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Wang S, Chen Y, Xiong L, Jin N, Zhao P, Liang Z, Cheng L, Kang L. Multimorbidity measures associated with cognitive function among community-dwelling older Chinese adults. Alzheimers Dement 2024. [PMID: 39072982 DOI: 10.1002/alz.14117] [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: 07/11/2023] [Revised: 05/17/2024] [Accepted: 06/07/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Older adults with multimorbidity are at high risk of cognitive impairment development. There is a lack of research on the associations between different multimorbidity measures and cognitive function among older Chinese adults living in the community. METHODS We used the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2018 and included data on dementia-free participants aged ≥65 years. Multimorbidity measures included condition counts, multimorbidity patterns, and trajectories. The association of multimorbidity measures with cognitive function was examined by generalized estimating equation and linear and logistic regression models. RESULTS Among 14,093 participants at baseline, 43.2% had multimorbidity. Multimorbidity patterns were grouped into cancer-inflammatory, cardiometabolic, and sensory patterns. Multimorbidity trajectories were classified as "onset-condition," "newly developing," and "severe condition." The Mini-Mental State Examination scores were significantly lower for participants with more chronic conditions, with cancer-inflammatory/cardiometabolic/sensory patterns, and with developing multimorbidity trajectories. DISCUSSION Condition counts, sensory pattern, cardiometabolic pattern, cancer-inflammatory pattern, and multimorbidity developmental trajectories were prospectively associated with cognitive function. HIGHLIGHTS Elderly individuals with a higher number of chronic conditions were associated with lower MMSE scores in the Chinese Longitudinal Healthy Longevity Survey data. MMSE scores were significantly lower for participants with specific multimorbidity patterns. Individuals with developing trajectories of multimorbidity were associated with lower MMSE scores and a higher risk of mild cognitive impairment.
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Affiliation(s)
- Shuojia Wang
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
- Post-doctoral Scientific Research Station of Basic Medicine, Jinan University, Guangzhou, China
| | - Yilin Chen
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
| | - Lijiao Xiong
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
| | - Nana Jin
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
- Post-doctoral Scientific Research Station of Basic Medicine, Jinan University, Guangzhou, China
| | - Pengfei Zhao
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
| | - Zhen Liang
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
| | - Lixin Cheng
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
| | - Lin Kang
- Department of Geriatrics, Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, China
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Sivarajkumar S, Tam TYC, Mohammad HA, Viggiano S, Oniani D, Visweswaran S, Wang Y. Extraction of sleep information from clinical notes of Alzheimer's disease patients using natural language processing. J Am Med Inform Assoc 2024:ocae177. [PMID: 39001795 DOI: 10.1093/jamia/ocae177] [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: 02/29/2024] [Revised: 06/19/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVES Alzheimer's disease (AD) is the most common form of dementia in the United States. Sleep is one of the lifestyle-related factors that has been shown critical for optimal cognitive function in old age. However, there is a lack of research studying the association between sleep and AD incidence. A major bottleneck for conducting such research is that the traditional way to acquire sleep information is time-consuming, inefficient, non-scalable, and limited to patients' subjective experience. We aim to automate the extraction of specific sleep-related patterns, such as snoring, napping, poor sleep quality, daytime sleepiness, night wakings, other sleep problems, and sleep duration, from clinical notes of AD patients. These sleep patterns are hypothesized to play a role in the incidence of AD, providing insight into the relationship between sleep and AD onset and progression. MATERIALS AND METHODS A gold standard dataset is created from manual annotation of 570 randomly sampled clinical note documents from the adSLEEP, a corpus of 192 000 de-identified clinical notes of 7266 AD patients retrieved from the University of Pittsburgh Medical Center (UPMC). We developed a rule-based natural language processing (NLP) algorithm, machine learning models, and large language model (LLM)-based NLP algorithms to automate the extraction of sleep-related concepts, including snoring, napping, sleep problem, bad sleep quality, daytime sleepiness, night wakings, and sleep duration, from the gold standard dataset. RESULTS The annotated dataset of 482 patients comprised a predominantly White (89.2%), older adult population with an average age of 84.7 years, where females represented 64.1%, and a vast majority were non-Hispanic or Latino (94.6%). Rule-based NLP algorithm achieved the best performance of F1 across all sleep-related concepts. In terms of positive predictive value (PPV), the rule-based NLP algorithm achieved the highest PPV scores for daytime sleepiness (1.00) and sleep duration (1.00), while the machine learning models had the highest PPV for napping (0.95) and bad sleep quality (0.86), and LLAMA2 with finetuning had the highest PPV for night wakings (0.93) and sleep problem (0.89). DISCUSSION Although sleep information is infrequently documented in the clinical notes, the proposed rule-based NLP algorithm and LLM-based NLP algorithms still achieved promising results. In comparison, the machine learning-based approaches did not achieve good results, which is due to the small size of sleep information in the training data. CONCLUSION The results show that the rule-based NLP algorithm consistently achieved the best performance for all sleep concepts. This study focused on the clinical notes of patients with AD but could be extended to general sleep information extraction for other diseases.
