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Mo W, Liu X, Yamakawa M, Koujiya E, Takeya Y, Shigenobu K, Adachi H, Ikeda M. Prevalence of sleep disturbances in people with mild cognitive impairment: A systematic review and meta-analysis. Psychiatry Res 2024; 339:116067. [PMID: 38964141 DOI: 10.1016/j.psychres.2024.116067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 05/28/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024]
Abstract
This review was performed to determine sleep disturbance prevalence in individuals with mild cognitive impairment (MCI). The MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were systematically searched from inception to January 20, 2024. Fifty-two studies fulfilling the eligibility criteria were included. However, six of these studies were excluded from data synthesis due to poor methodological quality. The subjective sleep disturbance prevalence among all individuals with MCI was 35.8 % (95 % CI: 31.9-39.7) across 44 studies, and the objective sleep disturbance prevalence was 46.3 % (95 % CI: 36.3-56.3) across 6 studies. Five studies examined TST and WASO, while three assessed SE. Among all potential objective assessments of sleep disturbance prevalence, only TST, WASO, and SE could be meta-analyzed in MCI because of the limited number of studies available. The estimated sleep disturbance prevalence differed significantly according to measurement method, geographical region, and research design. However, the data source did not significantly influence prevalence estimates. In meta-regression analysis, publication year, participant age, percentage of females, and study quality did not predict prevalence. As subjective and objective sleep disturbances are common in people with MCI, effective intervention strategies should be developed to alleviate them.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan.
| | - Eriko Koujiya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasushi Takeya
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Osaka, Japan; Asakayama General Hospital, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University
| | - Manabu Ikeda
- Department of Psychiatry, Graduate School of Medicine, Osaka University
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Stankeviciute L, Blackman J, Tort-Colet N, Fernández-Arcos A, Sánchez-Benavides G, Suárez-Calvet M, Iranzo Á, Molinuevo JL, Gispert JD, Coulthard E, Grau-Rivera O. Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms. J Sleep Res 2024; 33:e14108. [PMID: 38035770 DOI: 10.1111/jsr.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023]
Abstract
Sleep disturbances are prevalent in Alzheimer's disease (AD), affecting individuals during its early stages. We investigated associations between subjective sleep measures and cerebrospinal fluid (CSF) biomarkers of AD in adults with mild cognitive symptoms from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, considering the influence of memory performance. A total of 442 participants aged >50 years with a Clinical Dementia Rating (CDR) score of 0.5 completed the Pittsburgh Sleep Quality Index questionnaire and underwent neuropsychological assessment, magnetic resonance imaging acquisition, and CSF sampling. We analysed the relationship of sleep quality with CSF AD biomarkers and cognitive performance in separated multivariate linear regression models, adjusting for covariates. Poorer cross-sectional sleep quality was associated with lower CSF levels of phosphorylated tau and total tau alongside better immediate and delayed memory performance. After adjustment for delayed memory scores, associations between CSF biomarkers and sleep quality became non-significant, and further analysis revealed that memory performance mediated this relationship. In post hoc analyses, poorer subjective sleep quality was associated with lesser hippocampal atrophy, with memory performance also mediating this association. In conclusion, worse subjective sleep quality is associated with less altered AD biomarkers in adults with mild cognitive symptoms (CDR score 0.5). These results could be explained by a systematic recall bias affecting subjective sleep assessment in individuals with incipient memory impairment. Caution should therefore be exercised when interpreting subjective sleep quality measures in memory-impaired populations, emphasising the importance of complementing subjective measures with objective assessments.
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Affiliation(s)
- Laura Stankeviciute
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Jonathan Blackman
- North Bristol NHS Trust, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Núria Tort-Colet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Ana Fernández-Arcos
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Álex Iranzo
- Neurology Service, Hospital Clínic de Barcelona and Institut D'Investigacions Biomèdiques, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Elizabeth Coulthard
- North Bristol NHS Trust, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
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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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Estarellas M, Huntley J, Bor D. Neural markers of reduced arousal and consciousness in mild cognitive impairment. Int J Geriatr Psychiatry 2024; 39:e6112. [PMID: 38837281 DOI: 10.1002/gps.6112] [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: 11/08/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES People with Alzheimer's Disease (AD) experience changes in their level and content of consciousness, but there is little research on biomarkers of consciousness in pre-clinical AD and Mild Cognitive Impairment (MCI). This study investigated whether levels of consciousness are decreased in people with MCI. METHODS A multi-site site magnetoencephalography (MEG) dataset, BIOFIND, comprising 83 people with MCI and 83 age matched controls, was analysed. Arousal (and drowsiness) was assessed by computing the theta-alpha ratio (TAR). The Lempel-Ziv algorithm (LZ) was used to quantify the information content of brain activity, with higher LZ values indicating greater complexity and potentially a higher level of consciousness. RESULTS LZ was lower in the MCI group versus controls, indicating a reduced level of consciousness in MCI. TAR was higher in the MCI group versus controls, indicating a reduced level of arousal (i.e. increased drowsiness) in MCI. LZ was also found to be correlated with mini-mental state examination (MMSE) scores, suggesting an association between cognitive impairment and level of consciousness in people with MCI. CONCLUSIONS A decline in consciousness and arousal can be seen in MCI. As cognitive impairment worsens, measured by MMSE scores, levels of consciousness and arousal decrease. These findings highlight how monitoring consciousness using biomarkers could help understand and manage impairments found at the preclinical stages of AD. Further research is needed to explore markers of consciousness between people who progress from MCI to dementia and those who do not, and in people with moderate and severe AD, to promote person-centred care.
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Affiliation(s)
- Mar Estarellas
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Experimental Psychology Department, University College London, London, UK
- Department of Psychology, Cambridge University, Cambridge, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Daniel Bor
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychology, Cambridge University, Cambridge, UK
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Gabb VG, Blackman J, Morrison HD, Biswas B, Li H, Turner N, Russell GM, Greenwood R, Jolly A, Trender W, Hampshire A, Whone A, Coulthard E. Remote Evaluation of Sleep and Circadian Rhythms in Older Adults With Mild Cognitive Impairment and Dementia: Protocol for a Feasibility and Acceptability Mixed Methods Study. JMIR Res Protoc 2024; 13:e52652. [PMID: 38517469 PMCID: PMC10998181 DOI: 10.2196/52652] [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: 09/19/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Sleep disturbances are a potentially modifiable risk factor for neurodegenerative dementia secondary to Alzheimer disease (AD) and Lewy body disease (LBD). Therefore, we need to identify the best methods to study sleep in this population. OBJECTIVE This study will assess the feasibility and acceptability of various wearable devices, smart devices, and remote study tasks in sleep and cognition research for people with AD and LBD. METHODS We will deliver a feasibility and acceptability study alongside a prospective observational cohort study assessing sleep and cognition longitudinally in the home environment. Adults aged older than 50 years who were diagnosed with mild to moderate dementia or mild cognitive impairment (MCI) due to probable AD or LBD and age-matched controls will be eligible. Exclusion criteria include lack of capacity to consent to research, other causes of MCI or dementia, and clinically significant sleep disorders. Participants will complete a cognitive assessment and questionnaires with a researcher and receive training and instructions for at-home study tasks across 8 weeks. At-home study tasks include remote sleep assessments using wearable devices (electroencephalography headband and actigraphy watch), app-based sleep diaries, online cognitive assessments, and saliva samples for melatonin- and cortisol-derived circadian markers. Feasibility outcomes will be assessed relating to recruitment and retention, data completeness, data quality, and support required. Feedback on acceptability and usability will be collected throughout the study period and end-of-study interviews will be analyzed using thematic analysis. RESULTS Recruitment started in February 2022. Data collection is ongoing, with final data expected in February 2024 and data analysis and publication of findings scheduled for the summer of 2024. CONCLUSIONS This study will allow us to assess if remote testing using smart devices and wearable technology is a viable alternative to traditional sleep measurements, such as polysomnography and questionnaires, in older adults with and without MCI or dementia due to AD or LBD. Understanding participant experience and the barriers and facilitators to technology use for research purposes and remote research in this population will assist with the development of, recruitment to, and retention within future research projects studying sleep and cognition outside of the clinic or laboratory. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52652.
