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Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study.
Sleep. 2014 Apr 01; 37(4):655-63.S

Abstract

STUDY OBJECTIVES

To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline.

DESIGN

A population-based longitudinal study.

SETTING

Six centers in the United States.

PARTICIPANTS

Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y.

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

OBJECTIVELY MEASURED SLEEP PREDICTORS FROM WRIST ACTIGRAPHY: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase).

CONCLUSIONS

Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline.

Authors+Show Affiliations

Research Institute, California Pacific Medical Center, San Francisco, CA.Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA.Research Institute, California Pacific Medical Center, San Francisco, CA.Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA and the Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, San Diego, CA.Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.Research Institute, California Pacific Medical Center, San Francisco, CA.Research Institute, California Pacific Medical Center, San Francisco, CA.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24899757

Citation

Blackwell, Terri, et al. "Associations of Objectively and Subjectively Measured Sleep Quality With Subsequent Cognitive Decline in Older Community-dwelling Men: the MrOS Sleep Study." Sleep, vol. 37, no. 4, 2014, pp. 655-63.
Blackwell T, Yaffe K, Laffan A, et al. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. Sleep. 2014;37(4):655-63.
Blackwell, T., Yaffe, K., Laffan, A., Ancoli-Israel, S., Redline, S., Ensrud, K. E., Song, Y., & Stone, K. L. (2014). Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. Sleep, 37(4), 655-63. https://doi.org/10.5665/sleep.3562
Blackwell T, et al. Associations of Objectively and Subjectively Measured Sleep Quality With Subsequent Cognitive Decline in Older Community-dwelling Men: the MrOS Sleep Study. Sleep. 2014 Apr 1;37(4):655-63. PubMed PMID: 24899757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. AU - Blackwell,Terri, AU - Yaffe,Kristine, AU - Laffan,Alison, AU - Ancoli-Israel,Sonia, AU - Redline,Susan, AU - Ensrud,Kristine E, AU - Song,Yeonsu, AU - Stone,Katie L, AU - ,, Y1 - 2014/04/01/ PY - 2014/6/6/entrez PY - 2014/6/6/pubmed PY - 2015/1/23/medline KW - Aging KW - cognitive function KW - disturbed sleep KW - total sleep time SP - 655 EP - 63 JF - Sleep JO - Sleep VL - 37 IS - 4 N2 - STUDY OBJECTIVES: To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline. DESIGN: A population-based longitudinal study. SETTING: Six centers in the United States. PARTICIPANTS: Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: OBJECTIVELY MEASURED SLEEP PREDICTORS FROM WRIST ACTIGRAPHY: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase). CONCLUSIONS: Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline. SN - 1550-9109 UR - https://www.unboundmedicine.com/medline/citation/24899757/Associations_of_objectively_and_subjectively_measured_sleep_quality_with_subsequent_cognitive_decline_in_older_community_dwelling_men:_the_MrOS_sleep_study_ L2 - https://academic.oup.com/sleep/article-lookup/doi/10.5665/sleep.3562 DB - PRIME DP - Unbound Medicine ER -