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Yang Q, Li S, Yang Y, Lin X, Yang M, Tian C, Mao J. Prolonged sleep duration as a predictor of cognitive decline: A meta-analysis encompassing 49 cohort studies. Neurosci Biobehav Rev 2024; 164:105817. [PMID: 39032844 DOI: 10.1016/j.neubiorev.2024.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/05/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
Despite numerous studies have explored the association between sleep duration and cognition, the link between sleep duration trajectories and cognition remains underexplored. This systematic review aims to elucidate this correlation. We analyzed 55 studies from 14 countries, comprising 36 studies focusing on sleep duration, 20 on insomnia, and 13 on hypersomnia. A total of 10,767,085 participants were included in 49 cohort studies with a mean follow-up duration of 9.1 years. A non-linear association between sleep duration and cognitive decline was identified. Both long (risk ratio (RR):1.35, 95 % confidence intervals (CIs):1.23-1.48) and short sleep durations (RR: 1.12, 95 % CIs:1.03-1.22) were associated with an elevated risk of cognitive decline compared to moderate sleep duration. Additionally, hypersomnia (RR:1.26, 95 % CIs: 1.15-1.39) and insomnia (RR: 1.16, 95 % CIs: 1.002-1.34) were also linked to an increased risk. Moreover, prolonged sleep duration posed a higher risk of cognitive decline than stable sleep duration (RR:1.42, 95 % CIs:1.27-1.59). Importantly, transitioning from short or moderate to long sleep duration, as well as persistent long sleep duration, exhibited higher RRs for cognitive decline (RRs: 1.94, 1.40, and 1.28, respectively) compared to persistent moderate sleep duration. Our findings underscore the significance of prolonged sleep duration, alongside short and long sleep durations, with an elevated risk of cognitive decline. The association is tied to the degree of sleep duration changes. Our study highlights the importance of considering changes in sleep patterns over time, not just static sleep durations.
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Affiliation(s)
- Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Suya Li
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yang Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuechun Lin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mengshu Yang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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2
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Okuda M, Noda A, Iwamoto K, Hishikawa N, Miyata S, Yasuma F, Taoka T, Ozaki N, Suhr JA, Miyazaki S. Assessment of cognitive function and sleep-wake rhythms in community-dwelling older adults. Sleep Biol Rhythms 2024; 22:137-145. [PMID: 38476850 PMCID: PMC10899937 DOI: 10.1007/s41105-023-00491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/06/2023] [Indexed: 03/14/2024]
Abstract
Disruption of the circadian rhythm and sleep-wake cycles is a consequence of aging and is associated with the cognitive decline and many neurodegenerative conditions. We investigated the bedtime, wake-up time, sleep timing (midpoint between bedtime and wake-up time), and sleep timing standard deviation (SD) using the actigraphy among 80 consecutive volunteers aged ≥ 60 years. Global cognitive function and executive function of detailed cognitive domains were evaluated using the mini-mental state examination (MMSE) and Wisconsin card sorting test (WCST) and subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The category achievement (CA), total errors (TE), perseverative errors of Nelson (PEN), non-perseverative errors (NPE), and difficulties in maintaining set (DMS) on the WCST were significantly correlated with sleep timing SD (CA: r = - 0.276, p = 0.013, TE: r = 0.311, p = 0.005, PEN: r = 0.241, p = 0.032, NPE: r = 0.250, p = 0.025, DMS: r = 0.235, p = 0.036), but not with the MMSE score. Multiple regression analyses with the stepwise forward selection method including age, ESS score, bedtime, sleep timing, and sleep timing SD, revealed that the ESS score, and sleep timing SD were significant factors related to CA on the WCST (ESS score: β = - 0.322, p = 0.004; sleep timing SD: β = - 0.250, p = 0.022). Assessment of sleep-wake rhythms, daytime sleepiness, and cognitive function using the MMSE and WCST is valuable for the prediction of cognitive decline in the geriatric population.
