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Wang X, Luo L, Zhao J, Guo X, Tao L, Zhang F, Liu X, Gao B, Luo Y. Associations between sleep duration trajectories and cognitive decline: A longitudinal cohort study in China. Arch Gerontol Geriatr 2024; 124:105445. [PMID: 38733919 DOI: 10.1016/j.archger.2024.105445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/24/2024] [Accepted: 04/13/2024] [Indexed: 05/13/2024]
Abstract
OBJECT The relationship between sleep duration trajectories and cognitive decline remains uncertain. This study aims to examine the connections between various patterns of sleep duration and cognitive function. METHODS Group-based trajectory modeling (GBTM) was employed to identify longitudinal trajectories of sleep duration over four-year follow-up period, while considering age, sex and nap duration as adjustments. Logistic regression was utilized to analyze the association between sleep trajectories and cognition, with odds ratios (OR) and 95 % confidence intervals (CI) reported. Subgroup analyses based on various demographic characteristics were conducted to explore potential differences in sleep trajectories and cognitive decline across different population subgroups. RESULTS A total of 5061 participants were followed for four years, and three sleep duration trajectories were identified: high increasing (n = 2101, 41.6 %), stable increasing (n = 2087, 40.7 %), and low decreasing (n = 873, 17.7 %). After adjustment for basic demographic information, health status, and baseline cognition, the high increasing trajectory was found to be associated with cognitive decline in terms of global cognition (OR:1.52,95 %CI:1.18-1.96), mental intactness (OR:1.36,95 %CI:1.07-1.73) and episodic memory (OR:1.33, 95 %CI:1.05-1.67), as compared to stable increasing trajectory. These associations were particularly prominent among the non-elderly population (≤65 years) and those without depressive symptoms. CONCLUSION This study suggests that both high increasing and low decreasing sleep duration trajectories are linked to cognitive decline, as compared to the stable increasing trajectory. Long-term attention to changes in sleep duration facilitates early prevention of cognitive decline.
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Affiliation(s)
- Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lili Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Jianxi Zhao
- School of Applied Science, Beijing Information Science and Technology University, Beijing, 100192, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Bo Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, PR China.
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Esiaka D, Odo O, Luth E. Unraveling the Threads: Sleep Difficulties, Neighborhood Physical Disorder, and Subjective Cognitive Decline in Older Americans. J Alzheimers Dis 2024:JAD240142. [PMID: 38995787 DOI: 10.3233/jad-240142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Background Research suggests that the neighborhood in which people live can be a risk or protective factor for various health outcomes, including cognitive decline to Alzheimer's disease. Similar to the impact of neighborhood on health outcomes, sleep difficulties have been linked to cognitive function in older adults. However, few studies have examined how neighborhood physical disorders moderate the effects of sleep on subjective cognitive decline (SCD). Objective The study examined the moderating effect of neighborhood factors on the relationship between sleep difficulties and SCD. Methods Data were obtained from 2,494 respondents (1,065 males and 1,429 females) from Wave 11 of the National Health and Aging Trends (NHATS) data. Sleep difficulties were operationalized as the presence of difficulties in falling and staying asleep. Neighborhood physical disorder (e.g., vandalism, graffiti) was based on interviewer observations of respondents' neighborhoods. SCD was operationalized as subjective reports of increasing or worse memory loss in the past 12 months and present memory rating. We utilized Linear regression to test neighborhood physical disorder as a moderator of the relationship between sleep difficulties and SCD. Results We found a significant interaction between sleep difficulties and neighborhood physical disorder on SCD (β=0.03, SE = 0.01, 95% CI[0.00,0.51], p < 0.001). Participants who reported higher average sleep difficulties and higher levels of neighborhood physical disorder were more likely to report SCD. Conclusions Our findings add to inform future health interventions and policy recommendations that address modifiable sources of cognitive decline and risk of Alzheimer's disease.
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Affiliation(s)
- Darlingtina Esiaka
- Department of Behavioral Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
- Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Obinna Odo
- Department of Sociology and Gerontology, Miami University, Oxford, OH, USA
- Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Elizabeth Luth
- Department of Family Medicine and Community Health, Rutgers University, New Brunswick, NJ, USA
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
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Sayson LV, Jeon SJ, Ortiz DM, Lee HJ, Campomayor NB, Kim HJ, Kim M. Heukharang ( Lactuca sativa L.) extracts enhanced the sleep behavior of mice: potential involvement of adenosine A 1 and A 2A receptors. Sleep Biol Rhythms 2024; 22:385-394. [PMID: 38962793 PMCID: PMC11217248 DOI: 10.1007/s41105-024-00522-3] [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: 12/21/2023] [Accepted: 02/27/2024] [Indexed: 07/05/2024]
Abstract
A significant proportion of the world's population suffers from insomnia, a disorder characterized by complications in initiating and maintaining sleep. Many medications used to treat insomnia target the γ-aminobutyric acid (GABA) neurotransmitter system. However, these substances, such as benzodiazepines, induce significant adverse consequences, including dependence and memory impairment, after prolonged use. Thus, current studies are aimed at developing therapeutic hypnotics derived from natural sources that may cause less severe side effects. Heukharang is a variety of lettuce from Korea that was discovered to contain sleep-promoting compounds. Therefore, we investigated the potential effects of sub-chronic administration of Heukharang extract (FSD-LS) on sleep behavior (pentobarbital-induced sleeping test), brain wave activity and sleep architecture (electroencephalography), and physiological behavior (open-field test and rota-rod) in mice, along with radioligand binding assays (GABAA, adenosine A1 and A2A receptors). We found that FSD-LS prolonged the total sleep duration and reduced the onset time of sleep, and enhanced delta wave power and non-rapid eye movement (NREM) sleep duration, all indicating persistent sleep-enhancing effects. FSD-LS lacked adverse effects on the spontaneous locomotor activity and motor coordination of mice, unlike diazepam. Pharmacological blocking using caffeine and bicuculline supported the possible involvement of adenosine receptors in the sleep-promoting effects of FSD-LS, with partial contribution from GABA receptor activity. Overall, our study recommends FSD-LS as a potential source for the development of sleep-aiding therapeutics.
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Affiliation(s)
- Leandro Val Sayson
- Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
| | - Se Jin Jeon
- Department of Pharmacology, College of Medicine, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do 24252 Republic of Korea
| | - Darlene Mae Ortiz
- Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
- College of Pharmacy, Dongduk Women’s University, 60 Hwarang-ro, Seongbuk-gu, Seoul, 02748 Republic of Korea
| | - Hyun Jun Lee
- Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
| | - Nicole Bon Campomayor
- Department of Chemistry & Life Science, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
| | - Hee Jin Kim
- Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
| | - Mikyung Kim
- Department of Chemistry & Life Science, Sahmyook University, 815 Hwarang-ro, Nowon-gu, Seoul, 01795 Republic of Korea
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Balbim GM, Falck RS, Boa Sorte Silva NC, Kramer AF, Voss M, Liu-Ambrose T. The Association of the 24-Hour Activity Cycle Profiles With Cognition in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae099. [PMID: 38642387 PMCID: PMC11167489 DOI: 10.1093/gerona/glae099] [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: 08/30/2023] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviors can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles. METHODS We conducted a cross-sectional analysis utilizing baseline data from 3 randomized controlled trials involving 253 community-dwelling older adults (55 + years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition. RESULTS Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n = 103) engaged in all 24-HAC behaviors around the sample average. Profile 2 ("Active Chillers," n = 70) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behavior. Profile 3 ("Physical Activity Masters," n = 54) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n = 26) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p > .05). CONCLUSIONS Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.
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Affiliation(s)
- Guilherme Moraes Balbim
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Ryan S Falck
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Michelle Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
- Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa, USA
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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Mo W, Liu X, Yamakawa M, Koujiya E, Takeya Y, Shigenobu K, Adachi H, Ikeda M. Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116067. [PMID: 38964141 DOI: 10.1016/j.psychres.2024.116067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/28/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan.
| | - Eriko Koujiya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka, Japan; Asakayama General Hospital, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University
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Long JJ, Chen Y, Kim B, Bae S, Li Y, Orandi BJ, Chu NM, Mathur A, Segev DL, McAdams-DeMarco MA. Sleep Disorders and Dementia Risk in Older Patients with Kidney Failure: A Retrospective Cohort Study. Clin J Am Soc Nephrol 2024:01277230-990000000-00412. [PMID: 38913442 DOI: 10.2215/cjn.0000000000000504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024]
Abstract
Key Points
Older patients with kidney failure who are newly diagnosed with sleep disorders are at higher risk of developing any type of dementia, vascular dementia, and other/mixed types of dementia.For older patients with kidney failure who are diagnosed with obstructive sleep apnea, positive airway pressure therapy is an intervention that is associated with lower dementia risk.
Background
Community-dwelling older adults with sleep disorders are at higher risk of developing dementia. Greater than 50% of older patients with kidney failure experience sleep disorders, which may explain their high burden of dementia.
Methods
Among 216,158 patients (aged 66 years and older) with kidney failure (United States Renal Data System; 2008–2019), we estimated the risk of dementia (including subtypes) associated with sleep disorders using Cox proportional hazards models with propensity score weighting. We tested whether positive airway pressure (PAP) therapy was associated with reduced dementia risk among patients with obstructive sleep apnea (OSA).
Results
26.3% of patients were diagnosed with sleep disorders; these patients had a higher 5-year unadjusted cumulative incidence for any type of dementia (36.2% versus 32.3%; P < 0.001), vascular dementia (4.4% versus 3.7%; P < 0.001), and other/mixed dementia (29.3% versus 25.8%; P < 0.001). Higher risk of any type of dementia was identified in patients with insomnia (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 1.34 to 1.51), sleep-related breathing disorders (SRBDs) (aHR, 1.20, 95% CI, 1.17 to 1.23), and other sleep disorders (aHR, 1.24; 95% CI, 1.11 to 1.39). Higher vascular dementia risk was observed in patients with insomnia (aHR, 1.43; 95% CI, 1.19 to 1.73) and SRBDs (aHR, 1.15; 95% CI, 1.07 to 1.24). Patients with SRBDs (aHR, 1.07; 95% CI, 1.00 to 1.15) were at higher risk of Alzheimer disease. Among patients with OSA, PAP therapy was associated with lower risk of any type of dementia (aHR, 0.82; 95% CI, 0.76 to 0.90) and vascular dementia (aHR, 0.65; 95% CI, 0.50 to 0.85).
Conclusions
Older patients with kidney failure and sleep disorders are at a higher risk of dementia. Sleep is an important modifiable factor that should be considered for targeted interventions to mitigate dementia risk in patients with kidney failure. For patients with OSA, PAP therapy is associated with lower dementia risk.
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Affiliation(s)
- Jane J Long
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Yusi Chen
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Byoungjun Kim
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Sunjae Bae
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Yiting Li
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Babak J Orandi
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Medicine, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aarti Mathur
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dorry L Segev
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Mara A McAdams-DeMarco
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
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Wang K, Li Y, Na M, Wang C, Ba DM, Sun L, Gao X. Association between gardening and multiple sleep complaints: A nationwide study of 62,098 adults. J Affect Disord 2024; 355:131-135. [PMID: 38554878 DOI: 10.1016/j.jad.2024.03.102] [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: 10/27/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Physical activity was suggested to be related to sleep health, while the gardening-sleep association among the community population remained unrevealed. Therefore, this study aimed to explore whether gardening was associated with sleep complaints. METHODS A total of 62,098 adults from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) were included in this study and further categorized as non-exercisers, gardeners, and other exercisers, based on their self-reported exercise status. Sleep complaints including short/prolonged sleep duration, probable insomnia, daytime sleepiness, and sleep apnea were surveyed via a questionnaire. Primary outcome was multiple sleep complaints (coexistence of ≥2 sleep complaints) and secondary outcomes referred to individual sleep complaints. The adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated to assess the associations between gardening or tertiles of gardening duration and the outcomes using multivariable logistic regression models. RESULTS The sample included 16,707 non-exercisers, 4243 gardeners, and 41,148 other exercisers. Relative to non-exercisers, gardeners (OR 0.58, 95%CI 0.49-0.67) and other exercisers (OR 0.67, 95%CI 0.61-0.72) had a lower likelihood of experiencing multiple sleep complaints. The adjusted OR comparing the highest gardening duration tertile to non-exercise was 0.45 (95%CI 0.33-0.63) for multiple sleep complaints (P for trend <0.001). Similar patterns persisted in several individual sleep complaints, such as short sleep duration, probable insomnia, daytime sleepiness, and sleep apnea. LIMITATIONS Cross-sectional study design and use of self-reported variables. CONCLUSIONS This nationwide study observed an inverse association of gardening with multiple sleep complaints and several individual sleep complaints, in a dose-response manner.