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Affiliation(s)
- Sonish Sivarajkumar
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Thomas Yu Chow Tam
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Haneef Ahamed Mohammad
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Samuel Viggiano
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - David Oniani
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Shyam Visweswaran
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA 15260, United States
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Yanshan Wang
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA 15260, United States
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA 15260, United States
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA 15260, United States
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15260, United States
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Lau SCL, Hall ML, Terhorst L, Skidmore ER. Bidirectional temporal associations between sleep and affect and cognitive symptoms among community-dwelling stroke survivors: An ecological momentary assessment study. PM R 2024; 16:669-678. [PMID: 37950680 DOI: 10.1002/pmrj.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/13/2023] [Accepted: 11/04/2023] [Indexed: 11/13/2023]
Abstract
INTRODUCTION Sleep plays a critical role in daily functioning and stroke recovery but receives little attention in stroke rehabilitation. Sleep disturbances are linked to affective and cognitive impairments, but temporal associations between sleep and affect and cognitive symptoms are less clear. Understanding these temporal associations may inform new directions in intervention and prevention to support continued stroke recovery. OBJECTIVE To examine the bidirectional temporal associations between sleep and affect and cognitive symptoms among community-dwelling stroke survivors. DESIGN A secondary analysis of a longitudinal observational study involving 7 days of ecological momentary assessment (EMA), during which participants completed eight EMA surveys and a sleep diary per day. Multilevel modeling was used to analyze data. SETTING Community. PARTICIPANTS Community-dwelling stroke survivors (N = 40). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES EMA measures of depressed affect, cheerful affect, and cognitive symptoms. Sleep quality and duration as measured using a sleep diary. RESULTS Between-person sleep quality was negatively associated with next-day depressed affect (B = -.16; p = .028) and positively associated with next-day cheerful affect (B = .63; p < .001). Inversely, between-person depressed affect was negatively associated with next night sleep quality (B = -.77; p = .015), and vice versa for cheerful affect (between-person: B = .45; p < .001; within-person: B = .09; p = .008). Long sleep (>9 hours) was positively associated with next-day cognitive symptoms (B = .13; p = .002), whereas cognitive symptoms were associated with a higher odds of long sleep the following night (odds ratio [OR] = 0.25; p = .047). CONCLUSIONS This study identified the bidirectional associations of sleep with affect and cognitive symptoms in the context of the everyday life of stroke survivors. The findings suggest that interventions addressing sleep quality and duration may impact affect and cognitive symptoms, and vice versa.
