INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #57 Sleep Fragmentation and Self-Reported Insomnia and Poor Sleep Quality are Associated with Subjective Cognitive Decline in Older Adults Celina Pluim McDowell, Boston University, Boston, United States Julia Glueck, Boston University, Boston, United States Yakeel Quiroz, Massachusetts General Hospital/Harvard Medical School, Boston, United States Alice Cronin-Golomb, Boston University, Boston, United States Jeanne Duffy, Brigham and Women’s Hospital/Harvard Medical School, Boston, United States Category: Sleep and Sleep Disorders Keyword 1: sleep Keyword 2: self-report Keyword 3: memory complaints Objective: Older adults are vulnerable to changes in sleep, including earlier awakening, greater sleep fragmentation, and shorter sleep duration. Though some changes are part of normal aging, sleep-wake disturbances are observed in early stages of neurodegenerative disorders, including Alzheimer’s disease (AD). Poor sleep quality is associated with subjective cognitive decline (SCD), a risk factor for developing AD and Mild Cognitive Impairment. The associations between insomnia, objective sleep quality, and SCD are not well understood. We examined these associations in older adults using subjective and objective measures. Participants and Methods: Older adults without dementia (N=26, M_age=63.1 [SD=7.5]) were recruited from the community. Participants completed 1-2 weeks of rest-activity monitoring using wrist-worn actigraphy, a test of global cognitive functioning (Mini-Mental State Examination; MMSE), and questionnaires assessing insomnia (Insomnia Severity Index; ISI), subjective sleep quality (Pittsburgh Sleep Quality Index; PSQI), and SCD (Cognitive Function Instrument; CFI). Actigraphy measures (total sleep time, sleep efficiency, sleep latency, wake bouts, and sleep fragmentation) were derived from MotionWare software (CamNtech). Spearman correlations assessed relations among subjective and objective sleep quality, insomnia ratings, SCD, and global cognition. Post-hoc analyses examined the correlation of PSQI component scores (Sleep Quality, Sleep Latency, Sleep Duration, Sleep Efficiency, Sleep Disturbances, Medication Use, and Daytime Dysfunction) with SCD and global cognition. Alpha levels = 0.05 denote statistical significance. Results: On average, participants (11 men, 15 women) were college-educated (M=15.6 years [SD=2.5]) with intact global cognitive function (MMSE; M=28.0 [SD=1.5]), and endorsed mild SCD (CFI; M=2.0 [2.5]), subthreshold insomnia (ISI; M=8.2 [7.4], and significant sleep quality complaints (PSQI; M=6.8 [4.9]). Greater ISI ratings significantly correlated with greater SCD (ρ=0.645, p<0.001). Greater PSQI ratings significantly correlated with greater SCD (ρ=0.535, p=0.005) and worse global cognition (ρ=-0.472, p=0.015). On actigraphy-based measures (n=22), sleep fragmentation significantly correlated with SCD (ρ=0.474, p=0.026). Sleep efficiency (ρ=0.516, p=0.014), sleep time (ρ=0.539, p=0.010), and sleep fragmentation (ρ=-0.501, p=0.017) correlated with global cognition. All other associations between actigraphy measures and SCD or global cognition were nonsignificant (ρ’s 0.08). Post-hoc PSQI subscale analyses revealed that Sleep Quality (ρ=0.522, p=0.006), Sleep Latency (ρ=0.475, p=0.014), Sleep Disturbances (ρ=0.446, p=0.022), and Medication Use (ρ=0.522, p=0.006) correlated with higher SCD. Sleep Quality (ρ=-0.449, p=0.022), Sleep Duration (ρ=-0.452, p=0.020), Sleep Disturbances (ρ=-0.508, p=0.008), and Medication Use (ρ=-0.449, p=0.022) correlated with worse global cognition. All other component score correlations were nonsignificant (ρ’s 0.10). Conclusions: Self-reported insomnia symptoms and poor sleep quality were associated with SCD concerns, as was sleep fragmentation as measured by actigraphy. The findings suggest that poorer sleep quality, particularly due to difficulty falling asleep, fragmented or disturbed sleep, and requiring medications to sleep, may be associated with greater risk of cognitive decline, or that worries about cognition may deleteriously affect sleep. Subjective measures of sleep quality may be particularly useful to identify older adults at increased risk of developing cognitive impairment later in life. More work is needed with larger samples to comprehensively examine subjective and objective sleep quality with SCD and cognitive functioning in older adults.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #57