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Affiliation(s)
- Masato Okuda
- Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, 1200, Matsumoto-cho, Kasugai, Aichi 487-8501 Japan
| | - Akiko Noda
- Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, 1200, Matsumoto-cho, Kasugai, Aichi 487-8501 Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Seiko Miyata
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumihiko Yasuma
- Department of Biomedical Sciences, Chubu University Collage of Life and Health Sciences, Kasugai, Japan
| | - Toshiaki Taoka
- Department of Innovative Biomedical Visualization, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Julie A. Suhr
- Department of Psychology, Ohio University, Athens, OH USA
| | - Soichiro Miyazaki
- Research Institute of Life and Health Sciences, Chubu University, Kasugai, Japan
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3
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Putilina MV, Shabalina NI. [Results of a pilot study of the structure and evaluation of the therapy for chronic sleep disorders in comorbid patients with chronic cerebral ischemia]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:118-126. [PMID: 38676686 DOI: 10.17116/jnevro2024124041118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To evaluate the effect of the drug Cortexin on the clinical course and treatment of comorbid insomnia. MATERIAL AND METHODS The study included 50 patients, average age 50.4±2.26 years, with CHI stage 1-2. with concomitant diseases arterial hypertension, atherosclerosis, diabetes mellitus (study CHRONAS). All patients were examined on the day of treatment, 11-15 days and 30-31 days after the end of therapy. At all visits, complaints, neurological status, and changes in physiological and laboratory parameters were assessed. The condition was assessed using the following scales: mental status assessment (MMSE), quality of life questionnaire (EQ-5D), assessment of general health, Pittsburgh Sleep Quality Index (PSQI), Epworth daytime sleepiness assessment, hospital anxiety and depression (HADS)).: Patients with additional diabetic polyneuropathy were assessed using the Central Sensitization Inventory (CSI). RESULTS A high percentage of the prevalence of comorbid insomnia in patients was revealed. The structure of sleep disturbances in patients with chronic cerebral ischemia consisted of disturbances in sleep duration, difficulty falling asleep, frequent awakenings at night, and daytime sleepiness. After treatment, there was a regression of the main complaints, the severity of symptoms, including anxiety and depression, decreased, and a significant stabilization of cognitive status was observed. The positive dynamics persisted 1 month after the end of therapy. An additional normalizing effect of the drug on a number of biochemical parameters was revealed. Clinical dynamics were recorded already by the 11-15th day of treatment and persisted for up to 1 month. During observation, no patient had adverse drug interactions with other drugs (hypotensives, antiplatelet agents, statins). CONCLUSIONS The clinical effectiveness of the drug Cortexin has been proven for all types of sleep disorders. The clinical effectiveness of the drug Cortexin at a dose of 10 mg IM for 10 days has been proven in patients with chronic sleep disorders due to CHI.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N I Shabalina
- Central Clinical Hospital «RZD-Medicine», Moscow, Russia
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4
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Kong J, Zhou L, Li X, Ren Q. Sleep disorders affect cognitive function in adults: an overview of systematic reviews and meta-analyses. Sleep Biol Rhythms 2023; 21:133-142. [PMID: 38469285 PMCID: PMC10900040 DOI: 10.1007/s41105-022-00439-9] [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: 07/03/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Abstract
Sleep disorders frequently result in poor memory, attention deficits, as well as a worse prognosis for neurodegenerative changes, such as Alzheimer's disease. The purpose of this study is to investigate the impact of sleep disorders on cognition. We screened four databases for all meta-analyses and systematic reviews from the establishment through March 2022. We have carried out quality evaluation and review the eligible systematic reviews. Evidence grading and quality assessment were performed on 22 eligible articles. Sleep deprivation primarily affects simple attention, complex attention, and working memory in cognition and alertness. The moderate-to-high-quality evidence proves optimal sleep time as 7-8 h. Sleep time outside this range increases the risk of impaired executive function, non-verbal memory, and working memory. Sleep-related breathing disorders is more likely to cause mild cognitive impairment and affects several cognitive domains. In older adults, insomnia primarily affects working memory, episodic memory, inhibitory control, cognitive flexibility, problem-solving, operational ability, perceptual function, alertness, and complex attention, and maintaining sensitivity. Sleep disturbances significantly impair cognitive function, and early detection and intervention may be critical steps in reducing poor prognosis. A simple neuropsychological memory test could be used to screen people with sleep disorders for cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00439-9.
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Affiliation(s)
- Jingting Kong
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
| | - Lv Zhou
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
| | - Xiaoli Li
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 China
| | - Qingguo Ren
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 China
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5
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Randhi B, Gutlapalli SD, Pu J, Zaidi MF, Patel M, Atluri LM, Gonzalez NA, Sakhamuri N, Athiyaman S, Hamid P. Sleep Disorders in Mild Cognitive Impairment. Cureus 2023; 15:e36202. [PMID: 37065281 PMCID: PMC10103826 DOI: 10.7759/cureus.36202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
We have an increasingly aging population and, therefore, cognitive impairment and dementia are becoming more common. Similarly, sleep disorders are also more common among the older population. There is a bidirectional relationship between mild cognitive impairment and sleep disorders. Additionally, both of these issues are underdiagnosed. By identifying and treating sleep disturbances early, we may delay the onset of dementia. Sleep helps in clearing metabolites like amyloid-beta (A-beta) lipoprotein. Clearance leads to decreased fatigue and proper functioning of the brain. A-beta lipoprotein and tau aggregates lead to neurodegeneration. Slow-wave sleep that decreases with aging is important for memory consolidation. In the initial stages of Alzheimer's disease, A-beta lipoprotein and tau deposits were linked to lower slow-wave activity in non-rapid eye movement sleep. Improvement in sleep decreases oxidative stress which in turn leads to decreased A-beta lipoprotein accumulation.
