Associations of actigraphic sleep and circadian rest/activity rhythms with cognition in the early phase of Alzheimer’s disease

Abstract

Study Objectives To compare sleep and circadian rest/activity rhythms (RARs), quantified by standard and novel actigraphic metrics, between controls and participants with mild cognitive impairment (MCI), and to examine the cross-sectional relationships between these measures and cognition. Methods Actigraphy data were collected in 179 older individuals (mean age = 72.6 years) with normal cognition (n = 153) and MCI (n = 26). Sleep parameters (e.g. sleep efficiency), and standard nonparametric RARs (e.g. interdaily stability) were generated. Functional principal component analysis (fPCA) was used to generate three novel RAR metrics (fPC1, fPC2, and fPC3). Cognitive composite scores reflecting episodic memory and executive function were derived using factor analysis. Regression models compared sleep and RAR parameters between diagnostic groups and their association with cognitive performance. Results Compared to controls, the MCI group exhibited lower levels of the standard RAR parameter: relative amplitude and fPC3—a novel RAR whereby lower scores reflected a lower rhythm peak, as well as greater nighttime activity and less activity in the morning. Across groups, several standard RAR parameters (e.g. interdaily stability) and fPC3 were associated with better episodic memory and executive function performance. Additionally, several standard RAR measures (e.g. relative amplitude) and the novel RAR measure fPC1 (reflecting the total volume of activity and rhythm strength) were associated with better executive function performance. Conclusions Individuals with MCI have altered circadian RARs compared to controls, including the novel RAR metric fPC3, reflecting greater nighttime activity and less activity in the morning compared to mean values. Additionally, these measures are significantly associated with cognitive performance.

Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease

“…Eighteen studies adopted the diagnostic criteria of Petersen [ 5 , 63 , 66 , 69 , 87 , 88 , 90 , 92 , 96 , 97 , 99 , 100 , 101 , 102 , 104 , 106 , 110 , 116 , 117 , 118 , 119 ]. Five studies used the diagnostic criteria of Albert et al [ 59 , 66 , 85 , 92 , 108 , 120 ]. Four studies used the “Mini-Mental State Examination—MMSE” [ 121 ] as a diagnostic criterion, with different cut-offs: MMSE lower than 24 [ 91 ], MMSE lower than 20 [ 78 ], MMSE lower than 21 [ 80 ], MMSE lower than 17 [ 109 ].…”

“…Eight studies met the inclusion criteria and used actigraphy to evaluate sleep quality in pathological older people [ 59 , 68 , 82 , 83 , 85 , 101 , 102 , 108 ].…”

“…Four studies compared MCI and healthy subjects; two did not show significant differences. One [ 101 ] observed some differences in sleep onset and higher variability in MCI, while the other [ 108 ] highlighted lower SE% in MCI subjects.…”

Executive Performance Is Associated With Rest-Activity Rhythm in Nurses Working Rotating Shifts

“…All these parameters were relevant to fast rotating shift, instead of slow rotating shift. Actually, there existed evidence that unstable daily routine was associated with both memory and executive function in patients with liver cirrhosis ( Kim et al, 2021 ) and Alzheimer’s disease ( Alfini et al, 2021 ). The reason why we only find less aspects of cognition associated with IS might be that the participants recruited in the present study were all young healthy adults.…”

Higher 24-h Total Movement Activity Percentile Is Associated with Better Cognitive Performance in U.S. Older Adults

“…Because of the lack of cut points and age- and sex-related MIMS-units difference, we use the derived 24-h MIMS percentiles based on these data as our predictor to quantity this movement metric. However, by doing so, we are unable to remove the potential confounding effects of poor sleep (47–49) (e.g., greater nighttime movement) and potentially higher daily MIMS unit that may result. However, the standardize percentile can provide a reference for clinicians and researchers to use for brain and body health.…”