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Affiliation(s)
- Victoria Grace Gabb
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Jonathan Blackman
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Hamish Duncan Morrison
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Bijetri Biswas
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Haoxuan Li
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
- King's College Hospital, King's College Hospital NHS Foundation Trust, London, United Kingdom
- Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Nicholas Turner
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Rosemary Greenwood
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Research & Innovation, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Amy Jolly
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - William Trender
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Alan Whone
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
| | - Elizabeth Coulthard
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Neurology Department, Bristol Brain Centre, North Bristol NHS Trust, Bristol, United Kingdom
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Yang Y, Kim WS, Michaelian JC, Lewis SJG, Phillips CL, D'Rozario AL, Chatterjee P, Martins RN, Grunstein R, Halliday GM, Naismith SL. Predicting neurodegeneration from sleep related biofluid changes. Neurobiol Dis 2024; 190:106369. [PMID: 38049012 DOI: 10.1016/j.nbd.2023.106369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023] Open
Abstract
Sleep-wake disturbances are common in neurodegenerative diseases and may occur years before the clinical diagnosis, potentially either representing an early stage of the disease itself or acting as a pathophysiological driver. Therefore, discovering biomarkers that identify individuals with sleep-wake disturbances who are at risk of developing neurodegenerative diseases will allow early diagnosis and intervention. Given the association between sleep and neurodegeneration, the most frequently analyzed fluid biomarkers in people with sleep-wake disturbances to date include those directly associated with neurodegeneration itself, such as neurofilament light chain, phosphorylated tau, amyloid-beta and alpha-synuclein. Abnormalities in these biomarkers in patients with sleep-wake disturbances are considered as evidence of an underlying neurodegenerative process. Levels of hormonal sleep-related biomarkers such as melatonin, cortisol and orexin are often abnormal in patients with clinical neurodegenerative diseases, but their relationships with the more standard neurodegenerative biomarkers remain unclear. Similarly, it is unclear whether other chronobiological/circadian biomarkers, such as disrupted clock gene expression, are causal factors or a consequence of neurodegeneration. Current data would suggest that a combination of fluid biomarkers may identify sleep-wake disturbances that are most predictive for the risk of developing neurodegenerative disease with more optimal sensitivity and specificity.
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Affiliation(s)
- Yue Yang
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
| | - Woojin Scott Kim
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Johannes C Michaelian
- Healthy Brain Ageing Program, School of Psychology, Brain and Mind Centre & The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2050, Australia.
| | - Simon J G Lewis
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
| | - Craig L Phillips
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW 2109, Australia; Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
| | - Angela L D'Rozario
- Healthy Brain Ageing Program, School of Psychology, Brain and Mind Centre & The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2050, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW 2109, Australia.
| | - Pratishtha Chatterjee
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia.
| | - Ralph N Martins
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA 6009, Australia.
| | - Ron Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW 2109, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Glenda M Halliday
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Sharon L Naismith
- Healthy Brain Ageing Program, School of Psychology, Brain and Mind Centre & The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2050, Australia.
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Mo W, Liu X, Yamakawa M. Prevalence of sleep disturbances in people with mild cognitive impairment: a systematic review protocol. JBI Evid Synth 2023; 21:2211-2217. [PMID: 37338281 DOI: 10.11124/jbies-22-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE This review will determine the prevalence of sleep disturbances in individuals with mild cognitive impairment. INTRODUCTION Mild cognitive impairment is regarded as a transitional state between normal functioning and dementia, and has a high likelihood of conversion to dementia. Individuals with mild cognitive impairment may suffer more severe sleep disturbances compared with normal older people. In some studies, sleep disturbances were associated with significantly higher odds of mild cognitive impairment. There is a need for prevalence estimates of sleep disturbances in people with mild cognitive impairment based on the currently available literature to guide clinical health care professionals and public health policies. INCLUSION CRITERIA The review will consider studies reporting on the prevalence of sleep disturbances in individuals with mild cognitive impairment, using validated instruments, including subjective and/or objective measures. Studies will be excluded if the participants report sleep-related breathing or movement disorders. Studies using only the Mini-Mental State Examination to diagnose mild cognitive impairment will also be excluded. METHODS The review will follow the JBI methodology for systematic reviews of prevalence and incidence. The MEDLINE (Ovid), Embase, Cochrane Library (CDSR and CENTRAL), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Scopus, and Web of Science Core Collection databases will be systematically searched from inception to the present with no language limitations. Analytical observational studies, including prospective and retrospective cohort, case-control, and cross-sectional studies, will be considered. Two reviewers will independently conduct the study selection, critical appraisal, and data extraction. Methodological quality will be evaluated using the JBI critical appraisal checklist for studies reporting prevalence data. A meta-analysis will be conducted to synthesize the prevalence data, where possible. REVIEW REGISTRATION PROSPERO CRD42022366108.
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Affiliation(s)
- Wenping Mo
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Xiaoji Liu
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
| | - Miyae Yamakawa
- Department of Evidence-Based Clinical Nursing, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan
- The Japan Centre for Evidence-Based Practice: A JBI Centre of Excellence, Osaka, Japan
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Gu Y, Gagnon JF, Kaminska M. Sleep electroencephalography biomarkers of cognition in obstructive sleep apnea. J Sleep Res 2023; 32:e13831. [PMID: 36941194 DOI: 10.1111/jsr.13831] [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: 09/26/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 03/23/2023]
Abstract
Obstructive sleep apnea has been associated with cognitive impairment and may be linked to disorders of cognitive function. These associations may be a result of intermittent hypoxaemia, sleep fragmentation and changes in sleep microstructure in obstructive sleep apnea. Current clinical metrics of obstructive sleep apnea, such as the apnea-hypopnea index, are poor predictors of cognitive outcomes in obstructive sleep apnea. Sleep microstructure features, which can be identified on sleep electroencephalography of traditional overnight polysomnography, are increasingly being characterized in obstructive sleep apnea and may better predict cognitive outcomes. Here, we summarize the literature on several major sleep electroencephalography features (slow-wave activity, sleep spindles, K-complexes, cyclic alternating patterns, rapid eye movement sleep quantitative electroencephalography, odds ratio product) identified in obstructive sleep apnea. We will review the associations between these sleep electroencephalography features and cognition in obstructive sleep apnea, and examine how treatment of obstructive sleep apnea affects these associations. Lastly, evolving technologies in sleep electroencephalography analyses will also be discussed (e.g. high-density electroencephalography, machine learning) as potential predictors of cognitive function in obstructive sleep apnea.
