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Wang J, Wang W, Liu Y, Yao M, Du Q, Wei Y, Lu K, Li C, Li X, Li S, Tian X, Zhang T, Yin F, Ma Y. Relationship between cognitive function and sleep quality in middle-aged and older adults for minimizing disparities and achieving equity in health: Evidence from multiple nationwide cohorts. Arch Gerontol Geriatr 2024; 127:105585. [PMID: 39096555 DOI: 10.1016/j.archger.2024.105585] [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: 06/17/2024] [Revised: 07/10/2024] [Accepted: 07/24/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Cognitive decline, a heavy burden on middle-aged and older adults as global aging is aggravated, was found to be associated with sleep quality. However, the country-between heterogeneity of the association prevented us from quantifying underlying relationship and identifying potential effect modifiers for vulnerable populations and targeted interventions. METHODS We collected data from 79,922 eligible adults in five nationwide cohorts, examined the respective relationships between cognitive function and sleep quality, synthesized underlying average relationships by meta-analysis, and explored effect modifiers by meta-regressions. Additionally, we conducted subgroup and interaction analyses to identify vulnerable populations and to determine their disparities in vulnerability. RESULTS Although country-between disparities exist, cognitive function is robustly associated with sleep quality in middle-aged and older adults worldwide, with an effect (β) of 0.015 [0.003, 0.027]. Executive function is the subdomain most relevant to sleep quality. Disparities in the effects of sleep quality on subdomains exist in populations with different sexes (orientation: βfemale/βmale = 1.615, P = 0.020), marital statuses (orientation: βunmarried/βmarried = 2.074, P < 0.001), education levels (orientation:βuneducated/βeducated = 2.074, P < 0.001) and chronic disease statuses (memory: βunhealthy/βhealthy = 1.560, P = 0.005). CONCLUSIONS Cognitive function decreases with worsening sleep quality in middle-aged and older adults. Vulnerability to poor sleep generally persists in singles, females, the uneducated and people with chronic diseases. To minimize disparities and achieve health equity, we advocate for targeted interventions, i.e., encouraging socialization in singles, confirming effectiveness of hormone replacement therapy in females, employing compulsory education in middle-aged and older adults.
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Affiliation(s)
- Junyu Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Wei Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Menghan Yao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Qianqian Du
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Yuxin Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Kai Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Chen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Xuelin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Sheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Xinyue Tian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu, Sichuan 610036, China.
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Corney KB, Stuart AL, Pasco JA, Mohebbi M, Kavanagh BE, Sui SX, Williams LJ. Psychiatric symptoms, associated pharmacological treatments and cognitive function: A population-based study of men. J Affect Disord 2024; 356:657-663. [PMID: 38657772 DOI: 10.1016/j.jad.2024.04.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 04/09/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Psychiatric symptomatology and medications used in their treatment may be modifiable risk factors associated with cognitive function, although findings from population-based studies spanning the full adult age range are lacking. This study aimed to investigate associations between psychiatric symptomatology, psychotropic medication use and cognitive function in a population-based sample of men. METHODS Data for 537 men were drawn from the Geelong Osteoporosis Study. Cognitive function (psychomotor function, attention, working memory and visual learning) was determined using the Cog-State Brief Battery. Current depressive and anxiety symptomatology was determined using the Hospital Anxiety and Depression Scale, and psychotropic medication use was self-reported. Linear regression models were developed to determine associations between psychiatric symptomatology and psychotropic medication use with each cognitive measure. RESULTS Depressive symptomatology was associated with lower overall cognitive function (b-0.037 ± 0.010, η2 = 0.025, p < 0.001), psychomotor function (b 0.006 ± 0.002, η2 = 0.028 p < 0.001) and attention (b 0.004 ± 0.001, η2 = 0.021, p < 0.001), whereas psychotropic use was associated with lower overall cognitive function (b - 0.174 ± 0.075, η2 = 0.010, p = 0.021), attention (b 0.017 ± 0.008, η2 = 0.008, p = 0.038 and working memory (b 0.031 ± 0.012, η2 = 0.010, p = 0.010). Anticonvulsant use was associated with lower overall cognitive function (b - 0.723 ± 0.172, η2 = 0.032, p < 0.001), attention (b 0.065 ± 0.018, η2 = 0.029, p < 0.001) and working memory (b 0.088 ± 0.026, η2 = 0.022, p < 0.001). All relationships were found to have a small effect. There were no significant associations between anxiety symptomatology and antidepressant and anxiolytic use with any of the cognitive domains. CONCLUSION Depressive symptomatology and anticonvulsant use were associated with lower cognitive function. Understanding the underlying mechanisms involved in these relationships can advance knowledge on the heterogeneity in cognitive ageing and aid in prevention initiatives.