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Affiliation(s)
- Stephen C L Lau
- Department of Occupational Therapy, School of Health and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Martica L Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Callow DD, Spira AP, Zipunnikov V, Lu H, Wanigatunga SK, Rabinowitz JA, Albert M, Bakker A, Soldan A. Sleep and physical activity measures are associated with resting-state network segregation in non-demented older adults. Neuroimage Clin 2024; 43:103621. [PMID: 38823249 PMCID: PMC11179421 DOI: 10.1016/j.nicl.2024.103621] [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: 02/14/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
Greater physical activity and better sleep are associated with reduced risk of cognitive decline and dementia among older adults, but little is known about their combined associations with measures of brain function and neuropathology. This study investigated potential independent and interactive cross-sectional relationships between actigraphy-estimated total volume of physical activity (TVPA) and sleep patterns [i.e., total sleep time (TST), sleep efficiency (SE)] with resting-state functional magnetic resonance imaging (rs-fMRI) measures of large scale network connectivity and positron emission tomography (PET) measures of amyloid-β. Participants were 135 non-demented older adults from the BIOCARD study (116 cognitively normal and 19 with mild cognitive impairment; mean age = 70.0 years). Using multiple linear regression analyses, we assessed the association between TVPA, TST, and SE with connectivity within the default-mode, salience, and fronto-parietal control networks, and with network modularity, a measure of network segregation. Higher TVPA and SE were independently associated with greater network modularity, although the positive relationship of SE with modularity was only present in amyloid-negative individuals. Additionally, higher TVPA was associated with greater connectivity within the default-mode network, while greater SE was related to greater connectivity within the salience network. In contrast, longer TST was associated with lower network modularity, particularly among amyloid-positive individuals, suggesting a relationship between longer sleep duration and greater network disorganization. Physical activity and sleep measures were not associated with amyloid positivity. These data suggest that greater physical activity levels and more efficient sleep may promote more segregated and potentially resilient functional networks and increase functional connectivity within specific large-scale networks and that the relationship between sleep and functional networks connectivity may depend on amyloid status.
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Affiliation(s)
- Daniel D Callow
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Adam P Spira
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America; Johns Hopkins Center on Aging and Health, Baltimore, MD, the United States of America
| | - Vadim Zipunnikov
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Sarah K Wanigatunga
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, the United States of America
| | - Jill A Rabinowitz
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ US
| | - Marilyn Albert
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Arnold Bakker
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
| | - Anja Soldan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, the United States of America
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Ouyang M, Chen T, Chen J, Liu C, Luo H, Yang S, Liao W. The association between sleep duration, bedtime, and cognitive ability in Chinese adults: Evidence from the China family panel studies. Heliyon 2024; 10:e30009. [PMID: 38737242 PMCID: PMC11088265 DOI: 10.1016/j.heliyon.2024.e30009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Dementia is marked by a steady decline or worsening in cognitive abilities, affecting memory, logic, and social competencies. While many studies suggest a potential link between the amount of sleep and dementia risk, the outcomes are not yet consistent. This research delved into the relationship between sleep length and bedtime on cognitive abilities using an extensive dataset from the China Family Panel Studies (CFPS) from 2014 to 2020. Methods Data from 175,702 observations were collected, including cognitive function test data from 22,848 participants. Various cognitive tests were used to assess cognitive function. Restricted cubic spline (RCS) models were used for data analysis. Results The optimal sleep duration for cognitive function was found to be 6-7 h, and the optimal bedtime was generally between 22:00-23:00. Longitudinal analysis revealed that sleep duration four years prior had a significant impact on current cognitive function. After accounting for various factors, those who slept for 7-8 h and over 8 h displayed lower cognitive function scores. Conversely, individuals sleeping less than 6 h had higher scores on the Vocabulary Test. Bedtime before 22:00 was associated with lower scores on the Vocabulary Test and Mathematical Test. Subgroup analyses based on age, gender, and urban residence showed variations in optimal sleep duration for different populations. Propensity Score Matching (PSM) analysis supported the findings. Conclusions Maintaining a sleep duration of 6-7 h and a regular bedtime between 22:00-23:00 is important for optimizing cognitive performance.