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Affiliation(s)
- Yusing Gu
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jean-François Gagnon
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Marta Kaminska
- Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Respiratory Division & Sleep Laboratory, McGill University Health Centre, Montreal, Québec, Canada
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9
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Cannizzaro A, Ronat L, El Haffaf LM, Hanganu A. Associations between neuropsychiatric symptoms of affective and vegetative domains and brain morphology in aging people with mild cognitive impairment and Alzheimer's disease. Int J Geriatr Psychiatry 2023; 38:e5952. [PMID: 37351584 DOI: 10.1002/gps.5952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Neuropsychiatric symptoms (NPS) are common in mild cognitive impairment (MCI) and even more in Alzheimer's disease (AD). The symptom-based cluster including nighttime disturbances, depression, appetite changes, anxiety, and apathy (affective and vegetative symptoms) was associated with an increased risk of dementia in MCI and has common neuroanatomical associations. Our objective was to investigate the differences in brain morphology associations with affective and vegetative symptoms between three groups: cognitively normal older adults (CN), MCI and AD. MATERIAL AND METHODS Alzheimer's Disease Neuroimaging Initiative data of 223 CN, 367 MCI and 175 AD, including cortical volumes, surface areas and thicknesses and severity scores of the five NPS were analyzed. A whole-brain vertex-wise general linear model was performed to test for intergroup differences (CN-MCI, CN-AD, AD-MCI) in brain morphology associations with five NPS. Multiple regressions were conducted to investigate cortical change as a function of NPS severity in the AD-MCI contrast. RESULTS We found (1) signature differences in nighttime disturbances associations with prefrontal regions in AD-MCI, (2) signature differences in NPS associations with temporal regions in AD-MCI for depression and in CN-AD for anxiety, (3) decreased temporal metrics in MCI as nighttime disturbances and depression severity increased, (4) decreased pars triangularis metrics in AD as nighttime disturbances and apathy severity increased. CONCLUSION Each NPS seems to have a signature on brain morphology. Affective and vegetative NPS were primarily associated with prefrontal and temporal regions. These signatures open the possibility of potential future assessments of links between brain morphology and NPS on an individual level.
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Affiliation(s)
- Adriana Cannizzaro
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculté des Arts et des Sciences, Département de Psychologie, Université de Montréal, Montreal, Quebec, Canada
| | - Lucas Ronat
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculté de Médecine, Département de Médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Lyna Mariam El Haffaf
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculté des Arts et des Sciences, Département de Psychologie, Université de Montréal, Montreal, Quebec, Canada
| | - Alexandru Hanganu
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
- Faculté des Arts et des Sciences, Département de Psychologie, Université de Montréal, Montreal, Quebec, Canada
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Giannouli V, Tsolaki M. In the Hands of Hypnos: Associations between Sleep, Cognitive Performance and Financial Capacity in aMCI and Mild AD. Sleep Sci 2023; 16:231-236. [PMID: 37425966 PMCID: PMC10325838 DOI: 10.1055/s-0043-1770796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Objective The aim of this monocentric observational study is to assess whether sleep disorders can predict financial capacity in single-and multiple-domain aMCI (amnestic Mild Cognitive Impairment), mild Alzheimer's Disease (AD), and healthy controls. Methods Older participants from Northern Greece were examined with several neuropsychological tests, including Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Sleep duration and quality were based on caregiver/family members' reports in the Sleep Disorders Inventory (SDI). Results These preliminary findings coming from 147 participants indicate for the first time that apart from MMSE, complex cognitive functions, such as financial capacity may be also directly linked to the frequency of sleep-disturbed behaviours as indicated by SDI frequency questions, both in aMCI and mild AD. Discussion An urgency for further investigation of the neglected sleep factor should be added in financial capacity assessment protocols.
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Affiliation(s)
- Vaitsa Giannouli
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece, Greece
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11
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Andrews RAF, John B, Lancastle D. Symptom monitoring improves physical and emotional outcomes during menopause: a randomized controlled trial. Menopause 2023; 30:267-274. [PMID: 36727773 DOI: 10.1097/gme.0000000000002144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Objectives: A recent systematic review suggested that symptom monitoring can result in reductions in menopausal symptoms and improvements in health-related behaviors. To date, no studies have experimentally investigated whether symptom monitoring could be a beneficial intervention during the menopause transition.Methods: One hundred perimenopausal and postmenopausal women (mean age, 46 y; SD, 8 y) were randomized into either a monitoring-intervention or control group. A mixed between/within design was used, with group membership (ie, monitoring-intervention or control) as the between-subjects component and time (ie, baseline and 2-wk follow-up) as the within-subjects component. Dependent variables included symptom reductions and emotional reactions as measured via the Daily Record Keeping form. Secondary outcomes included help-seeking, communication, medical decision making, health awareness, self-efficacy, and health anxiety.Results: A linear mixed-effects model demonstrated that the monitoring-intervention group reported a 42% reduction in physical symptoms at follow-up versus a 12% reduction in the control group: ρ = 0.009, β = 6.3, 95% CI (1.5-11). Negative emotions also significantly reduced in the monitoring-intervention group but did not alter in the control group: ρ < 0.001, β = 3.4, and 95% CI (1.6-5.2). These effects remained significant after controlling for potential moderator variables such as trait neuroticism and coping preferences and potential confounders such as medical and demographic characteristics. Variances in other health outcomes were nonsignificant.Conclusions: Findings demonstrated that symptom monitoring reduced symptoms and negative emotions within a perimenopausal and postmenopausal sample, and these outcomes endured after controlling for key moderators and covariates. However, symptom monitoring was not related to improvements in health-related behavioral outcomes, which contrasts with previous findings. These findings show that symptom monitoring may be useful within healthcare settings by providing perimenopausal and postmenopausal women with a simple and accessible means of symptom alleviation while they await treatment or medical consultation.
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Affiliation(s)
| | - Bev John
- From the University of South Wales, Pontypridd, United Kingdom
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12
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Zhou L, Kong J, Li X, Ren Q. Sex differences in the effects of sleep disorders on cognitive dysfunction. Neurosci Biobehav Rev 2023; 146:105067. [PMID: 36716906 DOI: 10.1016/j.neubiorev.2023.105067] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Sleep is an essential physiological function that sustains human life. Sleep disorders involve problems with the quality, duration, and abnormal behaviour of sleep. Insomnia is the most common sleep disorder, followed by sleep-disordered breathing (SDB). Sleep disorders often occur along with medical conditions or other mental health conditions. Of particular interest to researchers is the role of sleep disorders in cognitive dysfunction. Sleep disorder is a risk factor for cognitive dysfunction, yet the exact pathogenesis is still far from agreement. Little is known about how sex differences influence the changes in cognitive functions caused by sleep disorders. This narrative review examines how sleep disorders might affect cognitive impairment, and then explores the sex-specific consequences of sleep disorders as a risk factor for dementia and the potential underlying mechanisms. Some insights on the direction of further research are also presented.