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6
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Liu R, Ren Y, Hou T, Liang X, Dong Y, Wang Y, Cong L, Wang X, Qin Y, Ren J, Sindi S, Tang S, Du Y, Qiu C. Associations of sleep timing and time in bed with dementia and cognitive decline among Chinese older adults: A cohort study. J Am Geriatr Soc 2022; 70:3138-3151. [PMID: 36128778 DOI: 10.1111/jgs.18042] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The longitudinal associations of sleep timing and time in bed (TIB) with dementia and cognitive decline in older adults are unclear. METHODS This population-based cohort study used data from 1982 participants who were aged ≥60 years, free of dementia, and living in rural communities in western Shandong, China. At the baseline (2014) and follow-up (2018) examinations, sleep parameters were assessed using standard questionnaires. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Dementia was diagnosed following the DSM-IV criteria, and the NIA-AA criteria for Alzheimer disease (AD). Data were analyzed using restricted cubic splines, Cox proportional-hazards models, and general linear models. RESULTS During the mean follow-up of 3.7 years, dementia was diagnosed in 97 participants (68 with AD). Restricted cubic spline curves showed J-shaped associations of sleep duration, TIB, and rise time with dementia risk, and a reverse J-shaped association with mid-sleep time. When sleep parameters were categorized into tertiles, the multivariable-adjusted hazard ratio (HR) of incident dementia was 1.69 (95%CI 1.01-2.83) for baseline sleep duration >8 hours (vs. 7-8 h), 2.17 (1.22-3.87) for bedtime before 9 p.m. (vs. 10 p.m. or later), and 2.00 (1.23-3.24) for mid-sleep time before 1 a.m. (vs. 1-1.5 a.m.). Early bedtime and mid-sleep time were significantly associated with incident AD (HR range: 2.25-2.51; p < 0.05). Among individuals who were free of dementia at follow-up, baseline long TIB, early bedtime and mid-sleep time, early and late rise time, and prolonged TIB and advanced bedtime and mid-sleep time from baseline to follow-up were associated with a greater decline in MMSE score (p < 0.05). These associations with cognitive decline were statistically evident mainly among men or participants who were aged 60-74 years. CONCLUSIONS Long TIB and early sleep timing are associated with an increased risk of dementia, and the associations with greater cognitive decline are evident only among older people aged 60-74 years and men.
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Affiliation(s)
- Rui Liu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Xiaoyan Liang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Yu Qin
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China
| | - Shireen Sindi
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, People's Republic of China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People's Republic of China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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7
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A systematic review of the validity of non-invasive sleep-measuring devices in mid-to-late life adults: Future utility for Alzheimer's disease research. Sleep Med Rev 2022; 65:101665. [DOI: 10.1016/j.smrv.2022.101665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022]
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8
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Murillo-Rodríguez E, Coronado-Álvarez A, López-Muciño LA, Pastrana-Trejo JC, Viana-Torre G, Barberena JJ, Soriano-Nava DM, García-García F. Neurobiology of dream activity and effects of stimulants on dreams. Curr Top Med Chem 2022; 22:1280-1295. [PMID: 35761491 DOI: 10.2174/1568026622666220627162032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 03/18/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
The sleep-wake cycle is the result of the activity of a multiple neurobiological network interaction. Dreaming feature is one interesting sleep phenomena that represents sensorial components, mostly visual perceptions, accompanied with intense emotions. Further complexity has been added to the topic of the neurobiological mechanism of dreams generation by the current data that suggests the influence of drugs on dream generation. Here, we discuss the review on some of the neurobiological mechanism of the regulation of dream activity, with special emphasis on the effects of stimulants on dreaming.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Astrid Coronado-Álvarez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Luis Angel López-Muciño
- Health Sciences Program. Health Sciences Institute. Veracruzana University. Xalapa. Veracruz. Mexico
| | - José Carlos Pastrana-Trejo
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Gerardo Viana-Torre
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Juan José Barberena
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group.,Escuela de Psicología, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | - Daniela Marcia Soriano-Nava
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud. Universidad Anáhuac Mayab. Mérida, Yucatán. México.,Intercontinental Neuroscience Research Group
| | - Fabio García-García
- Intercontinental Neuroscience Research Group.,Health Sciences Program. Health Sciences Institute. Veracruzana University. Xalapa. Veracruz. Mexico
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9
