The authors followed 5,437 people aged 55 years and older with normal baseline Mini-Mental State Examination score annually for 5 years. The mean incidence of cognitive impairment was 2.3% per year. Cognitive activities in both the individual item (playing board games and reading) and the composite measure were associated with the reduced risk of cognitive impairment, while watching television was associated with an increased risk of cognitive impairment.
Key Points
Question
Is caregiving for patients with dementia associated with shorter or poorer-quality sleep and treatable by behavioral interventions?
Findings
Based on the systematic review and meta-analysis of 35 studies (3268 caregivers), caregivers lost 2.42 to 3.50 hours of sleep each week due to difficulty falling asleep and maintaining sleep, a significant difference relative to age-matched noncaregiver controls. However, significantly better sleep quality was observed in caregivers after behavioral interventions.
Meaning
Many caregivers of patients with dementia have chronic sleep problems, but implementing behavioral sleep interventions is associated with better sleep quality in this population.
Childhood trauma may affect sleep health in adulthood. These findings align with the growing body of evidence linking childhood trauma to adverse health outcomes later in life.
Study Objectives: Prospective memory, or remembering to execute future intentions, accounts for half of everyday forgetting in older adults. Sleep intervals benefit prospective memory consolidation in young adults, but it is unknown whether age-related changes in slow wave activity, sleep spindles, and/or rapid eye movement (REM) sleep mediate hypothesized effects of aging on prospective memory consolidation. Methods: After an adaptation night, 76 adults aged 18-84 completed two experimental nights of in-laboratory polysomnography recording. In the evening, participants encoded and practiced a prospective memory task and were tested the next morning. On a counterbalanced night, they encoded and practiced a control task, and were tested the following morning. Results: Increasing age predicted worse prospective memory consolidation (r = −.34), even when controlling for encoding, speed, and control-task performance (all ps < .05). Frontal delta power, slow oscillations, and spindle density were not related to prospective memory consolidation. REM sleep duration, however, explained significant variance in prospective memory consolidation when controlling for age (∆R 2 = .10). Bootstrapping mediation showed that less REM sleep significantly mediated the aging effect on prospective memory consolidation [b = −.0016, SE = 0.0009 (95% confidence interval [CI] = −0.0042 to −0.0004)]. REM sleep continued to mediate 24.29% of the total effect of age on prospective memory after controlling for numerous demographic, cognitive, mental health, and sleep variables. Conclusion: Age-related variance in REM sleep is informative to how prospective memory consolidation changes with increasing age. Future work should consider how both REM sleep and slow wave activity contribute, perhaps in a sequential or dynamic manner, to preserving cognitive functioning with increasing age.
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