Department of Human Development, California State University, Long Beach, California, USA.
Department of Health Science, California State University, Long Beach, California, USA.
J Gerontol A Biol Sci Med Sci. 2023 Oct 9;78(10):1816-1825. doi: 10.1093/gerona/glad144.
Evidence on sleep duration or quality and cognitive function in diverse older adults is limited. We examined prospective associations between subjective sleep measures and cognitive function, with modifying effects of sex and age (<65 vs ≥65 years).
Data are from the longitudinal Boston Puerto Rican Health Study, Waves 2 (n = 943) and 4 (n = 444), with mean follow-up of 10.5 years (range 7.2-12.8). Subjective measures of sleep duration (short <7, ref. 7, or long ≥8 hours) and insomnia symptoms (sum of difficulty falling asleep, waking up at night, and early morning awakening), were assessed at Wave 2. Linear regression models were used to assess changes in global cognition, executive function, memory, and Mini-Mental State Examination, and tested for modifying roles of sex and age.
Significant 3-way interaction (sex × age × cognition) in fully adjusted models showed greater decline in global cognitive function in older men with short (β [95% confidence interval]: -0.67 [-1.24, -0.10]) or long sleep duration (-0.92 [-1.55, -0.30]), compared to women, younger men, and older men with 7 hours of sleep. Insomnia symptoms were associated with a greater decline in memory (-0.54, [-0.85, -0.22]) among older men, compared to women and younger men.
Sleep duration showed a U-shaped association with cognitive decline, and insomnia symptoms were associated with memory decline in fully adjusted models. Older men, versus women and younger men, were at relatively greater risk for cognitive decline associated with sleep factors. These findings are important for personalizing sleep interventions to support cognitive health.
关于不同老年人的睡眠时长或质量与认知功能的证据有限。我们研究了主观睡眠测量指标与认知功能之间的前瞻性关联，并探讨了性别和年龄（<65 岁与≥65 岁）的调节作用。
数据来自纵向波士顿波多黎各健康研究，第 2 波（n=943）和第 4 波（n=444），平均随访时间为 10.5 年（7.2-12.8 年）。第 2 波时评估了主观的睡眠时长（短睡眠<7 小时，参考值 7 小时或长睡眠≥8 小时）和失眠症状（入睡困难、夜间醒来和清晨早醒的总和）。使用线性回归模型评估全球认知、执行功能、记忆和简易精神状态检查的变化，并测试性别和年龄的调节作用。
在完全调整的模型中，性别、年龄和认知之间存在显著的三向交互作用。与女性、年轻男性和 7 小时睡眠的老年男性相比，短睡眠（β[95%置信区间]：-0.67[-1.24，-0.10]）或长睡眠（-0.92[-1.55，-0.30]）的老年男性，整体认知功能下降更为明显。与女性和年轻男性相比，失眠症状与老年男性的记忆下降（-0.54[-0.85，-0.22]）相关。
在完全调整的模型中，睡眠时长与认知能力下降呈 U 型关联，失眠症状与老年男性的记忆下降有关。与女性和年轻男性相比，老年男性因睡眠因素导致认知能力下降的风险相对较高。这些发现对于个性化睡眠干预以支持认知健康非常重要。
