Exploring the Bidirectional Associations Between Short or Long Sleep Duration and Lower Cognitive Function: A 7-Year Cohort Study in China

Hua, Jianian; Zhuang, Sheng; Shen, Yueping; Tang, Xiang; Sun, Hongpeng; Fang, Qi

doi:10.3389/fnagi.2021.727763

Cited by 11 publications

(7 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multivariable modified Poisson regression analysis in individuals during the period of menopausal transition revealed that the prevalence of severe complaints of reduced cognitive functioning was significantly higher in women with uncertain status and who were postmenopausal, those with short sleeping hours, who worked night-shifts, and had severe VMS. Although short sleeping hours and night-shift work do not necessarily cause cognitive complaints, Hue et al found a bidirectional relationship between sleep duration and cognitive function in a cohort study [ 18 ].The strong association with severe VMS suggests that the cognitive complaints during menopausal transition may in part be related to severe VMS. Current HRT use was not associated with complaints of reduced cognitive functioning in our study.…”

Section: Discussionmentioning

confidence: 99%

Complaints of reduced cognitive functioning during perimenopause: a cross-sectional analysis of the Japan Nurses’ Health Study

Hayashi

Ideno

Nagai

et al. 2022

womens midlife health

View full text Add to dashboard Cite

Background Many women experience various symptoms during the period of menopausal transition, including complaints of reduced cognitive functioning. However, these complaints are not necessarily recognized as core menopausal symptoms. In this study, we sought to characterize subjective complaints of reduced cognitive functioning by analyzing cross-sectional data from the Japan Nurses’ Health Study (JNHS). Methods The JNHS 4-year follow-up questionnaire containing a 21-item climacteric symptom checklist, which included a question about “poor memory or forgetfulness”, was mailed between 2005 and 2011 to all JNHS participants, regardless of their age at the time of the survey. We estimated the prevalence of slight and severe complaints in 5-year age-groups. We used principal component analysis to explore the underlying factors among the 21 symptoms during the menopausal transition period in women aged 45–54 years at the time of the survey. We also examined risk factors for complaints using multivariable modified Poisson regression analysis. Results In total, 12,507 women responded to the 4-year survey. The mean age at the time of the 4-year survey was 46.5 years (range 27–82). “Poor memory or forgetfulness” showed a peak prevalence of 81.7% (severe 27.9%; slight 53.8%) at 50–54 years, and gradually decreased after 55 years. Principal component analysis indicated that “poor memory or forgetfulness” belonged to somatic symptoms and was close to psychological symptoms in women aged 45–54 years. In women aged 45–54 years, the complaint was also significantly associated with hot flashes and sweats. Multivariable modified Poisson regression analysis showed that menopausal status (uncertain and postmenopausal), less sleep (sleep of < 5 h and sleep of 5– < 6 h), night-shift work, and severe vasomotor symptoms (VMS) were significantly associated with the prevalence of severe complaints of reduced cognitive functioning in women aged 45–54 years. Conclusions We found that prevalence of “poor memory or forgetfulness” was highest during the menopausal transition period and among perimenopausal women. This subjective complaint was associated with somatic, psychological complaints and VMS. It may be useful for women with cognitive problems in the transition period to consider management of comorbid menopausal symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Complaints of reduced cognitive functioning during perimenopause: a cross-sectional analysis of the Japan Nurses’ Health Study

Hayashi

Ideno

Nagai

et al. 2022

womens midlife health

View full text Add to dashboard Cite

show abstract

“…In addition to sleep deprivation, previous studies have revealed that an excessively long sleep duration is associated with increased risks for cognitive decline and various diseases as well as death in the elderly population (Cappuccio et al, 2010;Shen et al, 2016;Yin et al, 2017;Jike et al, 2018;Ohara et al, 2018;Ma et al, 2020;Hua et al, 2021); a U-shaped association between sleep duration and cognitive function is a common finding among recent studies. Based on those findings, the National Sleep Foundation has announced that deviation from an ideal sleep duration-<5 h or more than 9 h for elderly people-is not recommended for individuals who are 65 years and older (Hirshkowitz et al, 2015).…”

Section: Discussionmentioning

confidence: 97%

Short Sleep Duration on the Night Before Surgery Is Associated With Postoperative Cognitive Decline in Elderly Patients: A Prospective Cohort Study

Takamino

Kotoda

Nakadate

et al. 2022

Front. Aging Neurosci.

