cognitive performance, and processing speed in particular, with effects that were broadly independent of gross changes in sleep quality and quantity. These metrics included rapid eye movement duration, features of the electroencephalography power spectra derived from multivariate analysis, and spindle and slow oscillation morphology and coupling. These metrics were further embedded within broader associative networks linking sleep with aging and cardiometabolic disease: individuals who, compared with similarly aged peers, had better cognitive performance tended to have profiles of sleep metrics more often seen in younger, healthier individuals. Taken together, our results point to multiple facets of sleep neurophysiology that track coherently with underlying, age-dependent determinants of cognitive and physical health trajectories in older adults.
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Affiliation(s)
- Ina Djonlagic
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sara Mariani
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Alexis C Wood
- USDA/ARS Children's Nutrition Center, Baylor College of Medicine, Houston, TX, USA
| | - Teresa Seeman
- University of California, Los Angeles, Los Angeles, CA, USA
| | - Ha T Nguyen
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michael J Prerau
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | - Stephen R Rapp
- Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Gregory J Tranah
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Kristine Yaffe
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine E Burdick
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Susan Redline
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Shaun M Purcell
- Harvard Medical School, Boston, MA, USA.
- Brigham and Women's Hospital, Boston, MA, USA.
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46
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Fjell AM, Sørensen Ø, Amlien IK, Bartrés-Faz D, Brandmaier AM, Buchmann N, Demuth I, Drevon CA, Düzel S, Ebmeier KP, Ghisletta P, Idland AV, Kietzmann TC, Kievit RA, Kühn S, Lindenberger U, Magnussen F, Macià D, Mowinckel AM, Nyberg L, Sexton CE, Solé-Padullés C, Pudas S, Roe JM, Sederevicius D, Suri S, Vidal-Piñeiro D, Wagner G, Watne LO, Westerhausen R, Zsoldos E, Walhovd KB. Poor Self-Reported Sleep is Related to Regional Cortical Thinning in Aging but not Memory Decline-Results From the Lifebrain Consortium. Cereb Cortex 2020; 31:1953-1969. [PMID: 33236064 PMCID: PMC7945023 DOI: 10.1093/cercor/bhaa332] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/17/2020] [Accepted: 10/12/2020] [Indexed: 12/16/2022] Open
Abstract
We examined whether sleep quality and quantity are associated with cortical and memory changes in cognitively healthy participants across the adult lifespan. Associations between self-reported sleep parameters (Pittsburgh Sleep Quality Index, PSQI) and longitudinal cortical change were tested using five samples from the Lifebrain consortium (n = 2205, 4363 MRIs, 18–92 years). In additional analyses, we tested coherence with cell-specific gene expression maps from the Allen Human Brain Atlas, and relations to changes in memory performance. “PSQI # 1 Subjective sleep quality” and “PSQI #5 Sleep disturbances” were related to thinning of the right lateral temporal cortex, with lower quality and more disturbances being associated with faster thinning. The association with “PSQI #5 Sleep disturbances” emerged after 60 years, especially in regions with high expression of genes related to oligodendrocytes and S1 pyramidal neurons. None of the sleep scales were related to a longitudinal change in episodic memory function, suggesting that sleep-related cortical changes were independent of cognitive decline. The relationship to cortical brain change suggests that self-reported sleep parameters are relevant in lifespan studies, but small effect sizes indicate that self-reported sleep is not a good biomarker of general cortical degeneration in healthy older adults.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0188 Oslo, Norway
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Inge K Amlien
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Andreas M Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany, and London, UK
| | - Nikolaus Buchmann
- Department of Cardiology, Charité - University Medicine Berlin Campus Benjamin Franklin, 12203 Berlin, Germany
| | - Ilja Demuth
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Lipid Clinic at the Interdisciplinary Metabolism Center, Charité - Universitätsmedizin Berlin, BCRT - Berlin Institute of Health Center for Regenerative Therapies, 10117 Berlin, Germany
| | - Christian A Drevon
- Vitas AS, Research Park, Gaustadalleen 21, 0349 Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
| | - Sandra Düzel
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD UK
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, Swiss Distance University Institute, Swiss National Centre of Competence in Research LIVES, University of Geneva, 1205 Geneva, Switzerland
| | - Ane-Victoria Idland
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway.,Oslo Delirium Research Group, Department of Geriatric Medicine, University of Oslo, 0315 Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, 0315 Oslo, Norway
| | - Tim C Kietzmann
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 1TN, UK.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Rogier A Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 1TN, UK
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, 14195 Berlin, Germany.,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany, and London, UK
| | - Fredrik Magnussen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Didac Macià
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Athanasia M Mowinckel
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Lars Nyberg
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
| | - Claire E Sexton
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD UK.,Global Brain Health Institute, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX1 2JD, UK
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Sara Pudas
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
| | - James M Roe
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Donatas Sederevicius
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD UK.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX1 2JD, UK
| | - Didac Vidal-Piñeiro
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Gerd Wagner
- Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Leiv Otto Watne
- Oslo Delirium Research Group, Department of Geriatric Medicine, University of Oslo, 0315 Oslo, Norway
| | - René Westerhausen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD UK.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX1 2JD, UK
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0315 Oslo, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0188 Oslo, Norway
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47
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McPhillips MV, Li J, Hodgson NA, Cacchione PZ, Dickson VV, Gooneratne NS, Riegel B. Daytime sleepiness and napping in nursing-home eligible community dwelling older adults: A mixed methods study. Gerontol Geriatr Med 2020; 6:2333721420970730. [PMID: 35059470 PMCID: PMC8764400 DOI: 10.1177/2333721420970730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023] Open
Abstract
Objectives To describe perceptions and beliefs about daytime sleepiness and napping along with subjective and objective daytime sleep characteristics in nursing-home eligible community dwelling older adults. Methods A mixed methods study; we conducted semi-structured interviews and measured sleep variables via Actigraphy, sleep diary, and Epworth Sleepiness Scale (ESS). Napping was defined as >10 minutes; anything less was considered dozing. Results Final sample (n = 40) was primarily female (85%), Black (100%), with a mean age of 72 ± 9.5 years. Few (25%) reported daytime sleepiness (ESS >10). However, average duration of napping per day was 33.1 ± 11.5 minutes with a nap frequency of 2.5 ± 1.5 naps. Conclusion Our sample napped frequently throughout the day, yet the majority reported no daytime sleepiness. These older adults did not always recognize napping or how much they napped.