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Affiliation(s)
- Kaiyue Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200032, China
| | - Yaqi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200032, China
| | - Muzi Na
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA 16802, USA
| | - Chen Wang
- Shanghai Research Institute of Sports Science, Shanghai 200030, China
| | - Djibril M Ba
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200032, China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai 200032, China.
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Zhou L, Zhang Y, Ge M, Zhang G, Cheng R, Liu Y, Chen X, Liu X, Dong B. The associations of daytime napping and motoric cognitive risk syndrome: Findings from the China Health and Retirement Longitudinal Study. Exp Gerontol 2024; 191:112426. [PMID: 38604250 DOI: 10.1016/j.exger.2024.112426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Motoric cognitive risk syndrome (MCR), characterized by subjective cognitive complaints and slow gait in older populations, is associated with sleep duration. However, the association between MCR and daytime nap duration has not been thoroughly explored. METHODS Baseline data from the China Health and Retirement Longitudinal Study (CHARLS) were used in this study. MCR was defined as the coexistence of subjective cognitive complaints and objective slow gait speed without a history of dementia or mobility disability. Daytime nap duration was categorized into four groups: no napping, short napping (<30 min), moderate napping (30-89 min) and extended napping (≥90 min). Multivariable logistic regression models were used to explore the association of daytime napping duration and MCR. RESULTS A total of 4230 individuals aged ≥60 were included in the current analysis, of which 463 were diagnosed with MCR. Moderate napping of 30-89 min per day was found to be significantly associated with lower odds of MCR compared with the reference group of no napping. In subgroup analysis, individuals with sleep durations of <7 h per night had lower odds of MCR in the model that adjusted for all potential confounders with ≥30 min daytime nap duration compared with no napping. Interestingly, for people with a night sleep duration of 7-8 h, only those with a moderate nap of 30-89 min had lower odds of MCR than non-nappers after adjustment for potential confounders. CONCLUSION A moderate nap of 30-89 min could lower the odds of MCR, especially for older adults with a night sleep duration of ≤8 h.
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Affiliation(s)
- Lixing Zhou
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Zhang
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Meiling Ge
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Gongchang Zhang
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Cheng
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Department of Geriatrics, West China Xiamen Hospital of Sichuan University, Xiamen, China
| | - Yixin Liu
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoli Chen
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
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Rai P, Sundarakumar JS. Shorter sleep duration and lesser sleep efficiency are associated with poorer memory functions among non-demented, middle-aged, and older rural Indians. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae038. [PMID: 39011420 PMCID: PMC11247525 DOI: 10.1093/sleepadvances/zpae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/22/2024] [Indexed: 07/17/2024]
Abstract
Introduction Sleep is known to be involved in cognitive processes, such as memory encoding and consolidation, and poor sleep is a potential risk factor for dementia. This study aims to investigate the effect of sleep quality on memory functions among middle-aged and older adults from a rural Indian population. Methods Participants were non-demented, rural Indians (≥45 years) from an ongoing, prospective, aging cohort study, namely Srinivaspura Aging, NeuroSenescence, and COGnition (SANSCOG) study. Cross-sectional (baseline) data on seven sleep dimensions was obtained using the Pittsburgh Sleep Quality Index (PSQI). Memory functions were assessed using immediate recall, delayed recall, name-face association, and semantic association from a culturally validated, computerized, neurocognitive test battery. Linear regression models, unadjusted and adjusted for cognitive status, age, sex, and depression were used to analyze the association between each sleep dimension and the memory tests. Results A total of 1195 participants, with a mean age of 57.10 years, were included. Out of the seven sleep dimensions of the PSQI, only two dimensions, namely sleep duration and sleep efficiency, were significantly associated with memory functions. In the fully adjusted model, shorter sleep duration was significantly associated with poorer performance in delayed recall, and lesser sleep efficiency was significantly associated with poorer delayed recall and semantic association performance. Conclusions Specific sleep characteristics appear to influence memory functions in aging Indians well before the onset of dementia. In the backdrop of the non-availability of a definitive treatment for dementia, promptly identifying and addressing these problems could be an effective, community-level strategy for preventing dementia.
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Affiliation(s)
- Pooja Rai
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
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Hallab A. High serum Cholesterol and Triglyceride levels in older adults: associations with sleep and nighttime behavior disorders at baseline and a prediction analysis of incidental cases at 12 months follow-up. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.05.24308529. [PMID: 38883726 PMCID: PMC11178015 DOI: 10.1101/2024.06.05.24308529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Introduction This study explored the association between dyslipidemia and sleep and nighttime behavior disorders (SNBD) in the elderly. Methods ADNI population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between dyslipidemia and SNBD at baseline and 12 months. Relevant confounders were adjusted for. Results Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 (IQR: 68, 78). At baseline, 357 (16%) had SNBD, and 327 (18%) at 12 months; 187 were incident cases.There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, p-value=0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, p-value=0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, p-value<0.001).Only hypertriglyceridemia was significantly associated with baseline SNBD (crude OR=1.43, 95%CI: 1.13,1.80, p-value=0.003), even after adjustment for confounding factors (adj.OR=1.36, 95%CI: 1.06,1.74, p-value=0.016) and (BMI-adj.OR=1.29, 95%CI: 1.00,1.66, p-value=0.048). None of the dyslipidemia forms did predict incident cases at 12 months. Conclusions Hypertriglyceridemia, but not hypercholesterolemia, was associated with higher odds of SNBD. None of the dyslipidemia forms predicted incidental SNBD over 12 months.
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Affiliation(s)
- Asma Hallab
- Biologie Intégrative et Physiologie – Parcours Neurosciences Cellulaires. Faculté des Sciences et Ingénierie. Sorbonne Université, Paris, France
- Pathologie du Sommeil. Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin. Institut of Public Health. Berlin, Germany
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11
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Monti MM. The subcortical basis of subjective sleep quality. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.29.596530. [PMID: 38854024 PMCID: PMC11160773 DOI: 10.1101/2024.05.29.596530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Study objectives To assess the association between self-reported sleep quality and cortical and subcortical local morphometry. Methods Sleep and neuroanatomical data from the full release of the young adult Human Connectome Project dataset were analyzed. Sleep quality was operationalized with the Pittsburgh Sleep Quality Index (PSQI). Local cortical and subcortical morphometry was measured with subject-specific segmentations resulting in voxelwise thickness measurements for cortex and relative (i.e., cross-sectional) local atrophy measurements for subcortical regions. Results Relative atrophy across several subcortical regions, including bilateral pallidum, striatum, and thalamus, was negatively associated with both global PSQI score and sub-components of the index related to sleep duration, efficiency, and quality. Conversely, we found no association between cortical morphometric measurements and self-reported sleep quality. Conclusions This work shows that subcortical regions such as the bilateral pallidum, thalamus, and striatum, might be interventional targets to ameliorate self-reported sleep quality.
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Affiliation(s)
- Martin M. Monti
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, 90095, CA, USA
- Brain Injury Research Center (BIRC), Department of Neurosurgery, University of California Los Angeles, 300 Stein Plaza Driveway, Los Angeles, 90095, CA, USA
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12
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Islam MA, Sehar U, Sultana OF, Mukherjee U, Brownell M, Kshirsagar S, Reddy PH. SuperAgers and centenarians, dynamics of healthy ageing with cognitive resilience. Mech Ageing Dev 2024; 219:111936. [PMID: 38657874 DOI: 10.1016/j.mad.2024.111936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
Graceful healthy ageing and extended longevity is the most desired goal for human race. The process of ageing is inevitable and has a profound impact on the gradual deterioration of our physiology and health since it triggers the onset of many chronic conditions like dementia, osteoporosis, diabetes, arthritis, cancer, and cardiovascular disease. However, some people who lived/live more than 100 years called 'Centenarians" and how do they achieve their extended lifespans are not completely understood. Studying these unknown factors of longevity is important not only to establish a longer human lifespan but also to manage and treat people with shortened lifespans suffering from age-related morbidities. Furthermore, older adults who maintain strong cognitive function are referred to as "SuperAgers" and may be resistant to risk factors linked to cognitive decline. Investigating the mechanisms underlying their cognitive resilience may contribute to the development of therapeutic strategies that support the preservation of cognitive function as people age. The key to a long, physically, and cognitively healthy life has been a mystery to scientists for ages. Developments in the medical sciences helps us to a better understanding of human physiological function and greater access to medical care has led us to an increase in life expectancy. Moreover, inheriting favorable genetic traits and adopting a healthy lifestyle play pivotal roles in promoting longer and healthier lives. Engaging in regular physical activity, maintaining a balanced diet, and avoiding harmful habits such as smoking contribute to overall well-being. The synergy between positive lifestyle choices, access to education, socio-economic factors, environmental determinants and genetic supremacy enhances the potential for a longer and healthier life. Our article aims to examine the factors associated with healthy ageing, particularly focusing on cognitive health in centenarians. We will also be discussing different aspects of ageing including genomic instability, metabolic burden, oxidative stress and inflammation, mitochondrial dysfunction, cellular senescence, immunosenescence, and sarcopenia.
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Affiliation(s)
- Md Ariful Islam
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Omme Fatema Sultana
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Upasana Mukherjee
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sudhir Kshirsagar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA.
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Riemann D, Dressle RJ, Benz F, Spiegelhalder K, Johann AF, Nissen C, Hertenstein E, Baglioni C, Palagini L, Krone L, Perlis ML, Domschke K, Berger M, Feige B. Chronic insomnia, REM sleep instability and emotional dysregulation: A pathway to anxiety and depression? J Sleep Res 2024:e14252. [PMID: 38811745 DOI: 10.1111/jsr.14252] [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: 02/13/2024] [Revised: 04/21/2024] [Accepted: 05/19/2024] [Indexed: 05/31/2024]
Abstract
The world-wide prevalence of insomnia disorder reaches up to 10% of the adult population. Women are more often afflicted than men, and insomnia disorder is a risk factor for somatic and mental illness, especially depression and anxiety disorders. Persistent hyperarousals at the cognitive, emotional, cortical and/or physiological levels are central to most theories regarding the pathophysiology of insomnia. Of the defining features of insomnia disorder, the discrepancy between minor objective polysomnographic alterations of sleep continuity and substantive subjective impairment in insomnia disorder remains enigmatic. Microstructural alterations, especially in rapid eye movement sleep ("rapid eye movement sleep instability"), might explain this mismatch between subjective and objective findings. As rapid eye movement sleep represents the most highly aroused brain state during sleep, it might be particularly prone to fragmentation in individuals with persistent hyperarousal. In consequence, mentation during rapid eye movement sleep may be toned more as conscious-like wake experience, reflecting pre-sleep concerns. It is suggested that this instability of rapid eye movement sleep is involved in the mismatch between subjective and objective measures of sleep in insomnia disorder. Furthermore, as rapid eye movement sleep has been linked in previous works to emotional processing, rapid eye movement sleep instability could play a central role in the close association between insomnia and depressive and anxiety disorders.