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Affiliation(s)
- Mengqian Ouyang
- Department of Economics, Guangdong Institute of Public Administration, Guangzhou, China
| | - Tao Chen
- Structural Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiawei Chen
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chongxu Liu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haoyu Luo
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaoqing Yang
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wang Liao
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Huang S, Zhong W, Cheng Q, Shuai Y, Zhu J, Diao J. Instrumental activities of daily living function and cognitive status among Chinese older adults: a serial multiple mediation model. Front Public Health 2024; 12:1378979. [PMID: 38756886 PMCID: PMC11096471 DOI: 10.3389/fpubh.2024.1378979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study aimed to develop and validate a serial multiple mediation model to investigate the association between instrumental activities of daily living (IADL) function and cognitive status among older adults while exploring the underlying mechanisms. Methods This cross-sectional study involved 3,665 individuals aged 60 years and older who participated in the China Health and Retirement Longitudinal Survey (CHARLS). A serial multiple mediation model was utilized to explore the direct and indirect relationship between IADL function and cognitive status and whether sleep duration, social engagement, and depressive symptoms mediated this relationship. Results Decreased IADL function was associated with worse cognitive status [effect = -0.620, 95% CI: (-0.692, -0.540)]. Sleep duration, social participation (SP), and depressive symptoms all acted as mediators in the relationship between IADL function and cognitive status. Conclusion This study found both direct and indirect associations between IADL function and cognitive status, providing new insights into the effective prevention and intervention of cognitive decline among older adults.
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Affiliation(s)
| | - Wenjuan Zhong
- School of Medicine and Health, Wuhan Polytechnic University, Wuhan, China
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Zhu L, Wang Y, Wu Y, Wilson A, Zhou H, Li N, Wang Y. Longitudinal associations between the frequency of playing Mahjong and cognitive functioning among older people in China: evidence from CLHLS, 2008-2018. Front Public Health 2024; 12:1352433. [PMID: 38550318 PMCID: PMC10973127 DOI: 10.3389/fpubh.2024.1352433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/01/2024] [Indexed: 04/02/2024] Open
Abstract
Background Cognitive decline is prevalent among older adults, often resulting in decreased capabilities for self-care and a diminished quality of life. Mahjong, a culturally cherished and extensively played intellectual game in China, demands considerable cognitive function. While the cognitive benefits of playing Mahjong have been widely accepted, this study investigates an under explored aspect and aimed to ascertain the game's potential contributions toward bolstering self-care abilities, enhancing overall quality of life, and mitigating against rising societal healthcare costs. Methods The data analyzed in the study is collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with cognitive functioning being assessed through the Mini-Mental State Examination (MMSE). The frequency of playing Mahjong was measured through a self-reported questionnaire. Multiple linear regression models, latent variable growth models, and cross-lagged models were used to investigate the longitudinal relationship between game frequency and cognitive function in older people. Results Of the 7,535 participants, the mean (SD) age was 81.96 (10.53) years. There were 7,308 (97%), 4,453 (59%), and 1,974 (26%) participants in 2011, 2014, and 2018, respectively. The results showed that Mahjong players had significantly higher MMSE scores compared to non-players from 2008 to 2018 (β = 0.893; p < 0.001), and non-players had significantly lower scores in 2011, 2014, and 2018 than in 2008 (β = -1.326, -0.912, -0.833; Ps > 0.05). Moreover, the frequency of playing Mahjong was associated with improved various cognitive domains. The declining frequency of playing Mahjong was substantially associated with the declining rate of MMSE scores (r = 0.336; p < 0.001). Mahjong frequency showed positive effects on MMSE scores, while the influence of Mahjong on MMSE scores were not significant. Conclusion Playing Mahjong has a positive influence on the cognitive functioning among older people. It can help buffer against the decline in cognitive function and maintain cognitive function levels. The higher frequency of playing Mahjong is associated with improved reaction, attention and calculation, and self-coordination. A decline in the frequency of playing Mahjong was associated with a declining rate of cognitive function. The higher frequency of playing Mahjong among older people unilaterally influenced the improvement of cognitive function levels in older people in China.
