Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Kinesiology, University of Maryland, College Park, MD.
Med Sci Sports Exerc. 2024 Sep 1;56(9):1740-1746. doi: 10.1249/MSS.0000000000003454. Epub 2024 May 13.
INTRODUCTION/PURPOSE: As individuals age, the entorhinal cortex (ERC) and hippocampus-crucial structures for memory-tend to atrophy, with related cognitive decline. Simultaneously, lifestyle factors that can be modified, such as exercise and sleep, have been separately linked to slowing of brain atrophy and functional decline. However, the synergistic impact of fitness and sleep on susceptible brain structures in aging adults remains uncertain.
We examined both independent and interactive associations of fitness and subjective sleep quality with regard to ERC thickness and hippocampal volume in 598 middle-aged and older adults from the Human Connectome Lifespan Aging Project. Cardiorespiratory fitness was assessed using the 2-min walk test, whereas subjective sleep quality was measured with the continuous Pittsburgh Sleep Quality Index global score. High-resolution structural magnetic resonance imaging was used to examine mean ERC thickness and bilateral hippocampal volume. Through multiple linear regression analyses, we investigated the moderating effects of subjective sleep quality on the association between fitness and brain structure, accounting for age, sex, education, body mass index, gait speed, and subjective physical activity.
We found that greater cardiorespiratory fitness, but not subjective sleep quality, was positively associated with bilateral hippocampal volume and ERC thickness. Notably, significant interaction effects suggest that poor subjective sleep quality was associated with a weaker association between fitness and both hippocampal volume and ERC thickness.
Findings suggest the potential importance of both cardiorespiratory fitness and subjective sleep quality in preserving critical, age-vulnerable brain structures. Interventions targeting brain health should consider potential combined effects of sleep and fitness on brain health.
简介/目的：随着个体年龄的增长，负责记忆的内嗅皮层（ERC）和海马体——这些对记忆至关重要的结构——往往会萎缩，随之而来的还有认知能力下降。与此同时，一些可以改变的生活方式因素，如锻炼和睡眠，已经分别被证明可以减缓大脑萎缩和功能下降。然而，在衰老的成年人中，健康和睡眠对易受影响的大脑结构的协同影响仍不确定。
我们在人类连接体寿命老化项目中，检查了 598 名中年及以上成年人的健康和主观睡眠质量与 ERC 厚度和海马体体积之间的独立和交互关联。心肺健康使用 2 分钟步行测试来评估，而主观睡眠质量则使用匹兹堡睡眠质量指数的连续全球评分来衡量。高分辨率结构磁共振成像用于检查平均 ERC 厚度和双侧海马体体积。通过多元线性回归分析，我们调查了主观睡眠质量对健康和大脑结构之间关联的调节作用，同时考虑了年龄、性别、教育程度、体重指数、步态速度和主观身体活动。
我们发现，更高的心肺健康水平，而不是主观睡眠质量，与双侧海马体体积和 ERC 厚度呈正相关。值得注意的是，显著的交互效应表明，较差的主观睡眠质量与健康和海马体体积以及 ERC 厚度之间的关联较弱有关。
这些发现表明，心肺健康和主观睡眠质量在保护关键的、易受年龄影响的大脑结构方面都具有潜在的重要性。针对大脑健康的干预措施应考虑睡眠和健康对大脑健康的潜在综合影响。