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Affiliation(s)
- Lv Zhou
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Jingting Kong
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoli Li
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Qingguo Ren
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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13
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Smith L, Shin JI, Jacob L, Carmichael C, López Sánchez GF, Oh H, Butler LT, Barnett Y, Pizzol D, Tully MA, Soysal P, Veronese N, Koyanagi A. Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries. Exp Gerontol 2021; 154:111513. [PMID: 34384889 DOI: 10.1016/j.exger.2021.111513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings. OBJECTIVE To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs). DESIGN Cross-sectional. SETTING Study on Global Ageing and Adult Health (SAGE). SUBJECTS 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50-114 years; 51.7% females]. METHODS MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question "Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?" and categorized as "None", "Mild", "Moderate", "Severe/Extreme". Multivariable logistic regression analysis and meta-analysis were conducted. RESULTS Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50-2.16), and a low level of between-country heterogeneity was observed (I2 = 28.2%). CONCLUSIONS Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Christina Carmichael
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Laurie T Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation - Khartoum, Sudan
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Northern Ireland, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093 Fatih, İstanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain
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14
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Palmer JR, Duffy SL, Meares S, Pye J, Calamante F, Cespedes M, Hickie IB, Naismith SL. Rest-activity functioning is related to white matter microarchitecture and modifiable risk factors in older adults at-risk for dementia. Sleep 2021; 44:6082819. [PMID: 33428761 DOI: 10.1093/sleep/zsab007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/15/2020] [Indexed: 12/13/2022] Open
Abstract
STUDY OBJECTIVES Growing evidence demonstrates pronounced alterations in rest-activity functioning in older adults at-risk for dementia. White matter degeneration, poor cardiometabolic functioning, and depression have also been linked to a greater risk of decline; however, limited studies have examined the white matter in relation to rest-activity functioning in at-risk older adults. METHODS We investigated associations between nonparametric actigraphy measures and white matter microarchitecture using whole-brain fixel-based analysis of diffusion-weighted imaging in older adults (aged 50 years or older) at-risk for cognitive decline and dementia. The fixel-based metrics assessed were fiber density, fiber cross-section, and combined fiber-density, and cross-section. Interactions between rest-activity functioning and known clinical risk factors, specifically body mass index (BMI), vascular risk factors, depressive symptoms and self-reported exercise, and their association with white matter properties were then investigated. RESULTS Sixty-seven older adults were included (mean = 65.78 years, SD = 7.89). Lower relative amplitude, poorer 24-h synchronization and earlier onset of the least active 5-h period were associated with reductions in markers of white matter atrophy in widespread regions, including cortico-subcortical and cortical association pathways. Preliminary evidence was also found indicating more pronounced white matter alterations in those with lower amplitude and higher BMI (β = 0.25, 95% CI [0.05, 0.46]), poorer 24-h synchronization and more vascular risk factors (β = 0.17, 95% CI [-0.02, 0.36]) and earlier onset of inactivity and greater depressive symptoms (β = 0.17, 95% CI [0.03, 0.30]). CONCLUSIONS These findings highlight the complex interplay between rest-activity rhythms, white matter, and clinical risk factors in individuals at-risk for dementia that should be considered in future studies.
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Affiliation(s)
- Jake R Palmer
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.,School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Shantel L Duffy
- Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration, Sydney, NSW, Australia
| | - Susanne Meares
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Jonathon Pye
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Fernando Calamante
- Sydney Imaging and School of Biomedical Engineering, Faculty of Engineering, University of Sydney, Sydney, NSW, Australia
| | - Marcela Cespedes
- Australian e-Health Research Centre, CSIRO Health and Biosecurity, Herston, QLD, Australia
| | - Ian B Hickie
- Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration, Sydney, NSW, Australia
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15
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Mattos MK, Chang A, Pitcher K, Whitt C, Ritterband LM, Quigg MS. A Review of Insomnia Treatments for Patients with Mild Cognitive Impairment. Aging Dis 2021; 12:1036-1042. [PMID: 34221547 PMCID: PMC8219491 DOI: 10.14336/ad.2021.0423] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/23/2021] [Indexed: 12/21/2022] Open
Abstract
Mild cognitive impairment (MCI) impacts approximately 20% of older adults, with many also experiencing sleep disorders, such as insomnia. Given the relationship between sleep and dementia, addressing sleep issues may offer an opportunity to treat reversible causes. There are two primary treatments for insomnia: behavioral-based (cognitive behavioral therapy for insomnia, CBT-I) and pharmacological interventions. Although CBT-I is recommended as first-line treatment for insomnia in older adults, sedative-hypnotics are more likely to be recommended than non-pharmacological treatments given their convenience and accessibility. However, there are significant concerns in prescribing medications to patients with MCI. To explore this disconnect, we reviewed insomnia treatments in older adults with MCI studies and current guidelines of pharmacological therapy. First, we reviewed studies presenting non-pharmacological treatment of insomnia in older adults with MCI. Although the search yielded over 4,000 non-duplicate titles, only one article presented data on non-pharmacological treatment of insomnia in MCI. The literature covering comorbid insomnia, CBT-I, and MCI is sparse. In contrast to review of non-pharmacological studies, studies on the pharmacological treatment of insomnia in older adults were ample. Finally, we reviewed international guidelines for pharmacological treatment of insomnia in cognitive disorders. More widely used pharmacological interventions show short-term effectiveness with problems of recurrence, ineffectiveness in inadvertent or purposeful chronic use, and adverse side effects. Despite evidence regarding adverse consequences, pharmacological treatment of insomnia remains the most common treatment for insomnia. Reflecting on age-related changes in older adults, particularly those with MCI, inappropriate or mismanagement of medication can lead to unnecessary complications. Further research examining effective behavioral-based sleep management options in older adults with cognitive impairment is needed with exploration of improved sleep on cognitive function.
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Affiliation(s)
- Meghan K Mattos
- University of Virginia, School of Nursing, Charlottesville, VA 22903, USA.
| | - Angela Chang
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL 60611, USA.
| | - Katherine Pitcher
- University of Virginia Medical Center, Charlottesville, VA 22903, USA.
| | - Carley Whitt
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
| | - Lee M Ritterband
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
| | - Mark S Quigg
- University of Virginia, School of Medicine, Charlottesville, VA 22903, USA.
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16
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Physical Activity and Inhibitory Control: The Mediating Role of Sleep Quality and Sleep Efficiency. Brain Sci 2021; 11:brainsci11050664. [PMID: 34069547 PMCID: PMC8160741 DOI: 10.3390/brainsci11050664] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 01/25/2023] Open
Abstract
Objectives: the current study aimed to investigate the relationship between physical activity (PA) level and inhibitory control performance and then to determine whether this association was mediated by multiple sleep parameters (i.e., subjective sleep quality, sleep duration, sleep efficiency, and sleep disturbance). Methods: 180 healthy university students (age: 20.15 ± 1.92 years) from the East China Normal University were recruited for the present study. PA level, sleep parameters, and inhibitory control performance were assessed using the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index Scale (PSQI), and a Stroop test, respectively. The data were analyzed using structural equation modeling. Results: A higher level of PA was linked to better cognitive performance. Furthermore, higher subjective sleep quality and sleep efficiency were associated with better inhibitory control performance. The mediation analysis revealed that subjective sleep quality and sleep efficiency mediated the relationship between PA level and inhibitory control performance. Conclusion: our results are in accordance with the literature and buttress the idea that a healthy lifestyle that involves a relatively high level of regular PA and adequate sleep patterns is beneficial for cognition (e.g., inhibitory control performance). Furthermore, our study adds to the literature that sleep quality and sleep efficiency mediates the relationship between PA and inhibitory control performance, expanding our knowledge in the field of exercise cognition.
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17
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Kong SDX, Hoyos CM, Phillips CL, McKinnon AC, Lin P, Duffy SL, Mowszowski L, LaMonica HM, Grunstein RR, Naismith SL, Gordon CJ. Altered heart rate variability during sleep in mild cognitive impairment. Sleep 2021; 44:5988607. [PMID: 33306103 DOI: 10.1093/sleep/zsaa232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/31/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Cardiovascular autonomic dysfunction, as measured by short-term diurnal heart rate variability (HRV), has been reported in older adults with mild cognitive impairment (MCI). However, it is unclear whether this impairment also exists during sleep in this group. We, therefore, compared overnight HRV during sleep in older adults with MCI and those with subjective cognitive impairment (SCI). METHODS Older adults (n = 210) underwent overnight polysomnography. Eligible participants were characterized as multi-domain MCI or SCI. The multi-domain MCI group was comprised of amnestic and non-amnestic subtypes. Power spectral analysis of HRV was conducted on the overnight electrocardiogram during non-rapid eye movement (NREM), rapid eye movement (REM), N1, N2, N3 sleep stages, and wake periods. High-frequency HRV (HF-HRV) was employed as the primary measure to estimate parasympathetic function. RESULTS The MCI group showed reduced HF-HRV during NREM sleep (p = 0.018), but not during wake or REM sleep (p > 0.05) compared to the SCI group. Participants with aMCI compared to SCI had the most pronounced reduction in HF-HRV across all NREM sleep stages-N1, N2, and N3, but not during wake or REM sleep. The naMCI sub-group did not show any significant differences in HF-HRV during any sleep stage compared to SCI. CONCLUSIONS Our study showed that amnestic MCI participants had greater reductions in HF-HRV during NREM sleep, relative to those with SCI, suggesting potential vulnerability to sleep-related parasympathetic dysfunction. HF-HRV, especially during NREM sleep, may be an early biomarker for dementia detection.