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Affiliation(s)
- Lan Zhu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yixi Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuju Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Amanda Wilson
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Huan Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ningxiu Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Miyata J, Muraki I, Iso H, Yamagishi K, Yasuda N, Sawada N, Inoue M, Tsugane S. Sleep duration, its change, and risk of dementia among Japanese: The Japan Public Health Center-based Prospective Study. Prev Med 2024; 180:107884. [PMID: 38309314 DOI: 10.1016/j.ypmed.2024.107884] [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: 09/13/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE Previous findings on the association between sleep duration, changes in sleep duration, and long-term dementia risk were mixed. Thus, we aimed to investigate the association between midlife sleep duration, its change, and dementia. METHODS We recruited 41,731 Japanese (40-71 years) and documented their habitual sleep duration at baseline (1990-1994) and a 5-year follow-up survey. Changes in sleep duration were calculated as differences between baseline and 5-year measurements. We identified dementia using the Long-Term Care Insurance system (2007-2016). Hazard ratios (HRs) and 95% confidence intervals (CIs) of dementia were calculated using the area-stratified Cox model. RESULTS During 360,389 person-years, 4621 participants exhibited dementia. The multivariable HRs of dementia compared with 7 h of sleep were 1.13 (95% CI: 0.98-1.30) for 3-5 h, 0.93 (0.85-1.02) for 6 h, 1.06 (0.99-1.14) for 8 h, 1.13 (1.01-1.27) for 9 h, and 1.40 (1.21-1.63) for 10-12 h with a J-shaped fashion (p for linear < 0.001 and quadratic < 0.001). For its change, the HRs compared with no change were 1.02 (0.90-1.16) for decreased ≥2 h, 0.95 (0.88-1.03) for decreased 1 h, 1.00 (0.91-1.09) for increased 1 h, and 1.37 (1.20-1.58) for increased ≥2 h. The positive association for decreased sleep duration was observed in individuals with an initial sleep duration of ≤7 h, but not in those with ≥8 h (p for interaction = 0.007). CONCLUSIONS Long and increased sleep duration was associated with a higher risk of dementia.
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Affiliation(s)
- Jun Miyata
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, 205 Yoshikugicho, Goto, Nagasaki 853-8691, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Institute for Global Health Policy Research, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan; Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kohasu, Okoh-cho, Nankoku, Kochi 783-8505, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan; Division of Prevention, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institution for Cancer Control, 5-1-1 Tsukiji, Chuo, Tokyo 104-0045, Japan; International University of Health and Welfare Graduate School of Public Health, 4-1-26 Akasaka, Minato, Tokyo 107-8402, Japan
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Zhai L, Yang Y, Zhang J, Hou W, Yang Y, Ding D, Li C, Zhu Y. Association between cognitive dysfunction and diabetes in patients over 65 years old: a cross-sectional study using propensity score matching. J Rehabil Med 2024; 56:jrm18372. [PMID: 38380813 PMCID: PMC10896218 DOI: 10.2340/jrm.v56.18372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES To investigate the association between diabetes and cognitive dysfunction in the elderly population, and examine the impact of cognitive dysfunction on level of activities of daily living (ADL) in patients with diabetes. METHODS Data analysis was conducted on 2,951 individuals aged over 65 years from the Chinese Longitudinal Healthy Longevity Survey cohort. Propensity score matching was utilized to mitigate selection bias. Multivariate binary logistic regression was performed to analyse the association between diabetes and cognitive dysfunction in the study subjects. In addition, the relationship between ADL and cognitive function in patients with diabetes was analysed using the Wilcoxon rank-sum test. RESULTS A significant association (p = 0.017) was found between diabetes and the occurrence of cognitive dysfunction in older adults. Subgroup analyses revealed that diabetes patients with cognitive dysfunction exhibited a worse ADL dependence compared with those without cognitive dysfunction (p < 0.001). CONCLUSION These findings indicate that diabetes is associated with cognitive dysfunction in older adults. Meanwhile, there is an association between cognitive impairment and ADL level in subjects with diabetes. As such, healthcare professionals should pay close attention to the occurrence of cognitive dysfunction and ADL decline during diagnosis and treatment, and proactive prevention and intervention strategies should be implemented.
