Objective
Sleep disturbances are common in older adults. Little is known about the sleep of cognitively-intact older adults and its relationship to subsequent cognitive impairment. The objective of this study was to examine the association between objective sleep-wake measures and risk of incident cognitive impairment.
Design
Prospective cohort study
Setting
Four U.S. sites
Participants
1245 women (mean age 82.6 years) without dementia participating in the Study of Osteoporotic Fractures who completed actigraphy at baseline visit and comprehensive cognitive assessment at follow-up.
Measurements
Examine the association between sleep-wake patterns measured by actigraphy and risk of incident mild cognitive impairment (MCI) and dementia.
Results
A total of 473 (38%) women developed cognitive impairment during an average (SD) follow-up of 4.9 (0.6) years; 290 (23.3%) developed MCI and 183 (14.7%) developed dementia. After controlling for multiple potential confounders, women in the lowest quartile of average sleep efficiency (<74%) had a 1.5-fold higher odds of developing MCI or dementia compared to women in the highest quartile of sleep efficiency (>86% )(OR Q1 vs. Q4 1.53, 95% CI 1.07, 2.19; Wald χ2 [1, N=1223]=5.34 for p for trend=0.03). Longer average sleep latency, but not total sleep time, was also associated with higher odds of developing cognitive impairment. Greater variability in both sleep efficiency and total sleep time was associated with an increased odds of developing MCI or dementia.
Conclusions
Lower average sleep efficiency, longer average sleep latency, and greater variability in sleep efficiency and total sleep time are associated with increased odds of developing cognitive impairment. Further research is needed to explore the mechanisms underlying these associations.