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Affiliation(s)
- Shawn D X Kong
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Camilla M Hoyos
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.,CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia
| | - Craig L Phillips
- CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.,CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Andrew C McKinnon
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Pinghsiu Lin
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Shantel L Duffy
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Loren Mowszowski
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Haley M LaMonica
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Ronald R Grunstein
- CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.,CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia
| | - Christopher J Gordon
- CogSleep, Australian National Health and Medical Research Council Centre of Research Excellence, Australia.,CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia
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18
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Chong TW, Macpherson H, Schaumberg MA, Brown BM, Naismith SL, Steiner GZ. Dementia prevention: the time to act is now. Med J Aust 2021; 214:302-304.e1. [PMID: 33715184 DOI: 10.5694/mja2.50972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Terence Wh Chong
- University of Melbourne, Melbourne, VIC.,St Vincent's Hospital Melbourne, Melbourne, VIC
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, VIC
| | - Mia A Schaumberg
- University of the Sunshine Coast, Sunshine Coast, QLD.,University of Queensland, Brisbane, QLD
| | | | - Sharon L Naismith
- Charles Perkins Centre and Brain and Mind Centre, University of Sydney, Sydney, NSW
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19
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Menczel Schrire Z, Phillips CL, Duffy SL, Marshall NS, Mowszowski L, La Monica HM, Gordon CJ, Chapman JL, Saini B, Lewis SJG, Naismith SL, Grunstein RR, Hoyos CM. Feasibility of 3-month melatonin supplementation for brain oxidative stress and sleep in mild cognitive impairment: protocol for a randomised, placebo-controlled study. BMJ Open 2021; 11:e041500. [PMID: 33568368 PMCID: PMC7878132 DOI: 10.1136/bmjopen-2020-041500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Melatonin has multiple proposed therapeutic benefits including antioxidant properties, synchronisation of the circadian system and lowering of blood pressure. In this protocol, we outline a randomised controlled trial to assess the feasibility, acceptability and tolerability of higher dose (25 mg) melatonin to target brain oxidative stress and sleep disturbance in older adults with mild cognitive impairment (MCI). METHODS AND ANALYSIS The study design is a randomised double-blind, placebo-controlled, parallel group trial. Forty individuals with MCI will be recruited from the Healthy Brain Ageing Clinic, University of Sydney and from the community, and randomised to receive either 25 mg oral melatonin or placebo nightly for 12 weeks. The primary outcomes are feasibility of recruitment, acceptability of intervention and adherence to trial medication at 12 weeks. Secondary outcomes will include the effect of melatonin on brain oxidative stress as measured by magnetic resonance spectroscopy, blood pressure, blood biomarkers, mood, cognition and sleep. Outcomes will be collected at 6 and 12 weeks. The results of this feasibility trial will inform a future conclusive randomised controlled trial to specifically test the efficacy of melatonin on modifiable risk factors of dementia, as well as cognition and brain function. This will be the first trial to investigate the effect of melatonin in the population with MCI in this way, with the future aim of using this approach to reduce progression to dementia. ETHICS AND DISSEMINATION This protocol has been approved by the Sydney Local Health District Ethics Committee (X18-0077). This randomised controlled trial will be conducted in compliance with the protocol published in the registry, the International Conference for Harmonisation on Good Clinical Practice and all other applicable regulatory requirements. The findings of the trial will be disseminated via conferences, publications and media, as applicable. Participants will be informed of results of the study at the conclusion of the trial. Eligible authors will include investigators who are involved in the conception and design of the study, the conduct of the trial, the analysis of the results, and reporting and presentation of study findings. TRIAL REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry (ANZCTRN 12619000876190). PROTOCOL VERSION V.8 15 October 2020.
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Affiliation(s)
- Zoe Menczel Schrire
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
| | - Craig L Phillips
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nathaniel S Marshall
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Haley M La Monica
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Julia L Chapman
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
| | - Bandana Saini
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Simon J G Lewis
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Royal Prince Alfred Hosptial, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Healthy Brain Ageing Program, The University of Sydney School of Psychology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Brain & Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS, Centre for Sleep and Chronobiology, The Woolcock Institute of Medical Research, Camperdown, New South Wales, Australia
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20
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Sikkes SA, Tang Y, Jutten RJ, Wesselman LM, Turkstra LS, Brodaty H, Clare L, Cassidy-Eagle E, Cox KL, Chételat G, Dautricourt S, Dhana K, Dodge H, Dröes RM, Hampstead BM, Holland T, Lampit A, Laver K, Lutz A, Lautenschlager NT, McCurry SM, Meiland FJM, Morris MC, Mueller KD, Peters R, Ridel G, Spector A, van der Steen JT, Tamplin J, Thompson Z, Bahar-Fuchs A. Toward a theory-based specification of non-pharmacological treatments in aging and dementia: Focused reviews and methodological recommendations. Alzheimers Dement 2021; 17:255-270. [PMID: 33215876 PMCID: PMC7970750 DOI: 10.1002/alz.12188] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2020] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results. METHODS In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System. RESULTS Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols. DISCUSSION We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.
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Affiliation(s)
- Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Yi Tang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Linda M.P. Wesselman
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Henry Brodaty
- Centre for Healthy Brain Ageing and Dementia Centre for Research Collaboration, School of Psychiatry, UNSW, Sydney, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Erin Cassidy-Eagle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Kay L. Cox
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Klodian Dhana
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
- Department of Neurology, University of Michigan,Ann Arbor, Michigan, USA
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Thomas Holland
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Laver
- Department of Rehabilitation, Aged and Extended Care, College of Medicine and Public Health Flinders University, Adelaide, Australia
| | - Antoine Lutz
- Lyon Neuroscience Research Center INSERM U1028, CNRS UMR5292, Lyon University, Lyon, France
| | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, Australia
| | - Susan M. McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Franka J. M. Meiland
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Martha Clare Morris
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ruth Peters
- Department of Psychology, University of New South Wales, Randwick, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | | | - Aimee Spector
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Zara Thompson
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Bahar-Fuchs
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Research on Ageing, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
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21
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Torossian M, Fiske SM, Jacelon CS. Sleep, Mild Cognitive Impairment, and Interventions for Sleep Improvement: An Integrative Review. West J Nurs Res 2021:193945920986907. [PMID: 33455559 PMCID: PMC8282804 DOI: 10.1177/0193945920986907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep disturbance in mild cognitive impairment (MCI) is associated with progression to Alzheimer's disease (AD), more severe AD symptoms, and worse health outcomes. The aim of this review was to examine the relationship between sleep and MCI, and the effectiveness of sleep improvement interventions for older adults with MCI or AD. An integrative review was conducted using four databases, and findings were analyzed using an iterative process. Findings from 24 studies showed that alterations in sleep increased the risk of MCI and that the sleep quality of individuals with MCI or AD was poorer than healthy controls. Changes in brain anatomy were also observed in healthy older adults with sleep disturbances. Examined interventions were shown to be effective in improving sleep. Screening for sleep disturbances in individuals with MCI/AD is crucial to mitigate neurodegenerative or neurobehavioral risks in this population.