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Affiliation(s)
- Liwen Zhai
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yao Yang
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Zhang
- Department of Rehabilitation Medicine, Hainan Cancer Hospital, Haikou, Hainan, China
| | - Weiqian Hou
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yujie Yang
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Dongfang Ding
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Conghui Li
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China; Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Zhu
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
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Huang H, Zhuang Z, Wan Y, Shi J, Yuan X, Wang D, Chen S. Knowledge Structure and Emerging Trends of Mild Cognitive Impairment with Dyssomnias in Recent 20 Years: A Bibliometric Analysis via CiteSpace and VOSviewer. Behav Neurol 2024; 2024:6622212. [PMID: 38223295 PMCID: PMC10787659 DOI: 10.1155/2024/6622212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
Background Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its heightened propensity for progressing toward dementia. Sleep plays a pivotal role in cognitive function, with dyssomnias not only exacerbating cognitive and affective symptoms associated with neurodegenerative diseases but also contributing to disease progression. Aim This bibliometric analysis investigates the global research on MCI with dyssomnias over the past two decades, aiming to discern key findings, research domains, and emerging trends in this field. Methods In this study, a bibliometric analysis was conducted using the search terms "MCI" and "sleep". Data were extracted from the Web of Science Core Collection database, and visualization and collaborative analysis were performed using CiteSpace and VOSviewer. Results This study encompassed 546 publications from 2003 to 2023. The publication volume and citation rate consistently increased over time. Neurosciences, Clinical Neurology, and Geriatrics Gerontology emerged as the top three research fields. The Journal of Alzheimer's Disease had the highest publication count, while Sleep Medicine received the most citations. USA, China, and Italy led in publication output. Collaborative clusters among authors and institutions were identified, but cooperation between clusters was limited. Active cocited reference clusters included "obstructive sleep apnea", "possible mediating pathways", and "isolated rapid eye movement sleep behaviour disorder". The top frequently mentioned keywords, besides "MCI", were "Alzheimer's disease", "dementia", "risk factor", and "Parkinson's Disease". Notable keyword clusters spanned circadian rhythm, Parkinson's disease, MCI, dementia with Lewy body, subjective cognitive impairment, Lewy body disease, Alzheimer's disease, and dietary patterns. Conclusion The field of MCI with dyssomnias is rapidly expanding, encompassing a wide range of neurodegenerative disorders and sleep disturbances. Current research endeavors are primarily focused on elucidating the underlying pathogenesis, predicting disease progression, and developing innovative treatment strategies for individuals affected by MCI with dyssomnias.
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Affiliation(s)
- Haoyu Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Zesen Zhuang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Yiwen Wan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Jiao Shi
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Xu Yuan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Dan Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
| | - Shangjie Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen 518101, China
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11
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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12
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Bulycheva I, Watanabe Y, Kitamura K, Kabasawa K, Saito T, Takahashi A, Kobayashi R, Oshiki R, Takachi R, Tsugane S, Yamazaki O, Watanabe K, Nakamura K. Self-Reported Sleep Duration and Bedtime Are Associated with Dementia Risk in Community-Dwelling People Aged 40-74 Years: The Murakami Cohort Study. J Alzheimers Dis 2024; 99:535-547. [PMID: 38669530 DOI: 10.3233/jad-231104] [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: 04/28/2024]
Abstract
Background Sleep is a potentially modifiable factor associated with dementia, including Alzheimer's disease, but current evidence supporting this is insufficient. Objective This study aimed to determine whether sleep duration and bedtime patterns are associated with the risk of dementia among middle-aged and older people. Methods This cohort study had an eight-year follow-up period. Participants were 13,601 community-dwelling people aged 40-74 years living in Murakami (Niigata, Japan). Data were collected using a self-administered questionnaire. Predictors were self-reported sleep duration and bedtime, and the outcome was newly-diagnosed dementia determined using the long-term care insurance database. Covariates were demographic characteristics, body mass index, smoking, alcohol consumption, total physical activity, insomnia symptoms, disease history, and either bedtime or sleep duration. Cox proportional hazard models were used to calculate hazard ratios (HRs). Results The mean age of participants at baseline was 59.2 years. Over a mean follow-up period of 8.0 years, 319 cases of dementia were observed. A long self-reported sleep duration relative to the reference sleep duration (7 hours) was associated with increased dementia risk, with the "8 hours" group (adjusted HR = 1.30, 95% CI:0.99-1.73) and "≥9 hours" group (adjusted HR = 1.46, 95% CI:1.00-2.15) having an increased risk (marginally significant) relative to the reference group. Early bedtime was associated with increased dementia risk (adjusted p for trend = 0.0010), with the "21 : 00 or earlier" group (adjusted HR = 1.61, 95% CI:1.14-2.28) having an increased risk relative to the reference ("23 : 00"). Conclusions A long self-reported sleep duration and early bedtime are both associated with increased dementia risk in middle-aged and older people.