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Putilina M. Pathogenetic approaches to the treatment of sleep disorders in comorbid patients. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:11-16. [DOI: 10.17116/jnevro202212211111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Ohara T, Hata J, Tanaka M, Honda T, Yamakage H, Inoue T, Hirakawa Y, Kusakabe T, Shibata M, Kitazono T, Nakao T, Satoh-Asahara N, Ninomiya T. Association of daily sleep duration with the incident dementia by serum soluble TREM2 in a community. J Am Geriatr Soc 2021; 70:1147-1156. [PMID: 34970991 DOI: 10.1111/jgs.17634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Little is known about the influence of serum level of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), which is a soluble type of an innate immune receptor expressed on the microglia, on the association of the daily sleep duration with the risk of dementia. METHODS A total of 1230 Japanese community-residents aged 60 and older without dementia were followed prospectively for 10 years (2002-2012). Serum sTREM2 levels were divided into two groups using the median value (334.8 pg/ml). Self-reported daily sleep duration was grouped into three categories of <5.0, 5.0-7.9, and ≥8.0 h. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of daily sleep duration on the risk of dementia according to serum sTREM2 levels. RESULTS During the follow-up, 262 subjects developed dementia. In subjects with low serum sTREM2 levels, subjects with ≥8.0 h of daily sleep had a significantly greater risk of dementia (multivariable-adjusted HR 2.05 [95% CI 1.32-3.19]) than those with 5.0-7.9 h of daily sleep, but those with <5.0 h did not. In contrast, the risk of dementia increased significantly in subjects with both <5.0 (1.95 [1.03-3.68]) and ≥8.0 h of daily sleep (1.48 [1.06-2.07]) in the subjects with high serum sTREM2 levels. CONCLUSIONS The influence of daily sleep duration on risk of dementia differed according to serum sTREM2 levels in the older Japanese population. Short daily sleep may be associated with greater risk of dementia only in subjects with a high serum sTREM2 level.
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Affiliation(s)
- Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masashi Tanaka
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hajime Yamakage
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takayuki Inoue
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Kusakabe
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriko Satoh-Asahara
- Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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11
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Lifestyle Variables Such as Daily Internet Use, as Promising Protective Factors against Cognitive Impairment in Patients with Subjective Memory Complaints. Preliminary Results. J Pers Med 2021; 11:jpm11121366. [PMID: 34945838 PMCID: PMC8708750 DOI: 10.3390/jpm11121366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022] Open
Abstract
Subjective memory complaints (SMCs) may be important markers in the prediction of cognitive deterioration. The aim of this study was to find associations between individual lifestyle factors, which may contribute to cognitive impairment (CI) in people with SMCs and to conduct a literature review on the relationship between internet use and CI in subjects over 50 years old, as a related factor. This was a case-controlled study that included 497 subjects aged over 50 years with SMCs who were recruited from 19 community pharmacies. Three screening tests were used to detect possible CIs, and individuals with at least one test result compatible with a CI were referred to primary care for evaluation. Having self-referred SMC increased the odds of obtaining scores compatible with CI and this factor was significantly related to having feelings of depression (OR = 2.24, 95% CI [1.34, 3.90]), taking anxiolytics or antidepressants (OR = 1.93, 95% CI [1.23, 3.05]), and being female (OR = 1.83, 95% CI [1.15, 2.88]). Thirty percent of our sample obtained scores compatible with CI. Age over 70 years increased the odds of obtaining scores compatible with CI. A high-level education, reading, and daily internet use were factors associated with a reduced risk of positive scores compatible with CI (37–91%, 7–18%, and 67–86%, respectively), while one extra hour television per day increased the risk by 8–30%. Among others, modifiable lifestyle factors such as reading, and daily internet usage may slow down cognitive decline in patients over 50 with SMCs. Four longitudinal studies and one quasi-experimental study found internet use to be beneficial against CI in patients over 50 years of age.
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Palpatzis E, Bass N, Jones R, Mukadam N. Longitudinal association of apolipoprotein E and sleep with incident dementia. Alzheimers Dement 2021; 18:888-898. [PMID: 34477303 DOI: 10.1002/alz.12439] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Few longitudinal studies have explored the association between apolipoprotein E gene (APOE) status, sleep disturbances, and incident dementia among middle-aged participants. METHODS Cox regression analyses explored the association of sleep duration, insomnia, and daytime napping with incident all-cause dementia and their interaction with APOE genetic risk among 397,777 middle-aged adults. RESULTS During a median of 10.8 years follow-up, sleeping more or fewer than 7 hours was associated with a higher dementia risk (hazard ratio [HR] for 5 vs 7 hours: 1.35, 95% confidence interval [CI] 1.11-1.64; HR for 9 vs 7 hours: 1.59; 95% CI 1.37-1.85) as was daytime napping (HR for often/all of the time vs never/rarely: 1.67; 95% CI 1.37-2.03). Stratified analyses revealed that the effects of sleep disturbances were similar across all APOE genetic risk groups. DISCUSSION Short and long sleep duration and daytime napping in middle-aged individuals are associated with the development of dementia in later life. Sleep duration and quality are important for everyone regardless of their genetic risk by APOE genotype.