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22
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Singh S, Jadhav S, Subramanyam A, Raut N. A study of quality of sleep, quality of life, and cognition in elderly: Healthy control, depressed and with mild neurocognitive disorder. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Kim Y, Lee JH, Jung IC, Eom YJ, Cho SH. Efficacy and safety of Hominis placenta pharmacopuncture on mild cognitive impairment: Randomized, double blind, placebo-controlled, multi-center trial. Medicine (Baltimore) 2020; 99:e22956. [PMID: 33181659 PMCID: PMC7668472 DOI: 10.1097/md.0000000000022956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is cognitive decline which can be observed in a wide range of cognitive domains. It is considered as a prodromal stage of dementia; therefore, strategies for treatment are necessary, but current evidence is limited. Combining the memory enhancing effect of Hominis placenta (H placenta) and acupuncture elucidated separately in previous studies, efficacy of H placenta pharmacopuncture for treating MCI is anticipated. METHODS Thirty participants will be recruited. Male and female adults aged 50 to 80 who voluntarily participate in the trial, are diagnosed with MCI according to diagnostic and statistical manual of mental disorders-5 criteria, and have a Clinical Dementia Rating score 0.5 will be enrolled. Participants who meet the criteria will be randomly allocated to either pharmacopuncture group or control group. Participants will undergo H placenta pharmacopuncture or saline pharmacopuncture in GV20, ST36, and CV12 twice weekly for 8 weeks and will be evaluated a month after the last treatment. Primary outcome will be difference in mean change of Korean version of Montreal Cognitive Assessment scores between intervention group and control group. Cognition, mood, sleep quality and quality of life will be also assessed using other neuropsychological tests and questionnaires regarding depression, anxiety, sleep and quality of life. DISCUSSION Evaluating the efficacy and safety data obtained by assessing diverse aspects of patients with MCI will broaden the scope of MCI management and prevention of dementia progression. TRIAL REGISTRATION Clinical Research Information Service (KCT0005368), Registered 02 Sep 2020, https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=16425.
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Affiliation(s)
- Yunna Kim
- College of Korean Medicine
- Research Group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
| | - Jae Hyok Lee
- Department of Neuropsychiatry, College of Korean Medicine, Semyung University
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University
- Department of Neuropsychiatry, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
| | - Yoon Ji Eom
- College of Korean Medicine
- Research Group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
| | - Seung-Hun Cho
- College of Korean Medicine
- Research Group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul
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24
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Cai S, Li T, Zhang L, Shi L, Liao J, Li W, Cheng G, Tan W, Rong S. Characteristics of Sleep Structure Assessed by Objective Measurements in Patients With Amnestic Mild Cognitive Impairment: A Meta-Analysis. Front Neurol 2020; 11:577126. [PMID: 33281712 PMCID: PMC7689212 DOI: 10.3389/fneur.2020.577126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023] Open
Abstract
Objectives: This study aims to explore the differences of sleep structure between patients with amnestic mild cognitive impairment (aMCI) and elderly people with normal cognition, which will help to provide evidence for the relationship between sleep disturbances and cognitive impairment. Methods: A systematic review and meta-analysis were conducted on the literature on sleep parameters obtained by polysomnography or actigraphy in patients with aMCI. The PubMed and EMBASE databases were searched up to April 2020. Inclusion and exclusion criteria were established according to evidence-based medicine methods, and data of all eligible studies were meta-analyzed using the Review Manager 5.3 software. Results: Among the 1,171 literature articles on sleep structure of patients with MCI, eight case-control studies met the inclusion criteria and were included in this meta-analysis. A total of 278 subjects were included, of which 103 were patients with aMCI and 175 were elderly people with normal cognition. The results showed that sleep efficiency (SE) and slow wave sleep (SWS) of patients with aMCI were significantly lower than those of healthy elderly people. Compared with the control group, the percentage of stage 1 of non-rapid eye movement (N1%) in the aMCI patients group increased, and the percentage of stage 2 of non-rapid eye movement (N2%) decreased. Conclusions: Patients with aMCI may experience more severe sleep disturbances than normal cognitive elderly people. There were specific changes, especially in SE and SWS, in the sleep structure of patients with aMCI when compared to those with normal cognition.
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Affiliation(s)
- Sijie Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Tingting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Li Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan, China
| | - Longhua Shi
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Wenfang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Guangwen Cheng
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Community Health Service Center of Qingling, Wuhan, China
- Hospital of Wuhan University of Science and Technology, Wuhan, China
- Wei Tan
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Shuang Rong
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25
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Lee A, Lah S, Joplin S, Haroutonian C, Pye J, Mowszowski L, Duffy SL, Naismith SL. Actigraphy-recorded sleep efficiency and hippocampal volume are related to visual and verbal rate of forgetting in older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:936-958. [PMID: 33141652 DOI: 10.1080/13825585.2020.1842849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aimed to determine if older adults "at-risk" for dementia (those with MCI or SMC) exhibit accelerated long-term forgetting (ALF) and whether rate of forgetting (RoF) is associated with sleep efficiency, hippocampal volume and demographic/clinical features. Forty-nine "at-risk" participants and eighteen controls underwent examination. Memory was assessed using the Scene Memory Task (SMT) and WMS-III Logical Memory (LM) subtest. Tests were administered at baseline, 24 hours and 2 weeks. While our study did not find ALF in those "at-risk" for dementia, on the SMT, RoF over 24 hours and 2 weeks was negatively correlated with sleep efficiency. For LM, RoF at 2 weeks was moderately associated with left hippocampal volume. Neither visual or verbal RoF was correlated with demographic or clinical variables (age, MMSE, IQ, GDS-15). While ALF was not observed in this sample, our results suggest that visual and verbal forgetting have differential predictors.
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Affiliation(s)
- Alessandra Lee
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Samantha Joplin
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Carla Haroutonian
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.,Neurosleep, Australian National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
| | - Jonathon Pye
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Loren Mowszowski
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.,Neurosleep, Australian National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.,Neurosleep, Australian National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
| | - Sharon L Naismith
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.,Neurosleep, Australian National Health and Medical Research Council Centre of Research Excellence, Sydney, Australia
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26
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Guan Q, Hu X, Ma N, He H, Duan F, Li X, Luo Y, Zhang H. Sleep Quality, Depression, and Cognitive Function in Non-Demented Older Adults. J Alzheimers Dis 2020; 76:1637-1650. [DOI: 10.3233/jad-190990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Qing Guan
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xiaohui Hu
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Ning Ma
- Center for Sleep Research, School of Psychology, South China Normal University, Guangzhou, China
| | - Hao He
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Feiyan Duan
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China
| | - Yuejia Luo
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Haobo Zhang
- Center for Brain Disorder and Cognitive Science, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
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27
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Neurostimulation techniques to enhance sleep and improve cognition in aging. Neurobiol Dis 2020; 141:104865. [DOI: 10.1016/j.nbd.2020.104865] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 01/09/2023] Open
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28
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Cavuoto MG, Kinsella GJ, Ong B, Pike KE, Nicholas CL. Naturalistic Measurement of Sleep in Older Adults with Amnestic Mild Cognitive Impairment: Anxiety Symptoms Do Not Explain Sleep Disturbance. Curr Alzheimer Res 2020; 16:233-242. [PMID: 30827241 DOI: 10.2174/1567205016666190301104645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/14/2018] [Accepted: 01/31/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep disturbance is prevalent in Alzheimer's disease (AD). In amnestic mild cognitive impairment (aMCI), the preclinical stage of AD, deterioration in sleep quality has also been reported. Consensus is lacking, however, regarding what aspects of sleep are characteristically affected, whether the setting of the sleep recordings impacts these findings, and whether anxiety may account for the differences. OBJECTIVE The current study aimed to address these knowledge gaps by obtaining comprehensive sleep measurement in aMCI within a naturalistic environment using in-home sleep recordings. METHODS 17 healthy older adults and twelve participants with aMCI wore an actiwatch for two weeks to objectively record habitual sleeping patterns and completed two nights of in-home polysomnography. RESULTS In aMCI, habitual sleep disturbances were evident on actigraphy including greater wake after sleep onset (p = .012, d = 0.99), fragmentation (p = .010, d = 1.03), and time in bed (p = .046, d = .76). Although not statistically significant, there was a large group effect on polysomnography with aMCI demonstrating less slow-wave-sleep than controls (p >.05, d = .0.83). Anxiety did not mediate the relationship between the group and sleep in this small study. CONCLUSIONS The results indicate that people with aMCI have poorer quality sleep than healthy controls, as indicated by greater sleep disruption and less slow-wave sleep, even in naturalistic settings. Additionally, anxiety symptoms do not mediate the relationship. Therefore, this research supports the view that sleep disturbance is likely to be indicative of neuropathological changes in aMCI rather than being attributed to psychological factors.