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Affiliation(s)
- Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Division of Psychiatric Specialties, Department of Psychiatry, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - Elisabeth Hertenstein
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
| | - Laura Palagini
- Department of Experimental and Clinical Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Lukas Krone
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Physiology, Anatomy and Genetics, Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
- Centre for Neural Circuits and Behaviour, University of Oxford, Oxford, UK
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Center for Mental Health (DZPG) partner site Berlin, Berlin, Germany
| | - Mathias Berger
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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14
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Winer JR. The role of actigraphy in detecting and characterizing the early phases of Alzheimer's disease. Sleep 2024; 47:zsae076. [PMID: 38497688 PMCID: PMC11082468 DOI: 10.1093/sleep/zsae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
- Joseph R Winer
- Department of Neurology and Neurological Sciences, Stanford University, Stanford CA, USA
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15
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Spira AP, Liu F, Zipunnikov V, Bilgel M, Rabinowitz JA, An Y, Di J, Bai J, Wanigatunga SK, Wu MN, Lucey BP, Schrack JA, Wanigatunga AA, Rosenberg PB, Simonsick EM, Walker KA, Ferrucci L, Resnick SM. Evaluating a novel 24-hour rest/activity rhythm marker of preclinical β-amyloid deposition. Sleep 2024; 47:zsae037. [PMID: 38381532 PMCID: PMC11082462 DOI: 10.1093/sleep/zsae037] [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: 08/09/2023] [Revised: 01/10/2024] [Indexed: 02/23/2024] Open
Abstract
STUDY OBJECTIVES To compare sleep and 24-hour rest/activity rhythms (RARs) between cognitively normal older adults who are β-amyloid-positive (Aβ+) or Aβ- and replicate a novel time-of-day-specific difference between these groups identified in a previous exploratory study. METHODS We studied 82 cognitively normal participants from the Baltimore Longitudinal Study of Aging (aged 75.7 ± 8.5 years, 55% female, 76% white) with wrist actigraphy data and Aβ+ versus Aβ- status measured by [11C] Pittsburgh compound B positron emission tomography. RARs were calculated using epoch-level activity count data from actigraphy. We used novel, data-driven function-on-scalar regression analyses and standard RAR metrics to cross-sectionally compare RARs between 25 Aβ+ and 57 Aβ- participants. RESULTS Compared to Aβ- participants, Aβ+ participants had higher mean activity from 1:00 p.m. to 3:30 p.m. when using less conservative pointwise confidence intervals (CIs) and from 1:30 p.m. to 2:30 p.m. using more conservative, simultaneous CIs. Furthermore, Aβ+ participants had higher day-to-day variability in activity from 9:00 a.m. to 11:30 a.m. and lower variability from 1:30 p.m. to 4:00 p.m. and 7:30 p.m. to 10:30 p.m. according to pointwise CIs, and lower variability from 8:30 p.m. to 10:00 p.m. using simultaneous CIs. There were no Aβ-related differences in standard sleep or RAR metrics. CONCLUSIONS Findings suggest Aβ+ older adults have higher, more stable day-to-day afternoon/evening activity than Aβ- older adults, potentially reflecting circadian dysfunction. Studies are needed to replicate our findings and determine whether these or other time-of-day-specific RAR features have utility as markers of preclinical Aβ deposition and if they predict clinical dementia and agitation in the afternoon/evening (i.e. "sundowning").
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Affiliation(s)
- Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Murat Bilgel
- National Institute on Aging Intramural Research Program, Baltimore MD, USA
| | - Jill A Rabinowitz
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Yang An
- National Institute on Aging Intramural Research Program, Baltimore MD, USA
| | - Junrui Di
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jiawei Bai
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark N Wu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Jennifer A Schrack
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amal A Wanigatunga
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Keenan A Walker
- National Institute on Aging Intramural Research Program, Baltimore MD, USA
| | - Luigi Ferrucci
- National Institute on Aging Intramural Research Program, Baltimore MD, USA
| | - Susan M Resnick
- National Institute on Aging Intramural Research Program, Baltimore MD, USA
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16
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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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17
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Yu Z, Han L, Yan P, Liu W, Ren L, Xu Y, Yang L, Ma L, Liu Y, Wang S. Doxepin is more effective than zolpidem in improving executive function in patients with insomnia disorder. Sleep Breath 2024; 28:929-934. [PMID: 38123719 DOI: 10.1007/s11325-023-02972-4] [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: 03/27/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND : Insomnia disorder is associated with an impairment in cognitive performance. Doxepin and zolpidem have been found to be effective in improving sleep. In this study, we aimed to compare the effects of doxepin and zolpidem on sleep structure and executive function in patients with insomnia disorder. METHODS Patients with primary insomnia were randomly assigned to receive doxepin 6 mg/day orally or zolpidem 5-10 mg/day orally. Polysomnography (PSG) and the Pittsburgh Sleep Quality Index (PSQI) were used at baseline and after the 8-week treatment to compare clinical efficacy in the two groups. Safety was assessed using the Treatment Emergent Symptom Scale (TESS). Executive function was evaluated using the Wisconsin sorting card test (WSCT). RESULTS Of 120 patients enrolled in the study, 60 participants were assigned to each group. A total of 109 participants (53 in the doxepin group and 56 in the zolpidem group) completed the study. After treatment, the wake after sleep onset (WASO) and total sleep time (TST) values in the doxepin group were 80.3 ± 21.4 min and 378.9 ± 21.9 min, respectively, which were significantly better than those in the zolpidem group (132.9 ± 26.5 min and 333.2 ± 24.2 min, respectively; (P < 0.05)). The sleep onset latency (SOL) value in the zolpidem group (20.3 ± 4.7 min) was significantly better than that in the doxepin group (28.2 ± 5.6 min; P < 0.05). The sleep efficiency (SE) in the doxepin group was 77.8 ± 4.2%, which was significantly better than that in the zolpidem group (68.6 ± 5.0%; P < 0.05). The PSQI score of the doxepin group was 6.1 ± 1.1, which was significantly lower than that in the zolpidem group (7.9 ± 1.9; P < 0.05). The treatment adverse events in the doxepin group was 23.3%, which was significantly higher than that in the zolpidem group (13.3%; P < 0.05). The WSCT showed a significant improvement in persistent errors (PE), random errors (RE), and categories in the two groups after 8-week treatment, and the improvement in RE and the categories was more obvious in the doxepin group (P < 0.05). CONCLUSIONS Both doxepin and zolpidem were found to be effective in improving sleep quality, but the effects exhibited different patterns. Doxepin improved executive function more effectively than zolpidem in patients with insomnia disorder.
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Affiliation(s)
- Zhenghe Yu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Li Han
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Pan Yan
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
- The Molecular Biology Laboratory, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
| | - Wenjuan Liu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lishan Ren
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - You Xu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lili Yang
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Lisha Ma
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Yi Liu
- Department of Medical Psychology, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China
| | - Shengdong Wang
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou, 310013, China.
- The Molecular Biology Laboratory, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China.
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18
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Li J, Wang X, Liu M, Yin Y, Wu Y, Xu G, Ma X. Sex-specific grey matter abnormalities in individuals with chronic insomnia. Neurol Sci 2024; 45:2301-2310. [PMID: 38063921 DOI: 10.1007/s10072-023-07224-7] [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: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 04/17/2024]
Abstract
Previous studies have reported sex differences in altered brain function in patients with chronic insomnia (CI). However, sex-related alterations in brain morphology have rarely been investigated. This study aimed to investigate sex-specific grey matter (GM) alterations in patients with CI and to examine the relationship between GM alterations and neuropsychological assessments. Ninety-three (65 females and 28 males) patients and 78 healthy (50 females and 28 males) controls were recruited. Structural magnetic resonance imaging data were analysed using voxel-based morphometry to test for interactions between sex and diagnosis. Spearman's correlation was used to assess the associations among structure, disease duration, and sleep-, mood-, and cognition-related assessments. Males with CI showed reduced GM volume in the left inferior parietal lobe, left middle cingulate cortex, and right supramarginal gyrus. Females with CI showed increased GM volume in the right Rolandic operculum. Moreover, mood-related assessments were negatively correlated with GM volumes in the right supramarginal gyrus and left inferior parietal lobe in the male patients, and cognitive-related assessments were positively correlated with GM volumes in the Rolandic operculum in the female patients. Our findings indicate sex-specific alterations in brain morphology in CI, thereby broadening our understanding of sex differences in CI and potentially providing complementary evidence for the development of more effective therapies and individual treatments.
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Affiliation(s)
- Jingwen Li
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
- The Second School of Clinical Medicine, Southern Medial University, No. 253 Industrial Avenue Central, Guangzhou, 510260, P. R. China
| | - Xinzhi Wang
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Mengchen Liu
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Yi Yin
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Yunfan Wu
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Guang Xu
- Department of Neurology, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Xiaofen Ma
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China.
- The Second School of Clinical Medicine, Southern Medial University, No. 253 Industrial Avenue Central, Guangzhou, 510260, P. R. China.
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Tang F, Zhu Y, Jayawardena D, Jin G, Jiang Y. Sleep quality and cognitive functioning among Chinese older adults living in the US: A mixed-effects model analysis. RESEARCH SQUARE 2024:rs.3.rs-4293848. [PMID: 38746099 PMCID: PMC11092822 DOI: 10.21203/rs.3.rs-4293848/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Racial and ethnic disparities in sleep quality and cognitive health are increasingly recognized, yet little is understood about their associations among Chinese older adults living in the United States. This study aims to examine the relationships between sleep parameters and cognitive functioning in this population, utilizing data from the Population Study of Chinese Elderly in Chicago (PINE). Methods This observational study utilized a two-wave panel design as part of the PINE, including 2,228 participants aged 65 years or older, self-identified as Chinese, who completed interviews at two time points. Cognitive functioning was assessed using a battery of tests on perceptual speed, episodic memory, working memory, and mental status. Sleep quality was assessed using Pittsburgh sleep quality index (PSQI) with four aspects: subjective sleep quality, sleep latency, sleep efficiency, and sleep duration at night. Insomnia was assessed using four items from the Women's Health Initiative Insomnia Rating Scale. Mixed-effects regression models were estimated to assess the predictive effects of sleep parameters on baseline cognitive functioning and the rate of cognitive change over time. Results Significant negative associations were observed between poor sleep quality and baseline cognitive functioning across various domains, although these initial negative associations diminished over time. More insomnia problems were related to poorer perceptual speed and episodic memory. Long sleep latency, or a long time to sleep onset, was associated with worse functioning across all domains except mental status. Sleep efficiency showed inconsistent associations with various cognitive domains, while sleep duration showed no significant relation to any domains. Conclusions These findings suggest that poor sleep quality indicators serve as early markers of cognitive impairments. Hence, targeted interventions aimed at improving sleep quality could potentially enhance cognitive health outcomes.
