Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA.
J Gerontol A Biol Sci Med Sci. 2023 Mar 1;78(3):454-462. doi: 10.1093/gerona/glac180.
This study examined associations of actigraphy-estimated sleep parameters with concurrent and future cognitive performance in adults aged ≥ 50 years and explored interactions with race.
Participants were 435 cognitively normal adults in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy at baseline (mean = 6.6 nights) and underwent longitudinal testing of memory, attention, executive function, language, and visuospatial ability. On average, participants with follow-up data were followed for 3.1 years. Primary predictors were baseline mean total sleep time, sleep onset latency, sleep efficiency (SE), and wake after sleep onset (WASO). Fully adjusted linear mixed-effects models included demographics, baseline health-related characteristics, smoking status, sleep medication use, APOE e4 carrier status, and interactions of each covariate with time.
In adjusted models, higher SE (per 10%; B = 0.11, p = .012) and lower WASO (per 30 minutes; B = -0.12, p = .007) were associated with better memory cross-sectionally. In contrast, higher SE was associated with greater visuospatial ability decline longitudinally (B = -0.02, p = .004). Greater WASO was associated with poorer visuospatial ability cross-sectionally (B = -0.09, p = .019) but slower declines in visuospatial abilities longitudinally (B = 0.02, p = .002). Several sleep-cognition cross-sectional and longitudinal associations were stronger in, or limited to, Black participants (compared to White participants).
This study suggests cross-sectional sleep-cognition associations differ across distinct objective sleep parameters and cognitive domains. This study also provides preliminary evidence for racial differences across some sleep-cognition relationships. Unexpected directions of associations between baseline sleep and cognitive performance over time may be attributable to the significant proportion of participants without follow-up data and require further investigation.
本研究探讨了 50 岁及以上成年人的活动计估计睡眠参数与同期和未来认知表现的关联，并探索了与种族的相互作用。
参与者是巴尔的摩纵向老龄化研究中的 435 名认知正常的成年人，他们在基线（平均 6.6 晚）完成了手腕活动计，并进行了记忆、注意力、执行功能、语言和视空间能力的纵向测试。平均而言，有随访数据的参与者随访了 3.1 年。主要预测因素是基线平均总睡眠时间、睡眠潜伏期、睡眠效率（SE）和睡眠后觉醒时间（WASO）。完全调整的线性混合效应模型包括人口统计学、基线健康相关特征、吸烟状况、睡眠药物使用、APOE e4 携带者状态以及每个协变量与时间的相互作用。
在调整后的模型中，SE 每增加 10%（B=0.11，p=0.012）和 WASO 每减少 30 分钟（B=-0.12，p=0.007）与记忆的横断面表现更好相关。相反，SE 较高与纵向视空间能力下降相关（B=-0.02，p=0.004）。WASO 较高与视空间能力的横断面表现较差相关（B=-0.09，p=0.019），但与视空间能力的纵向下降较慢相关（B=0.02，p=0.002）。一些睡眠认知的横断面和纵向关联在黑人参与者中更强，或者仅限于黑人参与者（与白人参与者相比）。
本研究表明，不同的客观睡眠参数和认知领域的横断面睡眠认知关联不同。本研究还为一些睡眠认知关系中的种族差异提供了初步证据。与随时间推移的基线睡眠和认知表现之间的关联的意外方向可能归因于没有随访数据的参与者的比例很大，需要进一步调查。