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Affiliation(s)
- Eleni Palpatzis
- Division of Psychiatry, University College London, London, UK
| | - Nick Bass
- Division of Psychiatry, University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation trust, London, UK
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Cordone S, Scarpelli S, Alfonsi V, De Gennaro L, Gorgoni M. Sleep-Based Interventions in Alzheimer's Disease: Promising Approaches from Prevention to Treatment along the Disease Trajectory. Pharmaceuticals (Basel) 2021; 14:ph14040383. [PMID: 33921870 PMCID: PMC8073746 DOI: 10.3390/ph14040383] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
The multifactorial nature of Alzheimer’s disease (AD) has led scientific researchers to focus on the modifiable and treatable risk factors of AD. Sleep fits into this context, given the bidirectional relationship with AD confirmed by several studies over the last years. Sleep disorders appear at an early stage of AD and continue throughout the entire course of the pathology. Specifically, sleep abnormalities, such as more fragmented sleep, increase in time of awakenings, worsening of sleep quality and primary sleep disorders raise with the severity and progression of AD. Intervening on sleep, therefore, means acting both with prevention strategies in the pre-clinical phase and with treatments during the course of the disease. This review explores sleep disturbances in the different stages of AD, starting from the pre-clinical stage. Particular attention is given to the empirical evidence investigating obstructive sleep apnea (OSA) disorder and the mechanisms overlapping and sharing with AD. Next, we discuss sleep-based intervention strategies in the healthy elderly population, mild cognitive impairment (MCI) and AD patients. We mention interventions related to behavioral strategies, combination therapies, and bright light therapy, leaving extensive space for new and raising evidence on continuous positive air pressure (CPAP) treatment effectiveness. Finally, we clarify the role of NREM sleep across the AD trajectory and consider the most recent studies based on the promising results of NREM sleep enhancement, which use innovative experimental designs and techniques.
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Affiliation(s)
- Susanna Cordone
- UniCamillus, Saint Camillus International University of Health Sciences, 00131 Rome, Italy;
| | - Serena Scarpelli
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
| | | | - Luigi De Gennaro
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Correspondence:
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
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André C, Laniepce A, Chételat G, Rauchs G. Brain changes associated with sleep disruption in cognitively unimpaired older adults: A short review of neuroimaging studies. Ageing Res Rev 2021; 66:101252. [PMID: 33418092 DOI: 10.1016/j.arr.2020.101252] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/15/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
Ageing is characterized by a progressive decline of sleep quality. Sleep difficulties are increasingly recognized as a risk factor for Alzheimer's disease (AD), and have been associated with cognitive decline. However, the brain substrates underlying this association remain unclear. In this review, our objective was to provide a comprehensive overview of the relationships between sleep changes and brain structural, functional and molecular integrity, including amyloid and tau pathologies in cognitively unimpaired older adults. We especially discuss the topography and causality of these associations, as well as the potential underlying mechanisms. Taken together, current findings converge to a link between several sleep parameters, amyloid and tau levels in the CSF, and neurodegeneration in diffuse frontal, temporal and parietal areas. However, the existing literature remains heterogeneous, and the specific sleep changes associated with early AD pathological changes, in terms of topography and neuroimaging modality, is not clearly established yet. Notably, if slow wave sleep disruption seems to be related to frontal amyloid deposition, the brain correlates of sleep-disordered breathing and REM sleep disruption remain unclear. Moreover, sleep parameters associated with tau- and FDG-PET imaging are largely unexplored. Lastly, whether sleep disruption is a cause or a consequence of brain alterations remains an open question.