Sleep Fragmentation and Self-Reported Insomnia and Poor Sleep Quality are Associated with Subjective Cognitive Decline in Older Adults

Celina Pluim McDowell, Boston University, Boston, United States
Julia Glueck, Boston University, Boston, United States
Yakeel Quiroz, Massachusetts General Hospital/Harvard Medical School, Boston, United States
Alice Cronin-Golomb, Boston University, Boston, United States
Jeanne Duffy, Brigham and Women’s Hospital/Harvard Medical School, Boston, United States

Category: Sleep and Sleep Disorders

Keyword 1: sleep
Keyword 2: self-report
Keyword 3: memory complaints

Objective:

Older adults are vulnerable to changes in sleep, including earlier awakening, greater sleep fragmentation, and shorter sleep duration. Though some changes are part of normal aging, sleep-wake disturbances are observed in early stages of neurodegenerative disorders, including Alzheimer’s disease (AD). Poor sleep quality is associated with subjective cognitive decline (SCD), a risk factor for developing AD and Mild Cognitive Impairment. The associations between insomnia, objective sleep quality, and SCD are not well understood. We examined these associations in older adults using subjective and objective measures.

Participants and Methods:

Older adults without dementia (N=26, M_age=63.1 [SD=7.5]) were recruited from the community. Participants completed 1-2 weeks of rest-activity monitoring using wrist-worn actigraphy, a test of global cognitive functioning (Mini-Mental State Examination; MMSE), and questionnaires assessing insomnia (Insomnia Severity Index; ISI), subjective sleep quality (Pittsburgh Sleep Quality Index; PSQI), and SCD (Cognitive Function Instrument; CFI). Actigraphy measures (total sleep time, sleep efficiency, sleep latency, wake bouts, and sleep fragmentation) were derived from MotionWare software (CamNtech). Spearman correlations assessed relations among subjective and objective sleep quality, insomnia ratings, SCD, and global cognition. Post-hoc analyses examined the correlation of PSQI component scores (Sleep Quality, Sleep Latency, Sleep Duration, Sleep Efficiency, Sleep Disturbances, Medication Use, and Daytime Dysfunction) with SCD and global cognition. Alpha levels = 0.05 denote statistical significance.

Results:

On average, participants (11 men, 15 women) were college-educated (M=15.6 years [SD=2.5]) with intact global cognitive function (MMSE; M=28.0 [SD=1.5]), and endorsed mild SCD (CFI; M=2.0 [2.5]), subthreshold insomnia (ISI; M=8.2 [7.4], and significant sleep quality complaints (PSQI; M=6.8 [4.9]). Greater ISI ratings significantly correlated with greater SCD (ρ=0.645, p<0.001). Greater PSQI ratings significantly correlated with greater SCD (ρ=0.535, p=0.005) and worse global cognition (ρ=-0.472, p=0.015). On actigraphy-based measures (n=22), sleep fragmentation significantly correlated with SCD (ρ=0.474, p=0.026). Sleep efficiency (ρ=0.516, p=0.014), sleep time (ρ=0.539, p=0.010), and sleep fragmentation (ρ=-0.501, p=0.017) correlated with global cognition. All other associations between actigraphy measures and SCD or global cognition were nonsignificant (ρ’s 0.08). Post-hoc PSQI subscale analyses revealed that Sleep Quality (ρ=0.522, p=0.006), Sleep Latency (ρ=0.475, p=0.014), Sleep Disturbances (ρ=0.446, p=0.022), and Medication Use (ρ=0.522, p=0.006) correlated with higher SCD. Sleep Quality (ρ=-0.449, p=0.022), Sleep Duration (ρ=-0.452, p=0.020), Sleep Disturbances (ρ=-0.508, p=0.008), and Medication Use (ρ=-0.449, p=0.022) correlated with worse global cognition. All other component score correlations were nonsignificant (ρ’s 0.10).

Conclusions:

Self-reported insomnia symptoms and poor sleep quality were associated with SCD concerns, as was sleep fragmentation as measured by actigraphy. The findings suggest that poorer sleep quality, particularly due to difficulty falling asleep, fragmented or disturbed sleep, and requiring medications to sleep, may be associated with greater risk of cognitive decline, or that worries about cognition may deleteriously affect sleep. Subjective measures of sleep quality may be particularly useful to identify older adults at increased risk of developing cognitive impairment later in life. More work is needed with larger samples to comprehensively examine subjective and objective sleep quality with SCD and cognitive functioning in older adults.