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Affiliation(s)
- Irina Bulycheva
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshiko Saito
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | | | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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13
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Sen A, Tai XY. Sleep Duration and Executive Function in Adults. Curr Neurol Neurosci Rep 2023; 23:801-813. [PMID: 37957525 PMCID: PMC10673787 DOI: 10.1007/s11910-023-01309-8] [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] [Accepted: 09/26/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW To review the literature examining the relationship between sleep and cognition, specifically examining the sub-domain of executive function. We explore the impact of sleep deprivation and the important question of how much sleep is required for optimal cognitive performance. We consider how other sleep metrics, such as sleep quality, may be a more meaningful measure of sleep. We then discuss the putative mechanisms between sleep and cognition followed by their contribution to developing dementia. RECENT FINDINGS Sleep duration and executive function display a quadratic relationship. This suggests an optimal amount of sleep is required for daily cognitive processes. Poor sleep efficiency and sleep fragmentation are linked with poorer executive function and increased risk of dementia during follow-up. Sleep quality may therefore be more important than absolute duration. Biological mechanisms which may underpin the relationship between sleep and cognition include brain structural and functional changes as well as disruption of the glymphatic system. Sleep is an important modifiable lifestyle factor to improve daily cognition and, possibly, reduce the risk of developing dementia. The impact of optimal sleep duration and sleep quality may have important implications for every ageing individual.
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Affiliation(s)
- Aayushi Sen
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Level 6 West Wing, Oxford, UK.
| | - Xin You Tai
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Level 6 West Wing, Oxford, UK
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14
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Chen R, Chen Q, Lu G, Zhang M, Zhang M, Yang H, Qi K, Yu H, Zheng M, He Q. Sleep duration and depressive symptoms in Chinese middle-aged and older adults: The moderating effects of grip strength. J Affect Disord 2023; 339:348-354. [PMID: 37451435 DOI: 10.1016/j.jad.2023.07.059] [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: 03/06/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Evidence on the combined effect of sleep duration and grip strength on depressive symptoms is scarce. This study aimed to explore the moderating effect of grip strength on the association between sleep duration and depressive symptoms in a large cohort of middle-aged and older adults. METHOD Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018 wave. Grip strength and sleep duration were assessed by dynamometer and self-report, respectively. Depressive symptoms were determined by the Centre for Epidemiological Studies Depression scale (CESD-10). Multivariable cox regression model was used to explore the associations between sleep duration, and depressive symptoms, and assess moderation by grip strength. RESULTS A total of 4337 participants aged 57.0 ± 8.1 years (45.1 % females) were included in this study. During the 7-year follow up period, 1508 participants developed depressive symptoms. Short sleep duration (<6 h/d) was significantly associated with an increased risk of depressive symptoms [Hazard ratio (HR):1.24, 95 % confidence interval (CI):1.09, 1.40)]. This association remained in individuals with the low (HR:1.22, 95%CI:1.00, 1.49) and middle grip strength (HR:1.32, 95%CI: 1.07, 1.63), but attenuated in individuals with high grip strength (HR:1.11, 95%CI: 0.86, 1.43). CONCLUSIONS High grip strength mitigated the association between short sleep duration and higher risk of depressive symptoms. Thus, improving sleep duration and strengthening muscle strength are recommended to prevent depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Rui Chen
- School of Public Health, Wuhan University, Wuhan, China
| | - Qiutong Chen
- College of Language Intelligence, Sichuan International Studies University, Chongqing, China
| | - Gaolei Lu
- School of Public Health, Wuhan University, Wuhan, China
| | - Minjie Zhang
- School of Public Health, Wuhan University, Wuhan, China
| | - Minzhe Zhang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Kaijie Qi
- School of Public Health, Wuhan University, Wuhan, China
| | - Hongjie Yu
- School of Public Health, Wuhan University, Wuhan, China
| | - Miaobing Zheng
- School of Nutrition and Exercise, Deakin University, Melbourne, Australia.