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Affiliation(s)
| | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
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48
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Siachpazidou DI, Stavrou VT, Astara K, Pastaka C, Gogou E, Hatzoglou C, Economou NT, Gourgoulianis KI. Alzheimer's Disease in Patients with Obstructive Sleep Apnea Syndrome. TANAFFOS 2020; 19:176-185. [PMID: 33815537 PMCID: PMC8008406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is a disorder with high prevalence among adults and is an independent risk factor for various diseases, especially those affecting the central nervous system (CNS). Continuous positive airway pressure (CPAP) is usually the optimal choice of treatment for OSAS. Alzheimer's disease (AD) is a neurodegenerative disease affecting a large proportion of the elderly population. The purpose of this study was to collect information concerning the two pathological entities and investigate the effectiveness of CPAP in the treatment of AD. MATERIALS AND METHODS In this review, Twenty articles were found concerning OSAS and AD, of which one article was about treatment with donepezil and seven articles considered treatment with CPAP. RESULTS Serious OSAS and short sleep duration are associated with a high risk of developing dementia. Respiratory distress during sleep is associated with developing mild cognitive impairment at younger ages. The cerebrovascular damage of AD patients is correlated with the severity of OSAS. Lower cerebrospinal fluid levels are associated with memory disturbances and oxygen saturation parameters in patients with OSAS-AD. Continuous use of CPAP is related to the delayed onset of cognitive impairment and is suggested as an effective method of protecting cognitive function, depression, sleep quality and architecture, and daytime sleepiness in AD patients with good compliance. Treatment of CPAP patients with OSAS-AD is suggested as an effective method of protecting cognitive function. CONCLUSION Clinicians dealing with AD patients should consider CPAP treatment when OSAS coexists.
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Affiliation(s)
- Dimitra I. Siachpazidou
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Biopolis, Larissa, Greece
| | - Vasileios T. Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | - Kyriaki Astara
- Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | - Chaido Pastaka
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Biopolis, Larissa, Greece
| | - Eudoxia Gogou
- Department of Physiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | - Chrissi Hatzoglou
- Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | | | - Konstantinos I. Gourgoulianis
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Biopolis, Larissa, Greece,,Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece,Department of Physiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
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49
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Sleep, rest-activity fragmentation and structural brain changes related to the ageing process. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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50
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Ho LYW, Ng SSM. Non-pharmacological interventions for fatigue in older adults: a systematic review and meta-analysis. Age Ageing 2020; 49:341-351. [PMID: 32101281 DOI: 10.1093/ageing/afaa019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/14/2019] [Accepted: 01/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-pharmacological interventions are widely used to treat fatigue in clients with specific diseases but the findings may not be applicable to older adults experiencing fatigue, which also relates to the physiological changes of ageing. Non-pharmacological interventions for fatigue alleviation in older adults have not been reviewed and meta-analysed. OBJECTIVE To evaluate the immediate and long-term effects of non-pharmacological interventions on fatigue in community-dwelling older adults. METHODS Randomised controlled trials published from 2008 to May 2018 were searched in CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PubMed and Web of Science databases. The reference lists of the publications, forward citation and clinical trial registries were also reviewed. Relevant data were extracted and meta-analysis was conducted using Cochrane Review Manager 5.3. RESULTS Eight studies, with a total of 1093 participants, were identified. Non-pharmacological interventions included mindfulness meditation, a behavioural lifestyle programme, muscle relaxation, pet insect-assisted therapy, yoga, Tai Chi and cognitive behavioural therapy. Non-pharmacological interventions elicited significant immediate positive effects on fatigue (SMD: -0.40, 95% CI -0.62 to -0.18), although there was no lasting effect. Both physical and cognitive/mental interventions effectively alleviated fatigue. CONCLUSION Non-pharmacological interventions appear to be effective in alleviating fatigue at immediate post-intervention in community-dwelling older adults. More studies with robust designs and adequate sample sizes are needed in the future.
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Affiliation(s)
- Lily Y W Ho
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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