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Tang S, Liu R, Ren J, Song L, Dong L, Qin Y, Zhao M, Wang Y, Dong Y, Zhao T, Liu C, Hou T, Cong L, Sindi S, Winblad B, Du Y, Qiu C. Association of objective sleep duration with cognition and brain aging biomarkers in older adults. Brain Commun 2024; 6:fcae144. [PMID: 38756537 PMCID: PMC11098043 DOI: 10.1093/braincomms/fcae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/21/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
The neuropathological mechanisms underlying the association between sleep duration and mild cognitive impairment remain poorly understood. This population-based study included 2032 dementia-free people (age ≥ 60 years; 55.1% women) derived from participants in the Multimodal Interventions to Delay Dementia and Disability in Rural China; of these, data were available in 841 participants for Alzheimer's plasma biomarkers (e.g. amyloid-β, total tau and neurofilament light chain), 1044 for serum microvascular biomarkers (e.g. soluble adhesion molecules) and 834 for brain MRI biomarkers (e.g. whiter matter, grey matter, hippocampus, lacunes, enlarged perivascular spaces and white matter hyperintensity WMH). We used electrocardiogram-based cardiopulmonary coupling analysis to measure sleep duration, a neuropsychological test battery to assess cognitive function and the Petersen's criteria to define mild cognitive impairment. Data were analysed with multivariable logistic and general linear models. In the total sample (n = 2032), 510 participants were defined with mild cognitive impairment, including 438 with amnestic mild cognitive impairment and 72 with non-amnestic mild cognitive impairment. Long sleep duration (>8 versus 6-8 h) was significantly associated with increased likelihoods of mild cognitive impairment and non-amnestic mild cognitive impairment and lower scores in global cognition, verbal fluency, attention and executive function (Bonferroni-corrected P < 0.05). In the subsamples, long sleep duration was associated with higher plasma amyloid-β40 and total tau, a lower amyloid-β42/amyloid-β40 ratio and smaller grey matter volume (Bonferroni-corrected P < 0.05). Sleep duration was not significantly associated with serum-soluble adhesion molecules, white matter hyperintensity volume, global enlarged perivascular spaces and lacunes (P > 0.05). Alzheimer's and neurodegenerative pathologies may represent common pathways linking long sleep duration with mild cognitive impairment and low cognition in older adults.
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Affiliation(s)
- Shi Tang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Rui Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lingling Dong
- Department of Neurology, Dongying People’s Hospital, Dongying 257091, China
| | - Yu Qin
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng 252000, China
| | - Mingqing Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tong Zhao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Shireen Sindi
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Neuroepidemiology and Ageing Research Unit (AGE), School of Public Health, Imperial College London, London SW7 2AZ, United Kingdom
| | - Bengt Winblad
- Division of Neurogeriatrics and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
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Liu X, Lu B, Huang H. Investigation of the shared biological mechanisms and common biomarker APTAF1 of sleep deprivation and mild cognitive impairment using integrated bioinformatics analysis. Front Pharmacol 2024; 15:1387569. [PMID: 38694919 PMCID: PMC11061425 DOI: 10.3389/fphar.2024.1387569] [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: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction: The relationship between sleep loss and cognitive impairment has long been widely recognized, but there is still a lack of complete understanding of the underlying mechanisms and potential biomarkers. The purpose of this study is to further explore the shared biological mechanisms and common biomarkers between sleep loss and cognitive impairment. Methods: The mitochondria-related genes and gene expression data were downloaded from the MitoCarta3.0 and Gene Expression Omnibus (GEO) databases. We identified the differentially expressed mitochondrial-related genes by combing the differentially expressed genes (DEGs) in sleep deprivation (SD) and mild cognitive impairment (MCI) datasets with mitochondria-related gene lists. Shared DEGs were then further analyzed for enrichment analysis. Next, the common biomarker was identified using two machine learning techniques and further validated using two independent GEO datasets. Then GSEA and GSVA were conducted to analyze the functional categories and pathways enriched for the common biomarker. Finally, immune infiltration analysis was used to investigate the correlation of immune cell infiltration with the common biomarker in SD and MCI. Results: A total of 32 mitochondrial-related differentially expressed genes were identified in SD and MCI. GO analysis indicated that these genes were significantly enriched for mitochondrial transport, and KEGG analysis showed they were mainly involved in pathways of neurodegenerative diseases. In addition, ATPAF1, which was significantly down-regulated in both SD and MCI, was identified through machine learning algorithms as the common biomarker with favorable diagnostic performance. GSEA and GSVA revealed that ATPAF1 was mainly involved in metabolic pathways, such as oxidative phosphorylation, acetylcholine metabolic process, valine, leucine and isoleucine degradation. Immune infiltration analysis showed that the expression of ATPAF1 was correlated with changes in immune cells, especially those key immune cell types associated with SD and MCI. Discussion: This study firstly revealed that mitochondrial dysfunction may be the common pathogenesis of sleep loss and mild cognitive impairment and identified ATPAF1 as a possible biomarker and therapeutic target involved in SD and MCI.
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Affiliation(s)
- Xiaolan Liu
- Wuhan Mental Health Center, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Baili Lu
- Wuhan Mental Health Center, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
| | - Hui Huang
- Wuhan Mental Health Center, Wuhan, Hubei, China
- Wuhan Hospital for Psychotherapy, Wuhan, Hubei, China
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Guo H, Li LH, Lv XH, Su FZ, Chen J, Xiao F, Shi M, Xie YB. Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Elderly: A Retrospective Cohort Study. Nat Sci Sleep 2024; 16:389-400. [PMID: 38646462 PMCID: PMC11032121 DOI: 10.2147/nss.s452517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/04/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose Postoperative sleep disturbance, characterized by diminished postoperative sleep quality, is a risk factor for postoperative delirium (POD); however, the association between pre-existing sleep disturbance and POD remains unclear. This study aimed to evaluate the association between preoperative sleep disturbance and POD in elderly patients after non-cardiac surgery. Patients and methods This retrospective cohort study was conducted at a single center and enrolled 489 elderly patients who underwent surgery between May 1, 2020, and March 31, 2021. Patients were divided into the sleep disorder (SD) and non-sleep disorder (NSD) groups according to the occurrence of one or more symptoms of insomnia within one month or sleep- Numerical Rating Scale (NRS)≥6 before surgery. The primary outcome was the incidence of POD. Propensity score matching analysis was performed between the two groups. Multiple logistic regression analysis was performed to identify the risk factors for POD. Results In both the unmatched cohort (16.0% vs 6.7%, P=0.003) and the matched cohort (17.0% vs 6.2%, P=0.023), the incidence of POD was higher in the SD group than in the NSD group. In addition, the postoperative sleep quality and the VAS score at postoperative 24 h were significantly lower in the SD group than in the NSD group. Multivariate logistic regression analysis indicated that age (Odds Ratio, 1.13 [95% CI: 1.04-1.23], P=0.003) and preoperative sleep disturbance (Odds Ratio, 3.03 [95% CI: 1.09-9.52], P=0.034) were independent risk factors for the development of POD. Conclusion The incidence of POD was higher in patients with pre-existing sleep disturbance than those without it. Whether improving sleep quality for preoperative sleep disturbance may help prevent POD remains to be determined.
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Affiliation(s)
- Hao Guo
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Li-Heng Li
- Department of Anesthesiology, The Guilin Municipal Hospital of Traditional Chinese Medicine, Guangxi, People’s Republic of China
| | - Xiao-Hong Lv
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Feng-Zhi Su
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Jie Chen
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Fei Xiao
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Min Shi
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Yu-Bo Xie
- Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
- Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
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Ringin E, Dunstan DW, Meyer D, McIntyre RS, Owen N, Berk M, Hallgren M, Rossell SL, Van Rheenen TE. Relative associations of behavioral and physiological risks for cardiometabolic disease with cognition in bipolar disorder during mid and later-life: findings from the UK biobank. Psychol Med 2024:1-11. [PMID: 38563285 DOI: 10.1017/s0033291724000722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Cardiometabolic disease risk factors are disproportionately prevalent in bipolar disorder (BD) and are associated with cognitive impairment. It is, however, unknown which health risk factors for cardiometabolic disease are relevant to cognition in BD. This study aimed to identify the cardiometabolic disease risk factors that are the most important correlates of cognitive impairment in BD; and to examine whether the nature of the relationships vary between mid and later life. METHODS Data from the UK Biobank were available for 966 participants with BD, aged between 40 and 69 years. Individual cardiometabolic disease risk factors were initially regressed onto a global cognition score in separate models for the following risk factor domains; (1) health risk behaviors (physical activity, sedentary behavior, smoking, and sleep) and (2) physiological risk factors, stratified into (2a) anthropometric and clinical risk (handgrip strength, body composition, and blood pressure), and (2b) cardiometabolic disease risk biomarkers (CRP, lipid profile, and HbA1c). A final combined multivariate regression model for global cognition was then fitted, including only the predictor variables that were significantly associated with cognition in the previous models. RESULTS In the final combined model, lower mentally active and higher passive sedentary behavior, higher levels of physical activity, inadequate sleep duration, higher systolic and lower diastolic blood pressure, and lower handgrip strength were associated with worse global cognition. CONCLUSIONS Health risk behaviors, as well as blood pressure and muscular strength, are associated with cognitive function in BD, whereas other traditional physiological cardiometabolic disease risk factors are not.
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Affiliation(s)
- Elysha Ringin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, VIC, Australia
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Denny Meyer
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Roger S McIntyre
- Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, VIC, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Michael Berk
- Deakin University, The Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Orygen Youth Health, Melbourne, Australia
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
- St Vincent's Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
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Zhou L, Suwa S. Association among cognitive function, daytime activities, and nighttime sleep in older adults in a long-term care facility. Jpn J Nurs Sci 2024; 21:e12571. [PMID: 37937410 DOI: 10.1111/jjns.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 11/09/2023]
Abstract
AIM To determine how the nighttime sleep patterns of older adults in a long-term care facility vary according to cognitive function and participation in daytime activities. METHODS This observational study was conducted with older adults aged ≥65 years who are residents of a long-term care facility. Nighttime sleep was monitored using a non-wearable sleep monitor for 8 weeks. Based on the Mini-Mental State Examination scores for assessment of cognitive function, participants were classified into non-dementia, mild-to-moderate dementia, and severe dementia groups. The Mann-Whitney U test and Kruskal-Wallis test were used to analyze the data. RESULTS Twenty three older adults were included in this study. Sleep onset latency was significantly longer in the severe dementia group than in the non-dementia (p = .027) and mild-to-moderate dementia (p = .041) groups. Sleep efficiency was significantly lower in the severe dementia group than in the mild-to-moderate dementia group (p = .003), whereas wakefulness after sleep onset was significantly longer in the severe dementia group than in the mild-to-moderate dementia group (p = .011). The number of days spent engaging in recreational activities was <50%, whereas those spent taking a nap was >60% in all older adults. Older adults with mild-to-moderate dementia had better sleep and participated in more daytime activities than those with severe or no dementia. Moreover, bathing in a bathtub improved sleep onset latency. CONCLUSIONS This study demonstrates that participation in daytime activities and bathing in a bathtub affect nighttime sleep in older adults.
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Affiliation(s)
- Lu Zhou
- Doctoral Program, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Sayuri Suwa
- Department of Community Health Nursing, Division of Innovative Nursing for Life Course, Graduate School of Nursing, Chiba University, Chiba, Japan
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Guardia T, Cote KA, Healey MK, Gammage KL, Campbell KL. Self-reported physical activity and sleep quality is associated with working memory function in middle-aged and older adults during the COVID-19 pandemic. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024:1-20. [PMID: 38555591 DOI: 10.1080/13825585.2024.2333066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024]
Abstract
While previous work has shown a positive relationship between cognitive performance and lifestyle factors in younger adults, evidence for this relationship among middle-aged and older adults has been mixed. The current study aimed to further test the relationship among physical activity, sleep quality, and memory performance in middle-aged and older adults, and to test whether this relationship holds up during the COVID-19 pandemic. Our results showed that physical activity was associated with better sleep quality and better working memory performance, and better sleep quality was associated with better working memory and self-perceptions of everyday memory abilities. Additionally, we found that the effects of physical activity on working memory were partially mediated by sleep quality. While these effects were small and only correlational in nature, they lend further support to the notion that sleep quality and physical activity are beneficial to memory later in life, even during a global pandemic.
