Zaheed Afsara B, Tapia Amanda L, Oryshkewych Nina, Wheeler Bradley J, Butters Meryl A, Buysse Daniel J, Leng Yue, Barnes Lisa L, Lim Andrew, Yu Lan, Soehner Adriane M, Wallace Meredith L
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Alzheimers Dement. 2025 May;21(5):e70159. doi: 10.1002/alz.70159.
Comparing sleep and rest-activity rhythms across different cognitive aging pathways can identify novel risk factors and potential mechanisms. However, our current understanding is restricted by differences in sleep measurement, limited longitudinal data, and heterogeneous cognitive aging processes.
We applied cubic splines to longitudinal self-reported sleep and actigraphy data from 1449 participants in the Rush Memory and Aging Project and quantified differences in the levels and trajectories of sleep amount, regularity, and timing within and between three cognitive aging pathways: normal, stable mild cognitive impairment, dementia.
Sleep amount was lowest in the dementia pathway prior to cognitive impairment but increased with age, most rapidly after dementia. Regularity declined across all pathways, most rapidly after cognitive diagnoses. Timing advanced across all pathways.
Shorter sleep amount in cognitively healthy older adults may be a risk factor or prodromal indicator of dementia, while longer sleep amounts and decreasing regularity may reflect neurodegeneration.
We quantified longitudinal changes in sleep across three cognitive-aging pathways. We incorporated both subjective and objective measures of sleep health. Self-report duration increased noticeably from before to after cognitive diagnosis. Sleep irregularity increased most prominently after cognitive diagnosis. Advances in sleep timing occurred in both normal and pathological aging.
比较不同认知衰老途径中的睡眠和休息 - 活动节律可以识别新的风险因素和潜在机制。然而，我们目前的理解受到睡眠测量差异、纵向数据有限以及认知衰老过程异质性的限制。
我们将三次样条函数应用于拉什记忆与衰老项目中1449名参与者的纵向自我报告睡眠和活动记录仪数据，并量化了三种认知衰老途径（正常、稳定轻度认知障碍、痴呆）内部和之间在睡眠量、规律性和时间安排的水平及轨迹上的差异。
在认知障碍之前，痴呆途径中的睡眠量最低，但随年龄增长而增加，在痴呆发生后增加最快。规律性在所有途径中均下降，在认知诊断后下降最快。时间安排在所有途径中均提前。
认知健康的老年人睡眠量较短可能是痴呆的风险因素或前驱指标，而较长的睡眠量和降低的规律性可能反映神经退行性变。
我们量化了三种认知衰老途径中睡眠的纵向变化。我们纳入了睡眠健康的主观和客观测量方法。自我报告的睡眠时间从认知诊断前到诊断后显著增加。睡眠不规律性在认知诊断后增加最为显著。睡眠时间提前在正常衰老和病理性衰老中均有发生。
