Sleep and cognitive decline: A prospective nondemented elderly cohort study

Objective To investigate sleep disturbances that induce cognitive changes over 4 years in nondemented elderlies. Methods Data were acquired from a nationwide, population‐based, prospective cohort of Korean elderlies (2,238 normal cognition [NC] and 655 mild cognitive impairment [MCI]). At baseline a...

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Published in:Annals of neurology 2018-03, Vol.83 (3), p.472-482
Main Authors: Suh, Seung Wan, Han, Ji Won, Lee, Ju Ri, Byun, Seonjeong, Kwon, Soon Jai, Oh, Sang Hoon, Lee, Kyoung Hwan, Han, Guehee, Hong, Jong Woo, Kwak, Kyung Phil, Kim, Bong‐Jo, Kim, Shin Gyeom, Kim, Jeong Lan, Kim, Tae Hui, Ryu, Seung‐Ho, Moon, Seok Woo, Park, Joon Hyuk, Seo, Jiyeong, Youn, Jong Chul, Lee, Dong Young, Lee, Dong Woo, Lee, Seok Bum, Lee, Jung Jae, Jhoo, Jin Hyeong, Kim, Ki Woong
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging - pathology
Aging - physiology
Alzheimer's disease
Apolipoprotein E
Cognition
Cognitive ability
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - epidemiology
Cognitive Dysfunction - physiopathology
Cohort analysis
Cohort Studies
Consortia
Data acquisition
Female
Follow-Up Studies
Genotypes
Geriatrics
Humans
Insomnia
Latency
Longitudinal Studies
Male
Mental depression
Neurodegenerative diseases
Older people
Physical activity
Prospective Studies
Random Allocation
Regression analysis
Regression models
Republic of Korea - epidemiology
Reversion
Sleep
Sleep - physiology
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Summary:Objective To investigate sleep disturbances that induce cognitive changes over 4 years in nondemented elderlies. Methods Data were acquired from a nationwide, population‐based, prospective cohort of Korean elderlies (2,238 normal cognition [NC] and 655 mild cognitive impairment [MCI]). At baseline and 4‐year follow‐up assessments, sleep‐related parameters (midsleep time, sleep duration, sleep latency, subjective sleep quality, sleep efficiency, and daytime dysfunction) and cognitive status were measured using the Pittsburgh Sleep Quality Index and Consortium to Establish a Registry for Alzheimer's Disease Assessment, respectively. We used logistic regression models adjusted for covariates including age, sex, education, apolipoprotein E genotype, Geriatric Depression Scale, Cumulative Illness Rating Scale, and physical activity. Results In participants with NC, long sleep latency (>30 minutes), long sleep duration (≥7.95 hours), and late midsleep time (after 3:00 am) at baseline were related to the risk of cognitive decline at 4‐year follow‐up assessment; odds ratio (OR) was 1.40 for long sleep latency, 1.67 for long sleep duration, and 0.61 for late midsleep time. These relationships remained significant when these variables maintained their status throughout the follow‐up period. Newly developed long sleep latency also doubled the risk of cognitive decline. In those with MCI, however, only long sleep latency reduced the chance of reversion to NC (OR = 0.69). Interpretation As early markers of cognitive decline, long sleep latency can be used for elderlies with NC or MCI, whereas long sleep duration and relatively early sleep time might be used for cognitively normal elderlies only. Ann Neurol 2018;83:472–482
ISSN:0364-5134
1531-8249
DOI:10.1002/ana.25166