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Affiliation(s)
- Marina G Cavuoto
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Psychology, Caulfield Hospital, Caulfield, Victoria, Australia
| | - Glynda J Kinsella
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Department of Psychology, Caulfield Hospital, Caulfield, Victoria, Australia
| | - Ben Ong
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kerryn E Pike
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia.,Institute for Breathing & Sleep, Heidelberg, Victoria, Australia
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29
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Hudon C, Escudier F, De Roy J, Croteau J, Cross N, Dang-Vu TT, Zomahoun HTV, Grenier S, Gagnon JF, Parent A, Bruneau MA, Belleville S. Behavioral and Psychological Symptoms that Predict Cognitive Decline or Impairment in Cognitively Normal Middle-Aged or Older Adults: a Meta-Analysis. Neuropsychol Rev 2020; 30:558-579. [PMID: 32394109 DOI: 10.1007/s11065-020-09437-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.
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Affiliation(s)
- Carol Hudon
- École de psychologie, Université Laval, 2601, ch. de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada. .,CERVO Brain Research Centre, Québec, QC, Canada.
| | - Frédérique Escudier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jessie De Roy
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | - Jordie Croteau
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Nathan Cross
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | | | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
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30
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D'Rozario AL, Chapman JL, Phillips CL, Palmer JR, Hoyos CM, Mowszowski L, Duffy SL, Marshall NS, Benca R, Mander B, Grunstein RR, Naismith SL. Objective measurement of sleep in mild cognitive impairment: A systematic review and meta-analysis. Sleep Med Rev 2020; 52:101308. [PMID: 32302775 DOI: 10.1016/j.smrv.2020.101308] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/23/2019] [Accepted: 02/05/2020] [Indexed: 10/24/2022]
Abstract
Older adults with mild cognitive impairment (MCI) are at-risk of developing dementia, particularly Alzheimer's disease. While some research suggests that alterations in sleep architecture may mediate cognitive decline, the nature and magnitude of changes to sleep macro- (sleep stages) and micro-architecture (electroencephalography (EEG) oscillations) in MCI is not yet clear. This study aimed to systematically review and meta-analyse case-control studies objectively measuring sleep in MCI. A systematic search was conducted using PubMed, Scopus, Web of Science, Embase and Psycinfo databases and after review, a total of 10 studies met inclusion criteria. Of these, all reported sleep macro-architecture and four reported micro-architecture outcomes. A combined total of 430 participants (209 with and 221 without MCI) underwent objective sleep assessments in the included full text articles. Findings show that compared to healthy controls, those with MCI have pronounced changes in sleep macro-architecture with greater wake after sleep onset, reduced total sleep time, lower sleep efficiency, longer sleep onset latency, longer rapid eye movement sleep (REM) latency, reduced REM sleep, greater N1 sleep, and worse severity of hypoxemia. Pooling of sleep micro-architecture EEG measures was not possible due to limited studies, however reduced spindles in non-REM sleep and greater EEG slowing in REM sleep were reported.
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Affiliation(s)
- Angela L D'Rozario
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia.
| | - Julia L Chapman
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia
| | - Craig L Phillips
- Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jake R Palmer
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; School of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia
| | - Loren Mowszowski
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia; Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Nathaniel S Marshall
- Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ruth Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Bryce Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Ronald R Grunstein
- Woolcock Institute of Medical Research, University of Sydney, Glebe, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia; Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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31
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Naismith SL, Pye J, Terpening Z, Lewis S, Bartlett D. "Sleep Well, Think Well" Group Program for Mild Cognitive Impairment: A Randomized Controlled Pilot Study. Behav Sleep Med 2019; 17:778-789. [PMID: 30247939 DOI: 10.1080/15402002.2018.1518223] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective/Background: Sleep-wake disturbance is associated with poor cognitive functioning and several other adverse outcomes that increase dementia risk in older adults. Targeting sleep-wake disturbance in individuals at risk for dementia may be an important treatment. This study evaluated the efficacy of a four-session multicomponent group intervention for participants with mild cognitive impairment (MCI). Participants: Thirty-five older adults with MCI (mean age = 69.7 years, SD = 9.1), were recruited. MCI was determined via consensus from neuropsychological, medical, and neurological review. Methods: Participants were randomized to the "Sleep Well, Think Well" (SWTW) group condition or a passive control group. The SWTW group received four fortnightly face-to-face sessions conducted by an experienced sleep psychologist and neuropsychologist. The control group received written material detailing strategies to improve sleep quality. Both groups received fortnightly coaching phone calls. The primary outcome was subjective sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes included actigraphy sleep measures, daytime sleepiness, cognitive functioning, and depression severity. Results: The SWTW intervention was associated with a large and statistically significant improvement in subjective sleep quality (Cohen's d = 0.83, p < 0.02). A moderate nonsignificant effect was evident in reducing daytime sleepiness (Cohen's d = 0.70, p = .08). No significant effects were found on actigraphy markers, depressive symptoms, or tests of cognitive functioning. Conclusions: The eight-week SWTW group intervention for MCI significantly improved subjective sleep quality when compared with a passive control condition. The program also had a moderate (nonsignificant) effect on reducing daytime sleepiness.