| | - Qiqiang He
- School of Public Health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.
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15
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Lin J, Xiao J, Li Q, Cao L. Association between all-cause mortality and trajectories across quality and duration of sleep and cognitive function: based on Group-Based Multivariate Trajectory modeling. BMC Geriatr 2023; 23:528. [PMID: 37648983 PMCID: PMC10468863 DOI: 10.1186/s12877-023-04231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sleep duration and quality are associated with cognition, but the interaction of the 3 indicators and their association with all-cause mortality is unclear. METHODS We used data from the Chinese Longitudinal Healthy Longevity Survey from 2005-2018 to identify latent trajectories of sleep duration, sleep quality, and cognitive function. Secondly, the multinomial logistic model was adopted to determine predictors of trajectory groups. Finally, the Cox regression model was used to examine the association between these trajectory groups and all-cause mortality. RESULTS A total of 5046 adults (49% women) with an average age of 76.34 were included in the study. The median follow-up period was 11.11 years, during which 1784 (35%) participants died. We identified 4 latent groups among older adults: 'Good-performance' (51%), 'Decreasing' (26%), 'Oversleep & cognitive impairment' (12%), and 'Sleep-deprived' (11%). Individuals in the 'Decreasing' had a 51% increased risk of all-cause mortality (HR = 1.51, 95% CI: 1.25 - 1.81, p < .001). Individuals in the 'Oversleep & cognitive impairment' had a 170% increased risk of all-cause mortality (HR = 2.7 95% CI: 2.13 - 3.43, p < .001). Women had a higher risk of all-cause mortality regardless of trajectory group (47-143% men VS. 74-365% women). Both urban and rural areas have a similarly increased risk of all-cause mortality (48-179%). CONCLUSIONS Our study reveals the latent trajectories across sleep duration, sleep quality, and cognitive function in older Chinese and further explores their association with death. These findings provide a rational basis for cognitive interventions and reduce all-cause mortality.
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Affiliation(s)
- Jianlin Lin
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China
- Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital, Shenzhen, China
- Guangdong Provincial High-Level Clinical Key Specialty, Shenzhen, China
- Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen, China
| | - Jian Xiao
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Qiao Li
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China.
| | - Li Cao
- International School of Public Health and One Health, Hainan Medical University, No. 3 Xueyuan Road, Longhua District, Haikou, Hainan, 571199, China.
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16
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Associations between Sleep, Depression, and Cognitive Performance in Adolescence. Eur J Investig Health Psychol Educ 2023; 13:501-511. [PMID: 36826222 PMCID: PMC9955842 DOI: 10.3390/ejihpe13020038] [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: 12/30/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.
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17
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Hwang H, Kim KM, Yun CH, Yang KI, Chu MK, Kim WJ. Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study. Front Neurol 2023; 13:1095404. [PMID: 36698878 PMCID: PMC9868806 DOI: 10.3389/fneur.2022.1095404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status. Methods We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome. Results Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia. Conclusion A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.
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Affiliation(s)
- Heewon Hwang
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea,Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea,*Correspondence: Won-Joo Kim ✉
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