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Affiliation(s)
- Kayla B Corney
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia.
| | - Amanda L Stuart
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Barwon Health, Geelong, VIC, Australia; Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Deakin University, Faculty of Health, Biostatistics Unit, Melbourne, VIC, Australia
| | - Bianca E Kavanagh
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Deakin University, Deakin Rural Health, School of Medicine, Warrnambool, VIC, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Lana J Williams
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Barwon Health, Geelong, VIC, Australia
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Ganidagli S, Ozturk E, Ozturk ZA. Risk factors of poor sleep quality in older adults: an analysis based on comprehensive geriatric assessment. Curr Med Res Opin 2023; 39:701-706. [PMID: 36927301 DOI: 10.1080/03007995.2023.2192124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Sleep quality is associated with many diseases and conditions that affect individuals' health in various ways. We aimed to investigate the association between sleep quality and common geriatric conditions in older adults. METHODS The study included 237 older adults admitted to the geriatric outpatient clinic of a university hospital. All patients underwent comprehensive geriatric assessment (CGA). The Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), European Quality of Life (EQ-5D), Pittsburgh Sleep Quality Index (PSQI), Katz Index of Independence in Activities of Daily Living (ADL) and Lawton and Brody Instrumental Activities of Daily Living (IADL) questionnaires, Tinetti Balance and Gait Assessment (TBGA), and Mini Nutritional Assessment (MNA) were performed on the participants. RESULTS Participants had a mean age of 72.2 ± 6.3 years, and 146 (61.6%) of them had poor sleep quality. Of the participants, 61.2% were female. In the poor sleep quality group, GDS and BAI scores were higher while ADL, IADL, MNA, and EQ-5D index scores were lower. PSQI score had a negative correlation with ADL (r = -.207, p = .01), EQ-5D index (r = -.372, p = .00), MNA (r = -.277, p = .00), and TBGA (r = -.263, p = .41) scores and a positive correlation with GDS (r = .426, p = .00) and BAI (r = .450, p = .00) scores according to the results of correlation analysis. Multivariate logistic regression analysis showed that the presence of diabetes mellitus (DM) and higher GDS and BAI scores were independent variables for poor sleep quality [(p = .48, OR = 1.92; p = .20, OR = 1.11; and p <.01, OR = 1.11, respectively)]. CONCLUSIONS We found that DM and depressive and anxiety symptoms were the risks of poor sleep quality. In addition, participants with poor sleep quality had a worse quality-of-life and nutritional status. Improving sleep quality may be helpful in the management of geriatric syndromes and that sleep quality assessment should be part of CGA.
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Affiliation(s)
- Sencer Ganidagli
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Ercument Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
| | - Zeynel Abidin Ozturk
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey
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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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Liampas I, Siokas V, Lyketsos CG, Dardiotis E. The Relationship between Neuropsychiatric Symptoms and Cognitive Performance in Older Adults with Normal Cognition. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1586. [PMID: 36363543 PMCID: PMC9694960 DOI: 10.3390/medicina58111586] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
Background and Objectives: To explore whether specific Neuropsychiatric Symptoms (NPS) are related to worse performance in particular cognitive domains. Materials and Methods: A cross-sectional analysis of the baseline evaluations of older (≥60 years), cognitively unimpaired (CU) participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set was performed. Data were derived from 43 Alzheimer's Disease Research Centers. Cognitively impaired individuals, participants with psychiatric disorders and/or under treatment with antipsychotic, anxiolytic, sedative, or hypnotic agents were excluded. NPS were assessed using the Neuropsychiatric Inventory Questionnaire. The association of NPS with participants' performance on episodic memory, semantic memory, language, attention, processing speed and executive function was analysed using an adjusted (considering important demographic and medical factors) multivariate general linear model. Results: A total of 7179 CU, older, predominantly female, Caucasian, and well-educated participants were included in the present analysis. Among them, 1856 individuals had one or more NPS. Our analysis revealed that moderate/severe anxiety was related to worse performance on semantic memory, attention and executive function, the presence of hallucinations was linked to worse processing speed and executive function scores, while the presence of elation/euphoria and aberrant motor behaviour were associated with poorer attention and language performance, respectively. In the context of a secondary, exploratory analysis, the presence of moderate/severe delusions was related to worse processing speed and executive function performance. Conclusions: The relationship between specific NPS and worse performance in particular cognitive domains could inform the formulation of individualized preventive strategies directed to the ''fortification'' of specific cognitive functions in CU individuals with NPS.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece
| | - Constantine George Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Li C, Min X, Cheng G, Yan Y, Li Z. Bidirectional relationship between nocturnal subjective sleep duration and cognitive performance in Chinese over 45 years old: a national representative longitudinal study. BMC Geriatr 2022; 22:823. [PMID: 36289469 PMCID: PMC9608904 DOI: 10.1186/s12877-022-03468-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Previous studies have inconsistent associations between changes in sleep duration and cognitive function and have not separated interindividual effects from intraindividual effects. This study aimed to examine the bidirectional associations between subjective night sleep duration and cognitive function while differing intraindividual and interindividual effects. Methods A national representative sample was obtained from China Health and Retirement Longitudinal Study during 2011–2018. Night sleep duration and potential confounders were assessed and collected by questionnaires. Cognition was assessed in three categories (orientation, executive function, and memory), and z scores were used for global cognitive performance. The random intercept cross-lagged panel model was used to examine the temporal associations during 2011–2018. Results Across 9404 participants over 45, at interindividual level, moderate (β= -0.014) and long sleepers (β= -0.06) had positive association between sleep duration and cognitive decline after adjusted covariates, but short sleepers had negative associations between sleep duration and cognitive decline (β = 0.87). At intraindividual level, prolonged sleep duration predicted better cognition for short (β= -0.021 at wave2-3; β= -0.04 at wave3-4) and moderate (β= -0.017 at wave3-4) sleepers. Conclusion For short sleepers, longer subjective nocturnal sleep duration predicted better cognitive performance; but moderate and long sleepers showed opposite results—short and moderate sleepers with prolonged subjective nocturnal sleep duration would have later cognitive decline. Our findings tentatively suggested that an increased subjective night sleep duration and subjective long sleep duration could be regarded as useful tools for identifying middle- and old adults at higher risks of progressing to cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03468-8.
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Affiliation(s)
- Chao Li
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 410011 Changsha, Hunan China ,grid.452708.c0000 0004 1803 0208Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Medical Center for Mental Health, 410011 Changsha, Hunan China ,grid.216417.70000 0001 0379 7164Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, 410000 Changsha, Hunan China
| | - Xianying Min
- grid.216417.70000 0001 0379 7164Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, 410000 Changsha, Hunan China
| | - Gang Cheng
- grid.216417.70000 0001 0379 7164Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, 410000 Changsha, Hunan China
| | - Yan Yan
- grid.216417.70000 0001 0379 7164Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, 410000 Changsha, Hunan China
| | - Zexuan Li
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 410011 Changsha, Hunan China ,grid.452708.c0000 0004 1803 0208Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Medical Center for Mental Health, 410011 Changsha, Hunan China
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