Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Cross-Sectional Study

Sleep Characteristics in Older Adults with Different Levels of Risk for Dementia: A Cross-sectional Study

Author(s): Xiuxiu Huang, Shifang Zhang, Yuxi Fang, Xiaoyan Zhao, Ting Cao, Yongan Sun* and Qiaoqin Wan*

Volume 19, Issue 14, 2022

Published on: 15 March, 2023

Page: [954 - 964] Pages: 11

DOI: 10.2174/1567205020666230303110244

Price: $65

Abstract

Background: Sleep problems are very prevalent in older adults, especially in those at risk for dementia. But the relationships between sleep parameters and subjective or objective cognitive decline are still inconclusive.

Aim: The study aimed to investigate the self-reported and objectively measured sleep characteristics in older adults with mild cognitive impairment (MCI) and subjective cognitive decline (SCD).

Methods: This study adopted a cross-sectional design. We included older adults with SCD or MCI. Sleep quality was measured separately by the Pittsburgh sleep quality index (PSQI) and ActiGraph. Participants with SCD were divided into low, moderate, and high levels of SCD groups. Independent samples T-tests, one-way ANOVA, or nonparametric tests were used to compare the sleep parameters across groups. Covariance analyses were also performed to control the covariates.

Results: Around half of the participants (45.9%) reported poor sleep quality (PSQI<7), and 71.3% of participants slept less than 7 hours per night, as measured by ActiGraph. Participants with MCI showed shorter time in bed (TIB) (p<0.05), a tendency of shorter total sleep time (TST) at night (p = 0.074) and for each 24-hour cycle (p = 0.069), compared to those with SCD. The high SCD group reported the highest PSQI total score and longest sleep latency than all the other three groups (p<0.05). Both the MCI and high SCD groups had shorter TIB and TST for each 24-hour cycle than the low or moderate SCD groups. Besides, participants with multiple-domain SCD reported poorer sleep quality than those with single-domain SCD (p<0.05).

Conclusion: Sleep dysregulation is prevalent in older adults with a risk for dementia. Our findings revealed that objectively measured sleep duration might be an early sign of MCI. Individuals with high levels of SCD demonstrated poorer self-perceived sleep quality and deserved more attention. Improving sleep quality might be a potential target to prevent cognitive decline for people with a risk for dementia.

Keywords: Sleep, cognition, aged, subjective cognitive decline, mild cognitive impairment, dementia.