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15
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Ji X, Fu Y. The role of sleep disturbances in cognitive function and depressive symptoms among community-dwelling elderly with sleep complaints. Int J Geriatr Psychiatry 2021; 36:96-105. [PMID: 33411399 DOI: 10.1002/gps.5401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/28/2020] [Accepted: 08/08/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The relationships between sleep problems, cognitive impairments, and depression have been established in the aging population. However, less is known about the role of late-life onset insomnia and sex involved in these dyad or tripartite relationships. This study aimed to consider onset age of insomnia and sex in the relationship between sleep parameters, cognition and depression among older adults with current insomnia complaints. METHOD A multistep sampling method was adopted to recruit participants with current insomnia complaints in China in 2018. Sleep measures include onset age of insomnia (64 years old or before vs during/after 65), three factors from insomnia severity index (ISI; nighttime, daytime, and perception), excessive daytime sleepiness, and sleep duration. Outcome measures were mini-mental state examination (MMSE) and center for epidemiologic studies depression scale (CESD). RESULTS The average age of older adults was 75 (SD = 7.1). Among them, 62% participants are female. In general, older aged, female, late-life onset insomnia as well as interaction of sex * onset age of insomnia were significantly associated with poorer cognition. Yet, age, sex, and onset age of insomnia were not significant indicators for depression. For female participants, later onset of insomnia, nighttime symptoms of insomnia, excessive daytime sleepiness and depression were risk factors for cognitive decline. Nevertheless, only daytime sleepiness, together with depression, were found positively associated with male participants' cognitive decline. CONCLUSIONS There were robust associations between daytime sleepiness, depressive symptoms, and poor cognitive performance. More importantly, late-life onset insomnia was particularly indicative for poor cognitive performance among female older adults. Future study should emphasize the specific mechanism involved in changes of sleep patterns in the development of cognitive impairment among older adults. Sex differences in the relationship between onset age of insomnia and cognition also require further attention.
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Affiliation(s)
- Xiaowen Ji
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA
| | - Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
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16
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Xu W, Tan CC, Zou JJ, Cao XP, Tan L. Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2020; 91:236-244. [PMID: 31879285 PMCID: PMC7035682 DOI: 10.1136/jnnp-2019-321896] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/28/2019] [Accepted: 12/11/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To conduct an updated systematic review and meta-analysis of association between sleep and all-cause cognitive disorders. METHODS PubMed and EMBASE were searched from inception to 18 February 2019. Cohort studies exploring longitudinal associations of sleep with cognitive decline or dementia were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment. The robust error meta-regression model was used to conduct the dose-response meta-analysis for sleep duration. RESULTS 11 155 reports were searched and 51 eligible cohorts with 15 sleep problems were included for our meta-analyses. Ten types of sleep conditions or parameters, including six (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) with moderate-to-high levels of evidence, were linked to higher risk of all-cause cognitive disorders. Furthermore, a U-shaped relationship was revealed for the associations with sleep duration. CONCLUSIONS Sleep management might serve as a promising target for dementia prevention.
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Affiliation(s)
- Wei Xu
- Neurology Department, Qingdao Municipal Hospital Group, Qingdao University, Qingdao, Shandong, China
| | - Chen-Chen Tan
- Neurology Department, Qingdao Municipal Hospital Group, Qingdao University, Qingdao, Shandong, China
| | - Juan-Juan Zou
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; NHC Key Laboratory of Otorhinolaryngology, Shandong University, Jinan, China
| | - Xi-Peng Cao
- Clinical Research Center, Qingdao Municipal Hospital Group, Qingdao, Shandong, China
| | - Lan Tan
- Neurology Department, Qingdao Municipal Hospital Group, Qingdao University, Qingdao, Shandong, China
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Murillo-Rodríguez E, Budde H, Veras AB, Rocha NB, Telles-Correia D, Monteiro D, Cid L, Yamamoto T, Machado S, Torterolo P. The Endocannabinoid System May Modulate Sleep Disorders in Aging. Curr Neuropharmacol 2020; 18:97-108. [PMID: 31368874 PMCID: PMC7324886 DOI: 10.2174/1570159x17666190801155922] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022] Open
Abstract
Aging is an inevitable process that involves changes across life in multiple neurochemical, neuroanatomical, hormonal systems, and many others. In addition, these biological modifications lead to an increase in age-related sickness such as cardiovascular diseases, osteoporosis, neurodegenerative disorders, and sleep disturbances, among others that affect activities of daily life. Demographic projections have demonstrated that aging will increase its worldwide rate in the coming years. The research on chronic diseases of the elderly is important to gain insights into this growing global burden. Novel therapeutic approaches aimed for treatment of age-related pathologies have included the endocannabinoid system as an effective tool since this biological system shows beneficial effects in preclinical models. However, and despite these advances, little has been addressed in the arena of the endocannabinoid system as an option for treating sleep disorders in aging since experimental evidence suggests that some elements of the endocannabinoid system modulate the sleep-wake cycle. This article addresses this less-studied field, focusing on the likely perspective of the implication of the endocannabinoid system in the regulation of sleep problems reported in the aged. We conclude that beneficial effects regarding the putative efficacy of the endocannabinoid system as therapeutic tools in aging is either inconclusive or still missing.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Yucatán, México
- Intercontinental Neuroscience Research Group
| | - Henning Budde
- Intercontinental Neuroscience Research Group
- Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - André Barciela Veras
- Intercontinental Neuroscience Research Group
- Dom Bosco Catholic University, Campo Grande, Mato Grosso do Sul, Brazil
| | - Nuno Barbosa Rocha
- Intercontinental Neuroscience Research Group
- School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Diogo Telles-Correia
- Intercontinental Neuroscience Research Group
- University of Lisbon, Faculty of Medicine, Lisbon, Portugal
| | - Diogo Monteiro
- Intercontinental Neuroscience Research Group
- Sport Science School of Rio Maior-Polytechnic Institute of Santarém, Rio Maior, Portugal
- Research Center in Sport, Health and Human Development-CIDESD, Vila Real, Portugal
| | - Luis Cid
- Intercontinental Neuroscience Research Group
- Sport Science School of Rio Maior-Polytechnic Institute of Santarém, Rio Maior, Portugal
- Research Center in Sport, Health and Human Development-CIDESD, Vila Real, Portugal
| | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Sérgio Machado
- Intercontinental Neuroscience Research Group
- Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil
| | - Pablo Torterolo
- Intercontinental Neuroscience Research Group
- Laboratorio de Neurobiología del Sueño, Departamento de Fisiología, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Sleep Quality and Cognitive Function in Type 1 Diabetes: Findings From the Study of Longevity in Diabetes (SOLID). Alzheimer Dis Assoc Disord 2019; 34:18-24. [PMID: 31567303 DOI: 10.1097/wad.0000000000000351] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE The objective was to examine the association between sleep quality and global and domain-specific cognitive function among older individuals with type 1 diabetes (T1D). METHODS We evaluated 695 individuals with T1D aged 60 years or above who participated in the baseline assessment of the Study of Longevity in Diabetes (SOLID), which captured subjective sleep quality (Pittsburgh Sleep Quality Index) and global and domain-specific (language, executive function, episodic memory, and simple attention) cognitive function. Multivariable linear regressions estimated the associations between sleep quality quartiles and overall and domain-specific cognitive function adjusting for age, sex, race/ethnicity, education, depressive symptoms, and severe hypoglycemic episodes. Sensitivity analyses examined the associations between aspects of sleep quality and global cognitive function. RESULTS The worst sleep quality quartile was associated with lower global cognition (β=-0.08; 95% confidence interval: -0.17, -0.01) and lower executive function (β=-0.17, 95% confidence interval: -0.30, -0.03) compared with the best quartile of sleep quality adjusting for demographics and comorbidities. Sleep quality was not associated with language, episodic memory, or simple attention. Sleep medications and daytime dysfunction were most strongly associated with global cognition. CONCLUSION Our results suggest that sleep quality may be a modifiable risk factor for global cognitive function and executive function among elderly individuals with T1D.
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19
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Gabelle A, Gutierrez LA, Jaussent I, Ben Bouallegue F, De Verbizier D, Navucet S, Grasselli C, Bennys K, Marelli C, David R, Mariano-Goulart D, Andrieu S, Vellas B, Payoux P, Berr C, Dauvilliers Y. Absence of Relationship Between Self-Reported Sleep Measures and Amyloid Load in Elderly Subjects. Front Neurol 2019; 10:989. [PMID: 31572295 PMCID: PMC6753692 DOI: 10.3389/fneur.2019.00989] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/30/2019] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine the relationships between self-reported sleep profile and cortical amyloid load in elderly subjects without dementia. Methods: This cross-sectional study included 143 community-dwelling participants aged ≥70 years (median: 73 years [70–85]; 87 females) with spontaneous memory complaints but dementia-free. Sociodemographic characteristics, health status, neuropsychological tests, sleep, and 18F-florbetapir (amyloid) PET data were collected. The clinical sleep interview evaluated nighttime sleep duration, but also daytime sleep duration, presence of naps, and restless leg syndrome (RLS) at time of study. Validated questionnaires assessed daytime sleepiness, insomnia, and risk of sleep apnea. The cortical standardized uptake value ratio (SUVr) was computed across six cortical regions. The relationship between sleep parameters and SUVr (cut-off ratio>1.17 and tertiles) was analyzed using logistic regression models. Results: Amyloid-PET was positive in 40.6% of participants. Almost 40% were at risk for apnea, 13.5% had RLS, 35.5% insomnia symptoms, 22.1% daytime sleepiness, and 18.8% took sleep drugs. No significant relationship was found between positive amyloid PET and nighttime sleep duration (as a continuous variable, or categorized into <6; 6–7; ≥7 h per night). Logistic regression models did not show any association between SUVr and daytime sleep duration, 24-h sleep duration, naps, RLS, daytime sleepiness, insomnia symptoms, and sleep apnea risk (before and after adjustment for APOEε4 and depressive symptoms). Conclusion: Our study did not confirm the association between amyloid-PET burden, poor sleep quantity/quality in elderly population, suggesting that the interplay between sleep, and amyloid is more complex than described.