View full text Add to dashboard Cite

As the world is rapidly aging, and the number of elderly patients who undergo surgery is rising, postoperative cognitive decline among those patients has become an increasing healthcare problem. Although understanding the risk factors and mechanisms underlying the pathogenesis of postoperative cognitive decline is critically important from a preventative viewpoint, such knowledge and evidence are lacking. A growing body of evidence suggest an association between cognitive function and sleep duration. The purpose of this study was to investigate the association between postoperative cognitive function and sleep duration on the night before surgery using a wearable sleep tracker. In this 6-month prospective cohort study, we analyzed data from 194 patients aged ≥ 65 years who underwent elective non-cardiac and non-cranial surgery under general anesthesia. According to the sleep duration on the night before surgery, patients were categorized into following four groups: <5, 5–7, 7–9, and >9 h. Perioperative cognitive function and domains were assessed using a neuropsychological test battery, and the incidence and prevalence of cognitive decline over 6 months after surgery were analyzed using the multiple logistic regression analysis. During the 6-month follow-up period, 41 patients (21%) developed cognitive decline. The incidence of cognitive decline was significantly elevated for the patients with sleep duration < 5 h (vs. 7–9 h; surgical duration-adjusted odds ratio, 3.50; 95% confidence interval, 1.20–10.2; P < 0.05). The association between sleep duration and prevalence of cognitive decline was limited to the early postoperative period (at 1 week and 1 month). Among the cognitive domains assessed, attentional function was significantly impaired in patients with a sleep duration < 5 h [vs. 7–9 h at 1 week; 4/37 (10.8%) vs. 0/73 (0%); P < 0.05]. In conclusion, sleep duration < 5 h on the night before surgery was significantly associated with worse attentional function after surgery and higher incidence of cognitive decline. The present results indicate that sleep deprivation on the night before surgery may have a temporary but significantly negative influence on the patient's postoperative cognitive function and is a potential target for preventing cognitive decline.

show abstract

“…Short sleep duration contributes to cognitive impairment via several different pathologies such as impaired β-amyloid clearance, pathological tau, impaired synaptic plasticity, atrophy of the cortex, and circadian rhythm disturbances. In contrast, long sleep duration is relevant to sleep fragmentation and chronic inflammation, which are linked to lower cognition ( 46 ). Moreover, Spira et al ( 47 ) demonstrated that, among individuals with a normal cognitive function, sleep durations of < 7 h and of >7 h may accelerate frontotemporal gray matter atrophy and subsequently increase the cognitive impairment risk.…”

Section: Discussionmentioning

confidence: 99%

Incidence of cognitive impairment after hypothetical interventions on depression, nighttime sleep duration, and leisure activity engagement among older Chinese adults: An application of the parametric g-formula

Zhang

Chen²,

Wang³

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

BackgroundCognitive impairment is an age-relevant intermediate stage where cognition declines to a state between the normal aging process and dementia. Earlier studies reported that depression, inappropriate nighttime sleep duration (NSD), and limited leisure activity engagement are cognitive impairment risk factors among older adults. Thus, we postulated that interventions on depression, sleep duration, and leisure activity engagement can reduce cognitive impairment risk. However, no earlier research ever explored this.MethodsThe data of 4,819 respondents aged 60 years and above, without cognitive impairment at baseline and with no prior history of memory-related diseases, including Alzheimer's disease, Parkinson's disease, and encephalatrophy, were obtained from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula, an analytic tool for estimating standardized outcome distributions using covariate (exposure and confounders)-specific estimates of the outcome distribution, was used to estimate 7-year cumulative cognitive impairment risks among older Chinese adults, under independent hypothetical interventions on depression, NSD, and leisure activity engagement, which was subdivided into social activity (SA) and intellectual activity (IA) for the different intervention combinations.ResultsThe observed cognitive impairment risk was 37.52%. Independent intervention on IA was the most effective factor in reducing incident cognitive impairment, with a risk ratio (RR) of 0.75 (95% confidence interval [CI]: 0.67–0.82), followed by depression (RR: 0.89, 95% CI: 0.85–0.93) and NSD (RR: 0.88, 95% CI: 0.80–0.95). The joint intervention combining depression, NSD, and IA interventions could reduce the risk by 17.11%, with an RR of 0.56 (95% CI: 0.48–0.65). In subgroup analyses, independent interventions on depression and IA had analogously significant effects on men and women. However, interventions on depression and IA had stronger effects on literate than illiterate individuals.ConclusionsHypothetical interventions on depression, NSD, and IA reduced cognitive impairment risks among older Chinese adults, both independently and jointly. The findings of the present study suggest that the intervention measures on depression, inappropriate NSD, limited intellectual activities, and their combination may prove to be effective strategies for preventing cognitive impairment among older adults.

show abstract

Exploring the Bidirectional Associations Between Short or Long Sleep Duration and Lower Cognitive Function: A 7-Year Cohort Study in China

Cited by 11 publications

References 46 publications

Complaints of reduced cognitive functioning during perimenopause: a cross-sectional analysis of the Japan Nurses’ Health Study

Complaints of reduced cognitive functioning during perimenopause: a cross-sectional analysis of the Japan Nurses’ Health Study

Short Sleep Duration on the Night Before Surgery Is Associated With Postoperative Cognitive Decline in Elderly Patients: A Prospective Cohort Study

Incidence of cognitive impairment after hypothetical interventions on depression, nighttime sleep duration, and leisure activity engagement among older Chinese adults: An application of the parametric g-formula

Contact Info

Product

Resources

About