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Affiliation(s)
- Tiago Guardia
- Department of Psychology, Brock University, St. Catharines, Canada
| | - Kimberly A Cote
- Department of Psychology, Brock University, St. Catharines, Canada
| | - M Karl Healey
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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Overton M, Skoog J, Laukka EJ, Bodin TH, Mattsson AD, Sjöberg L, Hofer SM, Johansson L, Kulmala J, Kivipelto M, Solomon A, Skoog I, Kåreholt I, Sindi S. Sleep disturbances and change in multiple cognitive domains among older adults: a multicenter study of five Nordic cohorts. Sleep 2024; 47:zsad244. [PMID: 37708350 PMCID: PMC10925948 DOI: 10.1093/sleep/zsad244] [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: 02/09/2023] [Revised: 07/31/2023] [Indexed: 09/16/2023] Open
Abstract
STUDY OBJECTIVES We examined and compared cross-sectional and longitudinal associations between self-reported sleep disturbances and various cognitive domains in five separate Nordic European longitudinal aging studies (baseline N = 5631, mean age = 77.7, mean follow-up = 4.16 years). METHODS Comparable sleep parameters across studies included reduced sleep duration/quality, insomnia symptoms (sleep latency, waking up at night, and early awakenings), short and long sleep duration, and daytime napping. The cognitive domains were episodic memory, verbal fluency, perceptual speed, executive functioning, and global cognition (aggregated measure). A series of mixed linear models were run separately in each study and then compared to assess the level and rate of change in cognitive functioning across each sleep disturbance parameter. Models were adjusted for age, sex, education, hypnotic usage, depressive symptoms, lifestyle factors, cardiovascular, and metabolic conditions. By using a coordinated analytic approach, comparable construct-level measurements were generated, and results from identical statistical models were qualitatively compared across studies. RESULTS While the pattern of statistically significant results varied across studies, subjective sleep disturbances were consistently associated with worse cognition and steeper cognitive decline. Insomnia symptoms were associated with poorer episodic memory and participants sleeping less or more than 7-8 hours had a steeper decline in perceptual speed. In addition, daytime napping (>2 hours) was cross-sectionally and longitudinally associated with all examined cognitive domains. Most observed associations were study-specific (except for daytime napping), and a majority of association estimates remained significant after adjusting for covariates. CONCLUSION This rigorous multicenter investigation further supports the importance of sleep disturbance, including insomnia, long and short sleep duration, and daytime napping on baseline cognitive functioning and rate of change among older adults. These sleep factors may be targeted in future lifestyle interventions to reduce cognitive decline.
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Affiliation(s)
- Marieclaire Overton
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Johan Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Erika J Laukka
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Timothy Hadarsson Bodin
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Alexander Darin Mattsson
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Linnea Sjöberg
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Scott M Hofer
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Lena Johansson
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Jenni Kulmala
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ingemar Kåreholt
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Institute of Gerontology, School of Health and Welfare, Aging Research Network – Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
| | - Shireen Sindi
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
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Munns LB, Demnitz-King H, André C, Rehel S, Ourry V, de La Sayette V, Vivien D, Chételat G, Rauchs G, Marchant NL. Associations Between Repetitive Negative Thinking and Objective and Subjective Sleep Health in Cognitively Healthy Older Adults. Nat Sci Sleep 2024; 16:233-245. [PMID: 38476462 PMCID: PMC10928915 DOI: 10.2147/nss.s441509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/14/2024] Open
Abstract
Objective Poor sleep and high levels of repetitive negative thinking (RNT), including future-directed (ie, worry) and past-directed (ie, brooding) negative thoughts, have been associated with markers of dementia risk. The relationship between RNT and sleep health in older adults is unknown. This study aimed to investigate this association and its specificities including multiple dimensions of objective and subjective sleep. Methods This study used a cross sectional quantitative design with baseline data from 127 cognitively healthy older adults (mean age 69.4 ± 3.8 years; 63% female) who took part in the Age-Well clinical trial, France. RNT (ie, worry and brooding) levels were measured using the Penn State Worry Questionnaire and the Rumination Response Scale (brooding subscale). Polysomnography was used to assess sleep objectively, and the Pittsburgh Sleep Quality Index and the St. Mary's Hospital Sleep Questionnaire were used to measure sleep subjectively. In primary analyses the associations between RNT and sleep (ie, objective sleep duration, fragmentation and efficiency and subjective sleep disturbance) were assessed via adjusted regressions. Results Higher levels of RNT were associated with poorer objective sleep efficiency (worry: β=-0.32, p<0.001; brooding: β=-0.26, p=0.002), but not objective sleep duration, fragmentation, or subjective sleep disturbance. Additional analyses, however, revealed differences in levels of worry between those with short, compared with typical and long objective sleep durations (p < 0.05). Conclusion In cognitively healthy older adults, RNT was associated with sleep characteristics that have been implicated in increased dementia risk. It will take additional research to ascertain the causal link between RNT and sleep characteristics and how they ultimately relate to the risk of developing dementia.
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Affiliation(s)
- Lydia B Munns
- Division of Psychiatry, University College London, London, UK
- Department of Psychology, York University, York, UK
| | | | - Claire André
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
| | - Stéphane Rehel
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
| | - Valentin Ourry
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
| | | | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
- Département de Recherche Clinique, CHU Caen-Normandie, Caen, France
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
| | | | - On behalf of the Medit-Ageing Research Group
- Division of Psychiatry, University College London, London, UK
- Department of Psychology, York University, York, UK
- Normandie Univ, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Neuropresage Team, GIP Cyceron, Caen, France
- Service de Neurologie, CHU de Caen-Normandie, Caen, France
- Département de Recherche Clinique, CHU Caen-Normandie, Caen, France
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Wu J, Wang C, Qi S, Qin Z, Xu H, Hong X. Joint associations of sleep duration and physical activity with cognitive impairment among rural elderly over 65 years old: a cross-sectional study. Psychogeriatrics 2024; 24:174-181. [PMID: 38097502 DOI: 10.1111/psyg.13056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/09/2023] [Accepted: 11/26/2023] [Indexed: 03/04/2024]
Abstract
BACKGROUND During the long preclinical phase of dementia, accelerated cognitive impairment is regarded as a cardinal marker. Thus, the identification of risk factors for cognitive impairment is of great significance for dementia prevention. This study aims to examine the joint associations of sleep duration and physical activity with cognitive impairment among rural elderly over 65 years old, and provide suggestions for improving the cognitive function in rural elderly over 65 years old. METHODS A cross-sectional study was conducted in rural Nanjing by recruiting 1147 individuals aged above 65 years. Cognitive function was assessed using the brief community screening instrument for dementia. Physical activity was assessed using the Global Physical Activity Questionnaire. Data were analyzed by multivariate logistic regression models, and a significant difference was set at P < 0.05. RESULTS Compared with participants with proper sleep duration and sufficient physical activity, participants with short sleep duration and insufficient physical activity (odds ratio (OR): 1.820; 95% CI: 1.265 ~ 2.618), long sleep duration and sufficient physical activity (OR: 2.428; 95% CI: 1.137 ~ 5.183) showed an increased likelihood of cognitive impairment. CONCLUSIONS Inappropriate sleep duration combined with insufficient physical activity was associated with a significantly higher likelihood of cognitive impairment in rural elderly over 65 years old.
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Affiliation(s)
- Jie Wu
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
| | - Chenchen Wang
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
| | - Shengxiang Qi
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
| | - Zhenzhen Qin
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
| | - Hao Xu
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
| | - Xin Hong
- Department of Non-communicable Disease Prevention, Nanjing Municipal Centre for Disease Control and Prevention, Nanjing, China
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Gottesman RF, Lutsey PL, Benveniste H, Brown DL, Full KM, Lee JM, Osorio RS, Pase MP, Redeker NS, Redline S, Spira AP. Impact of Sleep Disorders and Disturbed Sleep on Brain Health: A Scientific Statement From the American Heart Association. Stroke 2024; 55:e61-e76. [PMID: 38235581 DOI: 10.1161/str.0000000000000453] [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] [Indexed: 01/19/2024]
Abstract
Accumulating evidence supports a link between sleep disorders, disturbed sleep, and adverse brain health, ranging from stroke to subclinical cerebrovascular disease to cognitive outcomes, including the development of Alzheimer disease and Alzheimer disease-related dementias. Sleep disorders such as sleep-disordered breathing (eg, obstructive sleep apnea), and other sleep disturbances, as well, some of which are also considered sleep disorders (eg, insomnia, sleep fragmentation, circadian rhythm disorders, and extreme sleep duration), have been associated with adverse brain health. Understanding the causal role of sleep disorders and disturbances in the development of adverse brain health is complicated by the common development of sleep disorders among individuals with neurodegenerative disease. In addition to the role of sleep disorders in stroke and cerebrovascular injury, mechanistic hypotheses linking sleep with brain health and biomarker data (blood-based, cerebrospinal fluid-based, and imaging) suggest direct links to Alzheimer disease-specific pathology. These potential mechanisms and the increasing understanding of the "glymphatic system," and the recognition of the importance of sleep in poststroke recovery, as well, support a biological basis for the indirect (through the worsening of vascular disease) and direct (through specific effects on neuropathology) connections between sleep disorders and brain health. Given promising evidence for the benefits of treatment and prevention, sleep disorders and disturbances represent potential targets for early treatment that may improve brain health more broadly. In this scientific statement, we discuss the evidence supporting an association between sleep disorders and disturbances and poor brain health ranging from stroke to dementia and opportunities for prevention and early treatment.
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Soni R, Dale C, Garfield V, Akhtar N. A cross-sectional observational study for ethno-geographical disparities in sleep quality, brain morphometry and cognition (a SOLACE study) in Indians residing in India, and South Asians and Europeans residing in the UK - a study protocol. Front Aging Neurosci 2024; 16:1294681. [PMID: 38450379 PMCID: PMC10914976 DOI: 10.3389/fnagi.2024.1294681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction As individuals age, their sleep patterns change, and sleep disturbances can increase the risk of dementia. Poor sleep quality can be a risk factor for mild cognitive impairment (MCI) and dementia. Epidemiological studies show a connection between sleep quality and cognitive changes, with brain imaging revealing grey matter volume reduction and amyloid beta accumulation in Alzheimer's disease. However, most research has focused on Europeans, with little attention to other ethnic groups. Methods This is a cross sectional study comparing effects across countries and ethnicities. Group 1 (n = 193) will be Indians residing in India (new participant recruitment), Group 2 will be South Asians residing in UK and group 3 will be Europeans residing in the UK. For group 2 and 3 (n = 193), data already collected by UK-based Southall and Brent REvisited (SABRE) tri-ethnic study will be used. For group 1, Pittsburgh Sleep Quality Index questionnaire (PSQI) will be used for assessment of sleep quality, Indian Council of Medical Research (Neurocognitive ToolBox) (ICMR-NCTB) for cognition testing and a 3 T MRI cerebral scan for brain morphometry. The data will be compared to sleep, cognitive function and brain MRI parameters from SABRE. Discussion Racial and ethnic differences can impact the relationships of cognitive function, sleep quality and brain structure in older adults. Earlier studies have highlighted higher prevalence of poor sleep among black individuals compared to white individuals. Genetic or epigenetic mechanisms may contribute to these variations. Socio-cultural and environmental factors, such as neighbourhood, migration, lifestyle, stress and perceived discrimination may influence sleep patterns. The aim of the study is to examine the ethnogeographic variations in sleep quality, cognitive performance and brain morphometry among Indians living in India, and South Asians and Europeans residing in the UK.