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Affiliation(s)
- Audrey Gabelle
- Department of Neurology, Memory Research and Resources Center, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France.,Université de Montpellier, MUSE, Montpellier, France
| | - Laure-Anne Gutierrez
- INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France.,Université de Montpellier, MUSE, Montpellier, France
| | - Isabelle Jaussent
- INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France.,Université de Montpellier, MUSE, Montpellier, France
| | - Fayçal Ben Bouallegue
- Université de Montpellier, MUSE, Montpellier, France.,Nuclear Medicine Department, CHU Montpellier, Montpellier, France.,PhyMedExp, INSERM-CNRS, Montpellier University, Montpellier, France
| | | | - Sophie Navucet
- Department of Neurology, Memory Research and Resources Center, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France
| | - Caroline Grasselli
- Department of Neurology, Memory Research and Resources Center, CHU Montpellier, Montpellier, France.,INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France
| | - Karim Bennys
- Department of Neurology, Memory Research and Resources Center, CHU Montpellier, Montpellier, France
| | - Cécilia Marelli
- Department of Neurology, Memory Research and Resources Center, CHU Montpellier, Montpellier, France
| | - Renaud David
- Department of Psychiatry, Memory Research and Resources Center, CHU Nice, Nice, France
| | - Denis Mariano-Goulart
- Université de Montpellier, MUSE, Montpellier, France.,Nuclear Medicine Department, CHU Montpellier, Montpellier, France.,PhyMedExp, INSERM-CNRS, Montpellier University, Montpellier, France
| | - Sandrine Andrieu
- Gérontopôle de Toulouse, Inserm UMR1027, Toulouse Université III, Toulouse, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, Inserm UMR1027, Toulouse Université III, Toulouse, France
| | - Pierre Payoux
- Nuclear Medicine Department, CHU Toulouse, Toulouse, France
| | - Claudine Berr
- INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France.,Université de Montpellier, MUSE, Montpellier, France
| | - Yves Dauvilliers
- INSERM, U1061, Neuropsychiatrie, Recherche Clinique et Epidémiologique, Montpellier, France.,Université de Montpellier, MUSE, Montpellier, France.,Department of Neurology, Narcolepsy National Reference Center, Sleep Center, CHU Montpellier, Montpellier, France
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Leng Y, Redline S, Stone KL, Ancoli-Israel S, Yaffe K. Objective napping, cognitive decline, and risk of cognitive impairment in older men. Alzheimers Dement 2019; 15:1039-1047. [PMID: 31227429 PMCID: PMC6699896 DOI: 10.1016/j.jalz.2019.04.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/11/2019] [Accepted: 04/10/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Little is known about the longitudinal association between napping and cognitive impairment in older adults. METHODS We used wrist actigraphy to measure naps in 2751 community-dwelling older men. Cognition was assessed repeatedly over 12 years, and clinically significant cognitive impairment was determined by physician diagnosis, Alzheimer's medication use or a significant cognitive decline. RESULTS After adjustment for all covariates, men with longer napping duration had greater cognitive decline and higher risk of cognitive impairment. Men who napped for ≥120 min/day (vs. <30 min/day) were 66% more likely to develop cognitive impairment (odds ratio = 1.66, 95% CI: 1.09-2.54) in 12 years. Further adjustment for nighttime sleep quality did not appreciably alter the results. The association between napping and cognitive impairment was more pronounced among those with higher sleep efficiency and average sleep duration. DISCUSSION Napping might be useful as an early marker of cognitive impairment in the elderly, and its cognitive effects may differ by nighttime sleep.
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Affiliation(s)
- Yue Leng
- Department of Psychiatry, University of California, San Francisco, CA, USA.
| | - Susan Redline
- Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | | | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA, USA
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Morgan K, Hartescu I. Sleep duration and all-cause mortality: links to physical activity and prefrailty in a 27-year follow up of older adults in the UK. Sleep Med 2019; 54:231-237. [DOI: 10.1016/j.sleep.2018.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
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22
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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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Proserpio P, Arnaldi D, Nobili F, Nobili L. Integrating Sleep and Alzheimer’s Disease Pathophysiology: Hints for Sleep Disorders Management. J Alzheimers Dis 2018; 63:871-886. [DOI: 10.3233/jad-180041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Paola Proserpio
- Centre of Sleep Medicine, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Dario Arnaldi
- Department of Neuroscience (DINOGMI), University of Genoa, Italy
- Clinical of Neurology, Polyclinic San Martino Hospital, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Italy
- Clinical of Neurology, Polyclinic San Martino Hospital, Genoa, Italy
| | - Lino Nobili
- Centre of Sleep Medicine, Department of Neuroscience, Niguarda Hospital, Milan, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Italy
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