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Affiliation(s)
- Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney , Camperdown , New South Wales , Australia.,NeuroSleep, NHMRC Centre of Research Excellence , Sydney.,Charles Perkins Centre, University of Sydney , Sydney , New South Wales , Australia.,School of Psychology, University of Sydney , Sydney , New South Wales , Australia
| | - Jonathon Pye
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney , Camperdown , New South Wales , Australia.,NeuroSleep, NHMRC Centre of Research Excellence , Sydney.,School of Psychology, University of Sydney , Sydney , New South Wales , Australia
| | - Zoe Terpening
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney , Camperdown , New South Wales , Australia
| | - Simon Lewis
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney , Camperdown , New South Wales , Australia.,NeuroSleep, NHMRC Centre of Research Excellence , Sydney.,Woolcock Institute for Medical Research , Sydney , New South Wales , Australia
| | - Delwyn Bartlett
- NeuroSleep, NHMRC Centre of Research Excellence , Sydney.,Woolcock Institute for Medical Research , Sydney , New South Wales , Australia
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32
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Papalambros NA, Weintraub S, Chen T, Grimaldi D, Santostasi G, Paller KA, Zee PC, Malkani RG. Acoustic enhancement of sleep slow oscillations in mild cognitive impairment. Ann Clin Transl Neurol 2019; 6:1191-1201. [PMID: 31353857 PMCID: PMC6649400 DOI: 10.1002/acn3.796] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/26/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Slow-wave activity (SWA) during sleep is reduced in people with amnestic mild cognitive impairment (aMCI) and is related to sleep-dependent memory consolidation. Acoustic stimulation of slow oscillations has proven effective in enhancing SWA and memory in younger and older adults. In this study we aimed to determine whether acoustic stimulation during sleep boosts SWA and improves memory performance in people with aMCI. METHODS Nine adults with aMCI (72 ± 8.7 years) completed one night of acoustic stimulation (stim) and one night of sham stimulation (sham) in a blinded, randomized crossover study. Acoustic stimuli were delivered phase-locked to the upstate of the endogenous sleep slow-waves. Participants completed a declarative recall task with 44 word-pairs before and after sleep. RESULTS During intervals of acoustic stimulation, SWA increased by >10% over sham intervals (P < 0.01), but memory recall increased in only five of the nine patients. The increase in SWA with stimulation was associated with improved morning word recall (r = 0.78, P = 0.012). INTERPRETATION Acoustic stimulation delivered during slow-wave sleep over one night was effective for enhancing SWA in individuals with aMCI. Given established relationships between SWA and memory, a larger or more prolonged enhancement may be needed to consistently improve memory in aMCI.
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Affiliation(s)
- Nelly A. Papalambros
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of MedicineChicagoIllinois
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Tammy Chen
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Daniela Grimaldi
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Giovanni Santostasi
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- DeepWave TechnologiesEncinitasCalifornia
| | - Ken A. Paller
- Department of PsychologyNorthwestern UniversityEvanstonIllinois
| | - Phyllis C. Zee
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
| | - Roneil G. Malkani
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinois
- Center for Circadian and Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinois
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33
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Pizzimenti NM, Savino AK, McCarthy MT. Sleep correlates of brain network activation and clinical measures in youth American football players. TRANSLATIONAL SPORTS MEDICINE 2019. [DOI: 10.1002/tsm2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gagnon JF, Lafrenière A, Rauchs G, Petit D, Carrier J. Sleep in Normal Aging, Alzheimer's Disease, and Mild Cognitive Impairment. HANDBOOK OF SLEEP RESEARCH 2019. [DOI: 10.1016/b978-0-12-813743-7.00045-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Burke SL, Hu T, Spadola CE, Li T, Naseh M, Burgess A, Cadet T. Mild cognitive impairment: associations with sleep disturbance, apolipoprotein e4, and sleep medications. Sleep Med 2018; 52:168-176. [PMID: 30359892 PMCID: PMC6800075 DOI: 10.1016/j.sleep.2018.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/22/2018] [Accepted: 09/04/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Mild cognitive impairment (MCI) is associated with increased memory problems although the ability to complete daily life activities remains relatively intact. This study examined: (1) if sleep disturbance increased the hazard of MCI; (2) if APOE e4 carriers with sleep disturbance experience an increased risk of MCI; and, (3) if prescription sleep medications provide a protective effect against MCI. We hypothesized that sleep disturbance increases the hazard of MCI, this relationship is stronger among APOE e4 carriers reporting a sleep disturbance. Furthermore, we hypothesized that sleep medications decrease the hazard of MCI. METHODS To determine whether sleep medication mediates the risk of developing MCI for individuals with sleep disturbance and/or APOE e4, we analyzed the National Alzheimer's Coordinating Center Uniform Data Set. We selected participants with normal cognition at baseline (n = 6798), and conduced survival analyses. RESULTS Our main findings indicated that the hazard of MCI was significantly associated with sleep disturbance. The hazard remained among those who did not use sleep medication. Trazodone and zolpidem users did not have a significant hazard of MCI, but the significant hazard remained for those who did not use these medications. APOE e4 carriers had a significantly higher hazard of MCI. Among e4 carriers who used trazodone or zolpidem, there was not a statistically significant risk of MCI. CONCLUSION This study demonstrated the potential utilization of trazodone and zolpidem in the treatment of sleep disturbance while potentially mitigating the risk of MCI. While trazodone and zolpidem have been shown to positively impact sleep disturbance in individuals with normal cognition, further research should explore these findings given that these medications are potentially inappropriate for older adults.
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Affiliation(s)
- Shanna L Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5 585, Miami, FL, 33199, USA.
| | - Tianyan Hu
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, 11200 S.W. 8th Street, AHC5 452, Miami, FL, 33199, USA.
| | - Christine E Spadola
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, 777 Glades Road SO303 Boca Raton, FL, 33431-0991, USA.
| | - Tan Li
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Biostatistics, 11200 S.W. 8th Street, AHC5464 Miami, FL, 33199, USA.
| | - Mitra Naseh
- Florida International University, Robert Stempel College of Public Health & Social Work, School of Social Work, Miami, FL, 33199, USA.
| | - Aaron Burgess
- Florida International University, Robert Stempel College of Public Health & Social Work, School of Social Work, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
| | - Tamara Cadet
- Simmons University, School of Social Work, Harvard School of Dental Medicine, Oral Health Policy and Epidemiology, Boston, MA 02115 USA.
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Climent MT, Pardo J, Muñoz-Almaraz FJ, Guerrero MD, Moreno L. Decision Tree for Early Detection of Cognitive Impairment by Community Pharmacists. Front Pharmacol 2018; 9:1232. [PMID: 30420808 PMCID: PMC6215965 DOI: 10.3389/fphar.2018.01232] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/09/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose: The early detection of Mild Cognitive Impairment (MCI) is essential in aging societies where dementia is becoming a common manifestation among the elderly. Thus our aim is to develop a decision tree to discriminate individuals at risk of MCI among non-institutionalized elderly users of community pharmacy. A more clinically and patient-oriented role of the community pharmacist in primary care makes the dispensation of medication an adequate situation for an effective, rapid, easy, and reproducible screening of MCI. Methods: A cross-sectional study was conducted with 728 non-institutionalized participants older than 65. A total of 167 variables were collected such as age, gender, educational attainment, daily sleep duration, reading frequency, subjective memory complaint, and medication. Two screening tests were used to detect possible MCI: Short Portable Mental State Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). Participants classified as positive were referred to clinical diagnosis. A decision tree and predictive models are presented as a result of applying techniques of machine learning for a more efficient enrollment. Results: One hundred and twenty-eight participants (17.4%) scored positive on MCI tests. A recursive partitioning algorithm with the most significant variables determined that the most relevant for the decision tree are: female sex, sleeping more than 9 h daily, age higher than 79 years as risk factors, and reading frequency. Moreover, psychoanaleptics, nootropics, and antidepressants, and anti-inflammatory drugs achieve a high score of importance according to the predictive algorithms. Furthermore, results obtained from these algorithms agree with the current research on MCI. Conclusion: Lifestyle-related factors such as sleep duration and the lack of reading habits are associated with the presence of positive in MCI test. Moreover, we have depicted how machine learning provides a sound methodology to produce tools for early detection of MCI in community pharmacy. Impact of findings on practice: The community of pharmacists provided with adequate tools could develop a crucial task in the early detection of MCI to redirect them immediately to the specialists in neurology or psychiatry. Pharmacists are one of the most accessible and regularly visited health care professionals and they can play a vital role in early detection of MCI.
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Affiliation(s)
| | - Juan Pardo
- Embedded Systems and Artificial Intelligence Group, Universidad CEU Cardenal Herrera, Valencia, Spain
| | | | | | - Lucrecia Moreno
- Department of Pharmacy, Universidad CEU Cardenal Herrera, Valencia, Spain
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