[1]
Feigin VL, Nichols E, Alam T, et al. Global, regional, and national burden of neurological disorders, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18(5): 459-80.
[http://dx.doi.org/10.1016/S1474-4422(18)30499-X] [PMID: 30879893]
[2]
Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: A cross-sectional study. Lancet Public Health 2020; 5(12): e661-71.
[http://dx.doi.org/10.1016/S2468-2667(20)30185-7] [PMID: 33271079]
[3]
Jessen F, Amariglio RE, Boxtel M, et al. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimers Dement 2014; 10(6): 844-52.
[http://dx.doi.org/10.1016/j.jalz.2014.01.001] [PMID: 24798886]
[4]
Jessen F, Wiese B, Bachmann C, et al. Prediction of dementia by subjective memory impairment: Effects of severity and temporal association with cognitive impairment. Arch Gen Psychiatry 2010; 67(4): 414-22.
[http://dx.doi.org/10.1001/archgenpsychiatry.2010.30] [PMID: 20368517]
[5]
van Harten AC, Mielke MM, Swenson-Dravis DM, et al. Subjective cognitive decline and risk of MCI. Neurology 2018; 91(4): e300-12.
[http://dx.doi.org/10.1212/WNL.0000000000005863] [PMID: 29959257]
[6]
Abner EL, Kryscio RJ, Caban-Holt AM, Schmitt FA. Baseline subjective memory complaints associate with increased risk of incident dementia: The PREADVISE trial. J Prev Alzheimers Dis 2015; 2(1): 1-6.
[http://dx.doi.org/10.14283/jpad.2015.37] [PMID: 26180776]
[7]
Roberts RO, Knopman DS, Mielke MM, et al. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology 2014; 82(4): 317-25.
[http://dx.doi.org/10.1212/WNL.0000000000000055] [PMID: 24353333]
[8]
Partinen M. Sleep research in 2020: COVID-19-related sleep disorders. Lancet Neurol 2021; 20(1): 15-7.
[http://dx.doi.org/10.1016/S1474-4422(20)30456-7] [PMID: 33340475]
[9]
Rozzini L, Conti MZ, Riva M, et al. Non-amnestic mild cognitive impairment and sleep complaints: A bidirectional relationship? Aging Clin Exp Res 2018; 30(6): 661-8.
[http://dx.doi.org/10.1007/s40520-017-0814-8] [PMID: 28849412]
[10]
Borges CR, Poyares D, Piovezan R, Nitrini R, Brucki S. Alzheimer’s disease and sleep disturbances: A review. Arq Neuropsiquiatr 2019; 77(11): 815-24.
[http://dx.doi.org/10.1590/0004-282x20190149] [PMID: 31826138]
[11]
Lim ASP, Kowgier M, Yu L, Buchman AS, Bennett DA. Sleep fragmentation and the risk of incident Alzheimer’s disease and cognitive decline in older persons. Sleep 2013; 36(7): 1027-32.
[http://dx.doi.org/10.5665/sleep.2802] [PMID: 23814339]
[12]
Pak VM, Onen SH, Bliwise DL, Kutner NG, Russell KL, Onen F. Sleep disturbances in MCI and AD: Neuroinflammation as a possible mediating pathway. Front Aging Neurosci 2020; 12: 69.
[http://dx.doi.org/10.3389/fnagi.2020.00069] [PMID: 32457592]
[13]
You JC, Jones E, Cross DE, et al. Association of β-amyloid burden with sleep dysfunction and cognitive impairment in elderly individuals with cognitive disorders. JAMA Netw Open 2019; 2(10): e1913383.
[http://dx.doi.org/10.1001/jamanetworkopen.2019.13383] [PMID: 31617927]
[14]
Zhang X, Jin D, Bao W, et al. Association between sleep duration and mild cognitive impairment in people aged 55 and above in 4 provinces of China. Wei Sheng Yen Chiu 2021; 50(1): 15-20.
[PMID: 33517956]
[15]
Palmer K, Mitolo M, Burgio F, Meneghello F, Venneri A. Sleep disturbance in mild cognitive impairment and association with cognitive functioning. A case-control study. Front Aging Neurosci 2018; 10: 360.
[http://dx.doi.org/10.3389/fnagi.2018.00360] [PMID: 30473661]
[16]
Tsapanou A, Vlachos GS, Cosentino S, et al. Sleep and subjective cognitive decline in cognitively healthy elderly: Results from two cohorts. J Sleep Res 2019; 28(5): e12759.
[http://dx.doi.org/10.1111/jsr.12759] [PMID: 30251362]
[17]
Kim JH, Ahn JH, Min CY, Yoo DM, Choi HG. Association between sleep quality and subjective cognitive decline: Evidence from a community health survey. Sleep Med 2021; 83: 123-31.
[http://dx.doi.org/10.1016/j.sleep.2021.04.031] [PMID: 33993029]
[18]
Bubbico G, Di Iorio A, Lauriola M, et al. Subjective cognitive decline and nighttime sleep alterations, a longitudinal analysis. Front Aging Neurosci 2019; 11: 142.
[http://dx.doi.org/10.3389/fnagi.2019.00142] [PMID: 31312133]
[19]
Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. CMAJ 2012; 184(3): E191-6.
[http://dx.doi.org/10.1503/cmaj.110829] [PMID: 22184363]
[20]
Leng M, Yin H, Zhang P, et al. Sleep quality and health-related quality of life in older people with subjective cognitive decline, mild cognitive impairment, and Alzheimer disease. J Nerv Ment Dis 2020; 208(5): 387-96.