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Affiliation(s)
- Rishabh Soni
- Baldev Singh Sleep Electrophysiology Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Caroline Dale
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Nasreen Akhtar
- Baldev Singh Sleep Electrophysiology Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Rezende TA, Giatti L, de Menezes ST, Griep RH, Ribeiro PCC, Barreto SM. Sleep duration, insomnia and cognitive performance in the Elsa-Brasil cohort: a cross-sectional analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240006. [PMID: 38324870 PMCID: PMC10846421 DOI: 10.1590/1980-549720240006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE To investigate the single and combined associations between sleep disturbances (sleep duration, insomnia symptoms in the last 30 nights, and daytime tiredness) and performance in cognitive tests. METHODS Cross-sectional analysis of data from visit 2 (2012-2014) of the Longitudinal Study of Adult Health from a cohort of active and retired civil servants from six Brazilian capitals. Polynomial regression with quadratic term and multiple linear regression models were performed to assess single and combined associations between sleep disturbances and memory performance, fluency, executive functions, and global cognition. RESULTS A total of 7,248 participants were included, with a mean age of 62.7 years (standard deviation [SD]=5.9), and 55.2% were women. Inverted U-shaped associations were observed between sleep duration and performance on all cognitive abilities, suggesting that durations shorter or longer than seven hours are associated with worse performance, regardless of age. Reported insomnia was associated with worse executive function (β: -0.08; 95% confidence interval [CI]: -0.15 to -0.01), and the magnitudes of associations were higher for individuals with insomnia at two or more moments (β: -0.12; 95%CI -0.19 to -0.05) or, especially, insomnia combined with short sleep (β: -0.18; 95%CI -0.24 to -0.11). Insomnia in two or more periods was also associated with lower memory and global cognition. There was no association between any sleep disturbance tested and verbal fluency. Isolated daytime tiredness was not associated with performance in the evaluated tests. CONCLUSION The results suggest that extreme sleep durations are detrimental to almost all cognitive abilities investigated, whereas insomnia appears to affect more severely the executive function.
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Affiliation(s)
- Tamiris Amanda Rezende
- Universidade Federal de Minas Gerais, Posgraduate Program in Public Health, Medical School – Belo Horizonte (MG), Brazil
| | - Luana Giatti
- Universidade Federal de Minas Gerais, Medical School and Clinical Hospital/EBSERH – Belo Horizonte (MG), Brazil
| | - Sara Teles de Menezes
- Universidade Federal de Minas Gerais, Medical School and Clinical Hospital/EBSERH – Belo Horizonte (MG), Brazil
| | - Rosane Harter Griep
- Instituto Oswaldo Cruz, Laboratory of Health and Environment Education – Rio de Janeiro (RJ), Brazil
| | - Pricila Cristina Correa Ribeiro
- Universidade Federal de Minas Gerais, Department of Psychology, Faculty of Philosophy and Human Sciences – Belo Horizonte (MG), Brazil
| | - Sandhi Maria Barreto
- Universidade Federal de Minas Gerais, Medical School and Clinical Hospital/EBSERH – Belo Horizonte (MG), Brazil
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Holingue C, Owusu JT, Tzuang M, Nyhuis CC, Yaffe K, Stone KL, Rebok GW, Ancoli-Israel S, Spira AP. Accelerometer-assessed sleep and decline in physical function in older men. Sleep Health 2024; 10:129-136. [PMID: 38143154 PMCID: PMC10922516 DOI: 10.1016/j.sleh.2023.11.004] [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: 01/28/2023] [Revised: 09/21/2023] [Accepted: 11/06/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES Assess the prospective association of actigraphically measured sleep with self-report and objective measures of physical function among community-dwelling older men. METHODS Participants were (n = 1496) men aged ≥65 years from the Osteoporotic Fractures in Men Study and ancillary sleep study who were followed up at 4 years for physical function outcomes. Sleep predictors included baseline total sleep time (<6, 6-8 hours [reference], >8 hours), sleep efficiency (<80% or ≥80% [reference]), wake after sleep onset (<90 [reference] or ≥90 minutes), and sleep onset latency (<30 [reference] or ≥30 minutes), measured by wrist actigraphy. Outcomes included self-reported difficulties in mobility and instrumental activities of daily living and objective measures of physical performance (time to complete chair stands, gait speed, grip strength, best narrow walk pace). Multivariable regression models estimated associations between the sleep predictors and change in physical function at follow-up, adjusting for demographic and health-related variables. RESULTS Participants with short average baseline total sleep time (<6 hours) had significantly greater slowing in their walking speed from baseline to follow-up. Participants with long baseline sleep onset latency (≥30 minutes) had significant increases in mobility difficulties and time to complete chair stands. Sleep efficiency and wake after sleep onset were not significantly associated with any outcomes. No sleep predictors were associated with change in instrumental activities of daily living. CONCLUSIONS These findings add to the body of evidence showing links between poor sleep and subsequent declines in physical function. Further experimental research is needed to understand the mechanisms at play.
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Affiliation(s)
- Calliope Holingue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Jocelynn T Owusu
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marian Tzuang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Casandra C Nyhuis
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, Epidemiology and Biostatistics, University of California, San Francisco, California, USA; San Francisco VA Medical Center, San Francisco, California, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, California, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
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Gorgoni M, De Gennaro L. Sleep in Healthy and Pathological Aging. Brain Sci 2024; 14:128. [PMID: 38391703 PMCID: PMC10886851 DOI: 10.3390/brainsci14020128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024] Open
Abstract
Human sleep physiology is strongly affected by age [...].
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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Carpi M, Fernandes M, Mercuri NB, Liguori C. Sleep Biomarkers for Predicting Cognitive Decline and Alzheimer's Disease: A Systematic Review of Longitudinal Studies. J Alzheimers Dis 2024; 97:121-143. [PMID: 38043016 DOI: 10.3233/jad-230933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Sleep disturbances are considered a hallmark of dementia, and strong evidence supports the association between alterations in sleep parameters and cognitive decline in patients with mild cognitive impairment and Alzheimer's disease (AD). OBJECTIVE This systematic review aims to summarize the existing evidence on the longitudinal association between sleep parameters and cognitive decline, with the goal of identifying potential sleep biomarkers of AD-related neurodegeneration. METHODS Literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to 28 March 2023. Longitudinal studies investigating the association between baseline objectively-measured sleep parameters and cognitive decline were assessed for eligibility. RESULTS Seventeen studies were included in the qualitative synthesis. Sleep fragmentation, reduced sleep efficiency, reduced REM sleep, increased light sleep, and sleep-disordered breathing were identified as predictors of cognitive decline. Sleep duration exhibited a U-shaped relation with subsequent neurodegeneration. Additionally, several sleep microstructural parameters were associated with cognitive decline, although inconsistencies were observed across studies. CONCLUSIONS These findings suggest that sleep alterations hold promise as early biomarker of cognitive decline, but the current evidence is limited due to substantial methodological heterogeneity among studies. Further research is necessary to identify the most reliable sleep parameters for predicting cognitive impairment and AD, and to investigate interventions targeting sleep that can assist clinicians in the early recognition and treatment of cognitive decline. Standardized procedures for longitudinal studies evaluating sleep and cognition should be developed and the use of continuous sleep monitoring techniques, such as actigraphy or EEG headband, might be encouraged.
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Affiliation(s)
- Matteo Carpi
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Claudio Liguori
- Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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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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Liang W, Wu D, Chuang YH, Fan YC, Chiu HY. Insomnia complaints correlated with higher risk of cognitive impairment in older adults following stroke: a National Representative Comparison Study. Sleep Biol Rhythms 2024; 22:41-47. [PMID: 38476858 PMCID: PMC10899963 DOI: 10.1007/s41105-023-00477-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 07/01/2023] [Indexed: 03/14/2024]
Abstract
Although associations among insomnia, cognitive impairment, and stroke have been demonstrated, whether insomnia increases the risk of cognitive impairment after stroke remains unclear. The aim of this study was to examine whether insomnia complaints moderated the association between stroke and cognitive impairment in older adults. This study was a secondary data analysis that used data from the National Health Interview Survey 2009. A total of 447 older adults with a mean age of 74.63 years (50.1% men) were included. Self-reported insomnia and stroke occurrence were determined using a questionnaire. Cognitive impairment was assessed using the Mini-Mental State Examination. We used multivariate logistic regression to analyze the association between insomnia complaints and cognitive impairment. Participants were categorized into four groups: those with stroke and insomnia (58), those with stroke without insomnia (91), those without stroke with insomnia (116), and those without stroke or insomnia (182). The prevalence of insomnia complaints was 38.9%, and the frequency of poststroke cognitive impairment was 50.3%. After controlling for potential confounders, participants with stroke (with or without insomnia) had a significantly higher risk of cognitive impairment than those without stroke or insomnia (adjusted odds ratios: 4.16 and 2.91, 95% confidence intervals: 1.91-9.07 and 1.56-5.43, respectively). Stroke with or without insomnia complaints was associated with a higher risk of cognitive impairment relative to older adults without stroke or insomnia. The risk of cognitive impairment was the highest among participants with both stroke and insomnia.
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Affiliation(s)
- Wei Liang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yen-Chun Fan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
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He Z, Liu Y, Li Z, Sun T, Li Z, Manyande A, Xiang H, Xiong J. Gut microbiota regulates circadian oscillation in hepatic ischemia-reperfusion injury-induced cognitive impairment by interfering with hippocampal lipid metabolism in mice. Hepatol Int 2023; 17:1645-1658. [PMID: 37004699 PMCID: PMC10661774 DOI: 10.1007/s12072-023-10509-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Hepatic ischemia-reperfusion injury (HIRI) is a common complication of liver surgery, which can lead to extrahepatic metabolic disorders, such as cognitive impairment. Recent observations have emphasized the critical effects of gut microbial metabolites in regulating the development of liver injury. Herein, we investigated the potential contribution of gut microbiota to HIRI-related cognitive impairment. METHODS HIRI murine models were established by ischemia-reperfusion surgery in the morning (ZT0, 08:00) and evening (ZT12, 20:00), respectively. Antibiotic-induced pseudo-germ-free mice were gavaged with fecal bacteria of the HIRI models. Behavioral test was used to assess cognitive function. 16S rRNA gene sequencing and metabolomics were used for microbial and hippocampal analysis. RESULTS Our results established that cognitive impairment caused by HIRI underwent diurnal oscillations; HIRI mice performed poorly on the Y-maze test and the novel object preference test when surgery occurred in the evening compared with the morning. In addition, fecal microbiota transplantation (FMT) from the ZT12-HIRI was demonstrated to induce cognitive impairment behavior. The specific composition and metabolites of gut microbiota were analyzed between the ZT0-HIRI and ZT12-HIRI, and bioinformatic analysis showed that the differential fecal metabolites were significantly enriched in lipid metabolism pathways. After FMT, the hippocampal lipid metabolome between the P-ZT0-HIRI and P-ZT12-HIRI groups was analyzed to reveal a series of lipid molecules with significant differences. CONCLUSIONS Our findings indicate that gut microbiota are involved in circadian differences of HIRI-related cognitive impairment by affecting hippocampal lipid metabolism.
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Affiliation(s)
- Zhigang He
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanbo Liu
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Li
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianning Sun
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhixiao Li
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, London, UK
| | - Hongbing Xiang
- Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Jun Xiong
- Hepatobiliary Surgery Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Chen Z, Tian F, Zeng Y. Polypharmacy, potentially inappropriate medications, and drug-drug interactions in older COVID-19 inpatients. BMC Geriatr 2023; 23:774. [PMID: 38001406 PMCID: PMC10675895 DOI: 10.1186/s12877-023-04487-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES The purpose of this study was to assess the impact of polypharmacy, potentially inappropriate medications, and drug-drug interactions on in-hospital mortality in older COVID-19 inpatients. METHODS A cross-sectional study was conducted using electronic medical data from a tertiary hospital in Chengdu from December 2022 to January 2023. The 2019 AGS/Beers criteria was used to evaluate the potentially inappropriate mediation (PIM) status of older COVID-19 inpatients (age ≥ 65 years), the drug-drug interactions were evaluated on Medscape, and multivariate logistic regression was used to identify the risk factors associated with in-hospital mortality. RESULTS A total of 206 older COVID-19 inpatients were included in the study. The mean number of drugs per day was 13.04. The prevalence of PIM use based on the 2019 AGS Beers Criteria was 66.99%. The prevalence of drug-drug interactions was 61.65%. Logistic regression demonstrated that age ≥ 80 (OR: 10.321, 95% CI: 1.649, 64.579, P = 0.013), renal insufficiency (OR: 4.740, 95% CI: 1.366, 16.447, P = 0.014), long-term hospitalization (OR: 6.637, 95% CI: 1.030, 42.779, P = 0.046), severe pneumonia (OR: 50.230, 95% CI: 5.180, 487.041, P = 0.001) were influencing factors associated with in-hospital mortality in older COVID-19 inpatients. CONCLUSIONS The polypharmacy, potentially inappropriate medications, and drug-drug interactions were seen in many older COVID-19 inpatients.
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Affiliation(s)
- Zhaoyan Chen
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Fangyuan Tian
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Ya Zeng
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
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Cavaillès C, Andrews SJ, Leng Y, Chatterjee A, Daghlas I, Yaffe K. Causal Associations of Sleep Apnea with Alzheimer's Disease and Cardiovascular Disease: a Bidirectional Mendelian Randomization Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.20.23298793. [PMID: 38045267 PMCID: PMC10690337 DOI: 10.1101/2023.11.20.23298793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Sleep apnea (SA) has been linked to an increased risk of dementia in numerous observational studies; whether this is driven by neurodegenerative, vascular or other mechanisms is not clear. We sought to examine the bidirectional causal relationships between SA, Alzheimer's disease (AD), coronary artery disease (CAD), and ischemic stroke using Mendelian randomization (MR). Methods Using summary statistics from four recent, large genome-wide association studies of SA (n=523,366), AD (n=64,437), CAD (n=1,165,690), and stroke (n=1,308,460), we conducted bidirectional two-sample MR analyses. Our primary analytic method was fixed-effects inverse variance weighted MR; diagnostics tests and sensitivity analyses were conducted to verify the robustness of the results. Results We identified a significant causal effect of SA on the risk of CAD (odds ratio (OR IVW ) =1.35 per log-odds increase in SA liability, 95% confidence interval (CI) =1.25-1.47) and stroke (OR IVW =1.13, 95% CI =1.01-1.25). These associations were somewhat attenuated after excluding single-nucleotide polymorphisms associated with body mass index (BMI) (OR IVW =1.26, 95% CI =1.15-1.39 for CAD risk; OR IVW =1.08, 95% CI =0.96-1.22 for stroke risk). SA was not causally associated with a higher risk of AD (OR IVW =1.14, 95% CI =0.91-1.43). We did not find causal effects of AD, CAD, or stroke on risk of SA. Conclusions These results suggest that SA increased the risk of CAD, and the identified causal association with stroke risk may be confounded by BMI. Moreover, no causal effect of SA on AD risk was found. Future studies are warranted to investigate cardiovascular pathways between sleep disorders, including SA, and dementia.
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Wu H, Huang L, Zhang S, Zhang Y, Lan Y. Daytime napping, biological aging and cognitive function among middle-aged and older Chinese: insights from the China health and retirement longitudinal study. Front Public Health 2023; 11:1294948. [PMID: 38045976 PMCID: PMC10693455 DOI: 10.3389/fpubh.2023.1294948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objective The complicated association of daytime napping, biological aging and cognitive function remains inconclusive. We aimed to evaluate the cross-sectional and longitudinal associations of daytime napping and two aging measures with cognition and to examine whether napping affects cognition through a more advanced state of aging. Methods Data was collected from the China Health and Retirement Longitudinal Study. Napping was self-reported. We calculated two published biological aging measures: Klemera and Doubal biological age (KDM-BA) and physiological dysregulation (PD), which derived information from clinical biomarkers. Cognitive z-scores were calculated at each wave. Linear mixed models were used to explore the longitudinal association between napping, two aging measures, and cognitive decline. Mediation analyses were performed to assess the mediating effects of biological age acceleration on the association between napping and cognition. Results Participants aged over 45 years were included in the analyses. Non-nappers had greater KDM-BA and PD [LS means (LSM) = 0.255, p = 0.007; LSM = 0.085, p = 0.011] and faster cognitive decline (LSM = -0.061, p = 0.005)compared to moderate nappers (30-90 min/nap). KDM-BA (β = -0.007, p = 0.018) and PD (β = -0.034, p < 0.001) showed a negative association with overall cognitive z scores. KDM-BA and PD partially mediated the effect of napping on cognition. Conclusion In middle-aged and older Chinese, compared to moderate nappers, non-nappers seem to experience a more advanced state of aging and increased rates of cognitive decline. The aging status possibly mediates the association between napping and cognition. Moderate napping shows promise in promoting healthy aging and reducing the burden of cognitive decline in Chinese middle-aged and older adults.
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Affiliation(s)
- Huiyi Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lei Huang
- West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Shushan Zhang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yajia Lan
- Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Yue WL, Ng KK, Koh AJ, Perini F, Doshi K, Zhou JH, Lim J. Mindfulness-based therapy improves brain functional network reconfiguration efficiency. Transl Psychiatry 2023; 13:345. [PMID: 37951943 PMCID: PMC10640625 DOI: 10.1038/s41398-023-02642-9] [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: 09/02/2022] [Revised: 08/29/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after intervention. Understanding the changes in functional brain activity and neural plasticity that underlie these benefits from mindfulness interventions is thus of interest in current neuroimaging research. Previous studies have found functional brain changes during resting and task states to be associated with mindfulness both cross-sectionally and longitudinally, particularly in the executive control, default mode and salience networks. However, limited research has combined information from rest and task to study mindfulness-related functional changes in the brain, particularly in the context of intervention studies with active controls. Recent work has found that the reconfiguration efficiency of brain activity patterns between rest and task states is behaviorally relevant in healthy young adults. Thus, we applied this measure to investigate how mindfulness intervention changed functional reconfiguration between rest and a breath-counting task in elderly participants with self-reported sleep difficulties. Improving on previous longitudinal designs, we compared the intervention effects of a mindfulness-based therapy to an active control (sleep hygiene) intervention. We found that mindfulness intervention improved self-reported mindfulness measures and brain functional reconfiguration efficiency in the executive control, default mode and salience networks, though the brain and behavioral changes were not associated with each other. Our findings suggest that neuroplasticity may be induced through regular mindfulness practice, thus bringing the intrinsic functional configuration in participants' brains closer to a state required for mindful awareness.
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Affiliation(s)
- Wan Lin Yue
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - Kwun Kei Ng
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amelia Jialing Koh
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Francesca Perini
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kinjal Doshi
- Department of Psychology, Singapore General Hospital, Singapore, Singapore
| | - Juan Helen Zhou
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore.
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore.
| | - Julian Lim
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Psychology, National University of, Singapore, Singapore.
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Xu CY, Zhu KT, Ruan XY, Zhu XY, Zhang YS, Tong WX, Li B. Effect of physical exercise on sleep quality in college students: Mediating role of smartphone use. PLoS One 2023; 18:e0288226. [PMID: 37922266 PMCID: PMC10624267 DOI: 10.1371/journal.pone.0288226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/22/2023] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVE To investigate the effect of physical exercise on sleep quality and the mediating effect of smartphone use behavior in college students. METHODS A cross-sectional study design was adopted. An online survey of 5,075 college students was conducted using the Physical Activity Rating Scale-3, the Pittsburgh Sleep Quality Index, and the Mobile Phone Addiction Tendency Scale. RESULTS The sleep quality of college students was poor, and the proportion of college students with good sleep quality was 23.567%. A significant correlation existed between sleep quality and physical exercise (r = -0.159, P < 0.001) and mobile phone addiction (r = 0.355, P < 0.001). Physical exercise can predict sleep quality in college students (β = -0.011, P < 0.001). Smartphone use plays a part in mediating the process by which physical exercise affects sleep quality. CONCLUSION Chinese college students have poor sleep quality. Physical exercise and smartphone use behavior are important factors affecting the sleep quality of college students. Physical exercise can directly predict the sleep quality of college students and can predict the sleep quality of college students through the mediating effect of smartphone use behavior.
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Affiliation(s)
- Chuan-Yi Xu
- Ministry of Sports, Guangxi University of Chinese Medicine, Nanning China
| | - Kai-Tuo Zhu
- Graduate School, Kyonggi University, Suwon City, Korea
| | | | - Xiao-Ya Zhu
- Physical Education College, Shangqiu University, Shangqiu, China
| | - Yang-Sheng Zhang
- School of Physical Education, Nanjing Xiao zhuang University, Nanjing, China
| | - Wen-Xia Tong
- Physical Education College, Yangzhou University, Yangzhou, China
| | - Bo Li
- Institute of Sports Science, Nantong University, Nantong, China
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Hussain R, Graham U, Elder A, Nedergaard M. Air pollution, glymphatic impairment, and Alzheimer's disease. Trends Neurosci 2023; 46:901-911. [PMID: 37777345 DOI: 10.1016/j.tins.2023.08.010] [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: 04/21/2023] [Revised: 07/12/2023] [Accepted: 08/29/2023] [Indexed: 10/02/2023]
Abstract
Epidemiological evidence demonstrates a link between air pollution exposure and the onset and progression of cognitive impairment and Alzheimer's disease (AD). However, current understanding of the underlying pathophysiological mechanisms is limited. This opinion article examines the hypothesis that air pollution-induced impairment of glymphatic clearance represents a crucial etiological event in the development of AD. Exposure to airborne particulate matter (PM) leads to systemic inflammation and neuroinflammation, increased metal load, respiratory and cardiovascular dysfunction, and sleep abnormalities. All these factors are known to reduce the efficiency of glymphatic clearance. Rescuing glymphatic function by restricting the impact of causative agents, and improving sleep and cardiovascular system health, may increase the efficiency of waste metabolite clearance and subsequently slow the progression of AD. In sum, we introduce air pollution-mediated glymphatic impairment as an important mechanistic factor to be considered when interpreting the etiology and progression of AD as well as its responsiveness to therapeutic interventions.
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Affiliation(s)
- Rashad Hussain
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA.
| | | | - Alison Elder
- Department of Environmental Medicine, University of Rochester, Rochester, NY 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14642, USA; Center for Translational Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark.
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Antonsdottir IM, Low DV, Chen D, Rabinowitz JA, Yue Y, Urbanek J, Wu MN, Zeitzer JM, Rosenberg PB, Friedman LF, Sheikh JI, Yesavage JA, Zipunnikov V, Spira AP. 24 h Rest/Activity Rhythms in Older Adults with Memory Impairment: Associations with Cognitive Performance and Depressive Symptomatology. Adv Biol (Weinh) 2023; 7:e2300138. [PMID: 37423973 DOI: 10.1002/adbi.202300138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/16/2023] [Indexed: 07/11/2023]
Abstract
Little is known about links of circadian rhythm alterations with neuropsychiatric symptoms and cognition in memory impaired older adults. Associations of actigraphic rest/activity rhythms (RAR) with depressive symptoms and cognition are examined using function-on-scalar regression (FOSR). Forty-four older adults with memory impairment (mean: 76.84 ± 8.15 years; 40.9% female) completed 6.37 ± 0.93 days of actigraphy, the Beck depression inventory-II (BDI-II), mini-mental state examination (MMSE) and consortium to establish a registry for Alzheimer's disease (CERAD) delayed word recall. FOSR models with BDI-II, MMSE, or CERAD as individual predictors adjusted for demographics (Models A1-A3) and all three predictors and demographics (Model B). In Model B, higher BDI-II scores are associated with greater activity from 12:00-11:50 a.m., 2:10-5:50 p.m., 8:40-9:40 p.m., 11:20-12:00 a.m., higher CERAD scores with greater activity from 9:20-10:00 p.m., and higher MMSE scores with greater activity from 5:50-10:50 a.m. and 12:40-5:00 p.m. Greater depressive symptomatology is associated with greater activity in midafternoon, evening, and overnight into midday; better delayed recall with greater late evening activity; and higher global cognitive performance with greater morning and afternoon activity (Model B). Time-of-day specific RAR alterations may affect mood and cognitive performance in this population.
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Affiliation(s)
- Inga M Antonsdottir
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins Medicine, Baltimore, MD, 21224, USA
| | - Dominique V Low
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Diefei Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, 21205, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
| | - Yiwei Yue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
| | - Jacek Urbanek
- Regeneron Pharmaceuticals Inc., Johns Hopkins University, 777 Old Saw Mill River Rd, Tarrytown, NY, 10591, USA
| | - Mark N Wu
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Paul B Rosenberg
- Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins Medicine, Baltimore, MD, 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5300 Alpha Commons Drive, Baltimore, MD, 21224, USA
| | - Leah F Friedman
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Javaid I Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, 24144, Qatar
| | - Jerome A Yesavage
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94305, USA
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Adam P Spira
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, 21205, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5300 Alpha Commons Drive, Baltimore, MD, 21224, USA
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Qi X, Pei Y, Malone S, Wu B. Social Isolation, Sleep Disturbance, and Cognitive Functioning (HRS): A Longitudinal Mediation Study. J Gerontol A Biol Sci Med Sci 2023; 78:1826-1833. [PMID: 36617184 PMCID: PMC10562894 DOI: 10.1093/gerona/glad004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Social isolation is prevalent and associated with dementia, yet the directionality and mechanisms are less understood. This study examined the association between social isolation and cognitive functioning and explored the mediating role of sleep disturbance on the social isolation-cognition relationship. METHODS Data from 5 753 dementia-free Americans aged ≥50 of 2006 (T1), 2010 (T2), and 2014 (T3) waves of the Health and Retirement Study. Social isolation was measured by the Steptoe Social Isolation Index. Cognitive functioning was measured by the Telephone Interview of Cognitive Status. Sleep disturbance was measured with the modified Jenkins Sleep Scale. We used cross-lagged panel models to determine the associations between social isolation, sleep disturbance, and cognitive functioning. RESULTS Social isolation is significantly associated with subsequent cognitive functioning (T1 to T2: β = -0.055, standard error [SE] = 0.014, p < .001; T2 to T3: β = -0.044, SE = 0.016, p < .001). Lower cognitive functioning is significantly associated with greater subsequent social isolation (T1 to T2: β = -0.101, SE = 0.020, p < .001; T2 to T3: β = -0.058, SE = .011, p < .001). Sleep disturbance at T2 partially mediated the effect of social isolation (T1) on cognitive functioning (T3), accounting for 6.2% of the total effect (β = -0.003, SE = 0.001, p < .01). CONCLUSIONS Social isolation may deteriorate cognitive functioning and vice versa. The association between social isolation and cognition is partially explained by sleep disturbance.
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Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Susan K Malone
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
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Whittaker DS, Akhmetova L, Carlin D, Romero H, Welsh DK, Colwell CS, Desplats P. Circadian modulation by time-restricted feeding rescues brain pathology and improves memory in mouse models of Alzheimer's disease. Cell Metab 2023; 35:1704-1721.e6. [PMID: 37607543 PMCID: PMC10591997 DOI: 10.1016/j.cmet.2023.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/12/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
Circadian disruptions impact nearly all people with Alzheimer's disease (AD), emphasizing both their potential role in pathology and the critical need to investigate the therapeutic potential of circadian-modulating interventions. Here, we show that time-restricted feeding (TRF) without caloric restriction improved key disease components including behavioral timing, disease pathology, hippocampal transcription, and memory in two transgenic (TG) mouse models of AD. We found that TRF had the remarkable capability of simultaneously reducing amyloid deposition, increasing Aβ42 clearance, improving sleep and memory, and normalizing daily transcription patterns of multiple genes, including those associated with AD and neuroinflammation. Thus, our study unveils for the first time the pleiotropic nature of timed feeding on AD, which has far-reaching effects beyond metabolism, ameliorating neurodegeneration and the misalignment of circadian rhythmicity. Since TRF can substantially modify disease trajectory, this intervention has immediate translational potential, addressing the urgent demand for accessible approaches to reduce or halt AD progression.
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Affiliation(s)
- Daniel S Whittaker
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA
| | - Laila Akhmetova
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA
| | - Daniel Carlin
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA
| | - Haylie Romero
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA
| | - David K Welsh
- Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Christopher S Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Paula Desplats
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA; Center for Circadian Biology, University of California, San Diego, La Jolla, CA, USA; Department of Pathology, University of California, San Diego, La Jolla, CA, USA.
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Ourry V, Rehel S, André C, Mary A, Paly L, Delarue M, Requier F, Hendy A, Collette F, Marchant NL, Felisatti F, Palix C, Vivien D, de la Sayette V, Chételat G, Gonneaud J, Rauchs G. Effect of cognitive reserve on the association between slow wave sleep and cognition in community-dwelling older adults. Aging (Albany NY) 2023; 15:9275-9292. [PMID: 37770186 PMCID: PMC10564409 DOI: 10.18632/aging.204943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 07/14/2023] [Indexed: 10/03/2023]
Abstract
Sleep, especially slow wave sleep (SWS), is essential for cognitive functioning and is reduced in aging. The impact of sleep quality on cognition is variable, especially in aging. Cognitive reserve (CR) may be an important modulator of these effects. We aimed at investigating this question to better identify individuals in whom sleep disturbances might have greater behavioral consequences. Polysomnography and neuropsychological assessments were performed in 135 cognitively intact older adults (mean age ± SD: 69.4 ± 3.8y) from the Age-Well randomized controlled trial (baseline data). Two measures of cognitive engagement throughout life were used as CR proxies. Linear regression analyses were performed between the proportion of SWS, and executive function and episodic memory composite scores. Then, interaction analyses between SWS and CR proxies on cognition were conducted to assess the possible impact of CR on these links. SWS was positively associated with episodic memory, but not with executive function. CR proxies modulated the associations between SWS and both executive and episodic memory performance. Specifically, individuals with higher CR were able to maintain cognitive performance despite low amounts of SWS. This study provides the first evidence that CR may protect against the deleterious effects of age-related sleep changes on cognition.
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Affiliation(s)
- Valentin Ourry
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
- Normandie University, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Stéphane Rehel
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
- Normandie University, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Claire André
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
- Normandie University, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Alison Mary
- Neuropsychology and Functional Imaging Research Group (UR2NF), Centre for Research in Cognition and Neurosciences (CRCN), UNI - ULB Neuroscience Institute, Bruxelles 1050, Belgium
| | - Léo Paly
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Marion Delarue
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Florence Requier
- University of Liege, GIGA CRC Vivo Imaging, Liege, Belgium
- University of Liege, Psychology and Neuroscience of Cognition, Liege, Belgium
| | - Anne Hendy
- Division of Psychiatry, University College London, London, United Kingdom
| | - Fabienne Collette
- University of Liege, GIGA CRC Vivo Imaging, Liege, Belgium
- University of Liege, Psychology and Neuroscience of Cognition, Liege, Belgium
| | | | - Francesca Felisatti
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Cassandre Palix
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Denis Vivien
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
- Département de Recherche Clinique, CHU de Caen, Caen, France
| | - Vincent de la Sayette
- Normandie University, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
- Service de Neurologie, CHU de Caen, Caen, France
| | - Gaël Chételat
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
| | - Géraldine Rauchs
- Normandie University, UNICAEN, INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain @ Caen-Normandie, Cyceron, France
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Eschbach E, Wang J. Sleep and critical illness: a review. Front Med (Lausanne) 2023; 10:1199685. [PMID: 37828946 PMCID: PMC10566646 DOI: 10.3389/fmed.2023.1199685] [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: 04/03/2023] [Accepted: 09/07/2023] [Indexed: 10/14/2023] Open
Abstract
Critical illness and stays in the Intensive Care Unit (ICU) have significant impact on sleep. Poor sleep is common in this setting, can persist beyond acute critical illness, and is associated with increased morbidity and mortality. In the past 5 years, intensive care clinical practice guidelines have directed more focus on sleep and circadian disruption, spurring new initiatives to study and improve sleep complications in the critically ill. The global SARS-COV-2 (COVID-19) pandemic and dramatic spikes in patients requiring ICU level care also brought augmented levels of sleep disruption, the understanding of which continues to evolve. This review aims to summarize existing literature on sleep and critical illness and briefly discuss future directions in the field.
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Affiliation(s)
- Erin Eschbach
- Division of Pulmonary, Critical Care, and Sleep, Mount Sinai Hospital, New York, NY, United States
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Rahja M, Laver K, Mordaunt DA, Adnan N, Vakulin A, Lovato N, Crotty M. "The Days Are Long But the Nights Are Even Longer": A Mixed-Method Study of Sleep Disturbances Among Patients in an Inpatient Rehabilitation Program. Arch Rehabil Res Clin Transl 2023; 5:100275. [PMID: 37744205 PMCID: PMC10517360 DOI: 10.1016/j.arrct.2023.100275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Objective To assess sleep quality of patients on a rehabilitation ward and to identify staff practices and beliefs about management of sleep disturbance. Design Mixed-methods design including patient surveys and staff interviews. Setting Inpatient rehabilitation ward in a tertiary teaching hospital in Adelaide, Australia. Participants Of the 345 screened inpatients who had been in a mixed post-acute rehabilitation ward for at least 5 days, 120 (43% women) were included. The mean age was 67.7 years and the main admission reason was functional decline (40%). Patients with stroke or traumatic brain injury were excluded. Eleven (n = 11) staff (a mix of doctors, nurses, and allied health) were interviewed. Main Outcome Measures The surveys comprised of the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Flinders Fatigue Scale, and the Sleep Inertia Questionnaire. The survey results were compared with functional outcomes using the functional independence measure (FIM). Staff interviews delved into barriers to good sleep, ward practices, and knowledge about sleep hygiene. Results 43% of the surveyed patients reported having healthy amount of sleep. Sleep quality was not significantly correlated with rehabilitation outcomes (assessed using FIM). Staff reported having a good awareness of sleep hygiene; however, acknowledged limitations about the environment and routine which were not conducive to healthy sleep. They identified several actions which could be taken to improve patients' sleep hygiene. Conclusions Sleep disturbance is common for patients in rehabilitation. Rehabilitation wards should address this often-neglected critical component of rehabilitation to improve patient experience and potential participation in therapy. Introducing a systematic approach for assessing sleep during admission, establishing clear roles regarding sleep assessment and intervention among staff, and ensuring that patients and staff are aware of good sleep hygiene practices may promote better sleep during inpatient rehabilitation.
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Affiliation(s)
- Miia Rahja
- Flinders Health and Medical Research Institute, Flinders University, Flinders Drive Bedford Park, Australia
| | - Kate Laver
- Flinders Health and Medical Research Institute, Flinders University, Flinders Drive Bedford Park, Australia
| | - Dylan A. Mordaunt
- Flinders Health and Medical Research Institute, Flinders University, Flinders Drive Bedford Park, Australia
- Department of Rehabilitation Aged and Palliative Care, Flinders Medical Centre, Bedford Park, Australia
| | - Nurul Adnan
- Department of Rehabilitation Aged and Palliative Care, Flinders Medical Centre, Bedford Park, Australia
| | - Andrew Vakulin
- Flinders Health and Medical Research Institute Sleep Health, Flinders University, Bedford Park, Australia
| | - Nicole Lovato
- Flinders Health and Medical Research Institute Sleep Health, Flinders University, Bedford Park, Australia
| | - Maria Crotty
- Flinders Health and Medical Research Institute, Flinders University, Flinders Drive Bedford Park, Australia
- Department of Rehabilitation Aged and Palliative Care, Flinders Medical Centre, Bedford Park, Australia
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