Division of Social and Economic Well-Being, RAND Corporation, Pittsburgh, PA, USA.
Division of Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, CA, USA.
J Alzheimers Dis. 2022;87(4):1591-1601. doi: 10.3233/JAD-215530.
Sleep problems may contribute to the disproportionate burden of Alzheimer's disease and related dementias (ADRD) among African Americans (AAs).
To examine the role of sleep problems in contributing to cognitive function and clinically adjudicated cognitive impairment in a predominantly AA sample.
This study (n = 216, 78.8% female; mean age = 67.7 years) examined associations between 1) the level (i.e., measured in 2018) and 2) change over time (from 2013 to 2018; n = 168) in actigraphy-assessed sleep with domain-specific cognitive function and clinically adjudicated cognitive impairment (2018) in a community-dwelling, predominantly AA (96.9%) sample. A comprehensive cognitive battery assessed global cognitive function (3MS) and domain-specific cognitive function (attention, visuo-spatial ability, language, delayed recall, immediate recall, and executive function) in 2018. Sleep was measured in 2013 and 2018 via actigraphy.
Higher sleep efficiency and less wakefulness after sleep onset (WASO; measured in 2018) were associated with greater attention, executive function, and visuospatial ability. Increases in sleep efficiency between 2013 and 2018 were associated with better executive function, language, immediate recall, and visuospatial ability, whereas increases in WASO (2013-2018) were associated with poorer attention, executive function, and visuospatial ability. Level or change in sleep duration were not associated with domain-specific cognitive function, nor were any sleep measures associated with clinically adjudicated cognitive impairment.
In a predominantly AA sample of older adults, both the level and change (i.e., worsening) of sleep efficiency and WASO were associated with poorer cognitive function. Improving sleep health may support ADRD prevention and reduce health disparities.
睡眠问题可能是导致非裔美国人（AA）中阿尔茨海默病及相关痴呆（ADRD）负担不成比例的原因之一。
在以 AA 为主的样本中，研究睡眠问题对认知功能和经临床判断的认知障碍的影响。
本研究（n=216，78.8%为女性；平均年龄=67.7 岁）考察了 1）在一个以 AA 为主的社区居住者样本中，通过活动记录仪评估的睡眠水平（2018 年测量）和 2）随时间变化（2013 年至 2018 年；n=168）与特定领域认知功能和 2018 年临床判断的认知障碍之间的关系。2018 年使用全面认知测试包评估了整体认知功能（3MS）和特定领域认知功能（注意力、视空间能力、语言、延迟回忆、即刻回忆和执行功能）。2013 年和 2018 年通过活动记录仪测量睡眠。
更高的睡眠效率和更少的睡眠潜伏期后觉醒（WASO；2018 年测量）与更好的注意力、执行功能和视空间能力相关。2013 年至 2018 年期间睡眠效率的增加与更好的执行功能、语言、即刻回忆和视空间能力相关，而 WASO 的增加（2013-2018 年）与较差的注意力、执行功能和视空间能力相关。睡眠时长的水平或变化与特定领域的认知功能无关，也没有任何睡眠指标与临床判断的认知障碍相关。
在以 AA 为主的老年人群体中，睡眠效率和 WASO 的水平和变化（即恶化）与认知功能较差有关。改善睡眠健康可能有助于预防 ADRD，并减少健康差异。