[http://dx.doi.org/10.1097/NMD.0000000000001137] [PMID: 31977718]
[21]
Jia X, Wang Z, Huang F, et al. A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: A cross-sectional study. BMC Psychiatry 2021; 21(1): 485.
[http://dx.doi.org/10.1186/s12888-021-03495-6] [PMID: 34607584]
[22]
Lu J, Li D, Li F, et al. Montreal cognitive assessment in detecting cognitive impairment in Chinese elderly individuals: A population-based study. J Geriatr Psychiatry Neurol 2011; 24(4): 184-90.
[http://dx.doi.org/10.1177/0891988711422528] [PMID: 22228824]
[23]
Gifford KA, Liu D, Romano RR III, Jones RN, Jefferson AL. Development of a subjective cognitive decline questionnaire using item response theory: A pilot study. Alzheimers Dement 2015; 1(4): 429-39.
[http://dx.doi.org/10.1016/j.dadm.2015.09.004] [PMID: 26878034]
[24]
Hao L, Hu X, Han Y, Jia J. Localization of english version of SCD-Q9 and reliability and validity test. Chin General Pract 2019; 22: 3238-45.
[25]
Fernandez-Blazquez MA, Avila-Villanueva M, Medina M. The Dimensional Structure of Subjective Cognitive Decline. In: Perneczky R, Ed. Biomarkers for Preclinical Alzheimer’s Disease Humana Press. New York, NY: Neuromethods 2018; Vol. 137: pp. 45-62.
[http://dx.doi.org/10.1007/978-1-4939-7674-4_3]
[26]
Lu T, Li Y, Xia P, Zhang G, Wu D. Analysis on reliability and validity of the Pittsburgh sleep quality index. Chongqing Med 2014; 43(3): 260-3.
[27]
Han LH. A clinical research on the insomnia quo and related factors in the elderly. Shanghai: Shanghai Jiao Tong University 2016.
[28]
Marino M, Li Y, Rueschman MN, et al. Measuring sleep: Accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. Sleep 2013; 36(11): 1747-55.
[http://dx.doi.org/10.5665/sleep.3142] [PMID: 24179309]
[29]
Baek J, Han K, Choi-Kwon S. Sleep diary- and actigraphy-derived sleep parameters of 8-hour fast-rotating shift work nurses: A prospective descriptive study. Int J Nurs Stud 2020; 112: 103719.
[http://dx.doi.org/10.1016/j.ijnurstu.2020.103719] [PMID: 32807562]
[30]
Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The self-administered comorbidity questionnaire: A new method to assess comorbidity for clinical and health services research. Arthritis Rheum 2003; 49(2): 156-63.
[http://dx.doi.org/10.1002/art.10993] [PMID: 12687505]
[31]
Li N, Xu G, Chen G, Zheng X. Sleep quality among Chinese elderly people: A population-based study. Arch Gerontol Geriatr 2020; 87: 103968.
[http://dx.doi.org/10.1016/j.archger.2019.103968] [PMID: 31751901]
[32]
Yan LIU, Xiao-xuan L, Ji-lei W, Xiao-chun Q. The effect of sleep duration on self-rated health and its age difference. Pop Develop 2020; 26(3): 65-72.
[33]
Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science 2013; 342(6156): 373-7.
[http://dx.doi.org/10.1126/science.1241224] [PMID: 24136970]
[34]
Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders. Lancet Neurol 2018; 17(11): 1016-24.
[http://dx.doi.org/10.1016/S1474-4422(18)30318-1] [PMID: 30353860]
[35]
Alperin N, Wiltshire J, Lee SH, et al. Effect of sleep quality on amnestic mild cognitive impairment vulnerable brain regions in cognitively normal elderly individuals. Sleep 2019; 42(3): zsy254.
[http://dx.doi.org/10.1093/sleep/zsy254] [PMID: 30541112]
[36]
Daulatzai MA. Evidence of neurodegeneration in obstructive sleep apnea: Relationship between obstructive sleep apnea and cognitive dysfunction in the elderly. J Neurosci Res 2015; 93(12): 1778-94.
[http://dx.doi.org/10.1002/jnr.23634] [PMID: 26301370]
[37]
Lovato N, Lack L. The effects of napping on cognitive functioning. Prog Brain Res 2010; 185: 155-66.
[http://dx.doi.org/10.1016/B978-0-444-53702-7.00009-9] [PMID: 21075238]
[38]
Brownlow JA, Miller KE, Gehrman PR. Insomnia and cognitive performance. Sleep Med Clin 2020; 15(1): 71-6.
[http://dx.doi.org/10.1016/j.jsmc.2019.10.002] [PMID: 32005351]
[39]
Haussmann R. von Lieres und Wilkau AFE, Sauer C, Nilles F, Donix M. Impact of cognitive reserve on clinical and neuropsychological measures in patients with mild cognitive impairment. Australas Psychiatry 2020; 28(4): 386-90.
[http://dx.doi.org/10.1177/1039856220908171] [PMID: 32174124]
[40]
Liguori C, Placidi F, Izzi F, Spanetta M, Mercuri NB, Di Pucchio A. Correction to: Sleep dysregulation, memory impairment, and CSF biomarkers during different levels of neurocognitive functioning in Alzheimer’s disease course. Alzheimers Res Ther 2020; 12(1): 53.
[http://dx.doi.org/10.1186/s13195-020-00624-3] [PMID: 32384931]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy