How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults

Gadie, Andrew; Shafto, Meredith A.; Leng, Yue; Kievit, Rogier A.

doi:10.1136/bmjopen-2016-014920

Cited by 162 publications

(138 citation statements)

References 89 publications

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“…No significant age-interactions were found for any of the sleep items. Thus, the UKB results were in agreement with the lack of meaningful cross-sectional sleep-hippocampal volume relationships in Lifebrain, and aligns with previous findings within a Lifebrain cohort (Cam-CAN) which found no cross-sectional associations between PSQI subcomponents and white matter microstructure (indexed by Fractional anisotropy) across ten tracts [58].…”

Section: Resultssupporting

confidence: 89%

“…Whereas sleep duration, efficiency and problems were worse with higher age in Lifebrain, self-reported sleep quality was better with age, and sleep latency and daytime tiredness showed improvement until middle age or longer. The global PSQI score showed little change before 50 years of age, after which worse scores were seen for the rest of the age-span, suggesting PSQI sum score may not be the best measure to use in lifespan cohorts [58]. These patterns fit well with the results from a meta-analysis of polysomnography data [2].…”

Section: Discussionmentioning

confidence: 61%

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Self-reported sleep relates to hippocampal atrophy across the adult lifespan – results from the Lifebrain consortium

Fjell

Sørensen

Amlien

et al. 2019

Preprint

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BackgroundPoor sleep is associated with multiple age-related neurodegenerative and neuropsychiatric conditions. The hippocampus plays a special role in sleep and sleep-dependent cognition, and accelerated hippocampal atrophy is typically seen with higher age. Hence, it is critical to establish how the relationship between sleep and hippocampal volume loss unfolds across the adult lifespan.MethodsSelf-reported sleep measures and MRI-derived hippocampal volumes were obtained from 3105 cognitively normal participants (18-90 years) from major European brain studies in the Lifebrain consortium. Hippocampal volume change was estimated from 5116 MRIs from 1299 participants, covering up to 11 years. Cross-sectional analyses were repeated in a sample of 21390 participants from the UK Biobank.ResultsThe relationship between self-reported sleep and age differed across sleep items. Sleep duration, efficiency, problems, and use of medication worsened monotonously with age, whereas subjective sleep quality, sleep latency, and daytime tiredness improved. Women reported worse sleep in general than men, but the relationship to age was similar. No cross-sectional sleep – hippocampal volume relationships was found. However, worse sleep quality, efficiency, problems, and daytime tiredness were related to greater hippocampal volume loss over time, with high scorers showing on average 0.22% greater annual loss than low scorers. Simulations showed that longitudinal effects were too small to be detected as age-interactions in cross-sectional analyses.ConclusionsWorse self-reported sleep is associated with higher rates of hippocampal decline across the adult lifespan. This suggests that sleep is relevant to understand individual differences in hippocampal atrophy, but limited effect sizes call for cautious interpretation.

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Section: Resultssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 61%

Self-reported sleep relates to hippocampal atrophy across the adult lifespan – results from the Lifebrain consortium

Fjell

Sørensen

Amlien

et al. 2019

Preprint

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“…Among them, only sleep efficiency has been indicated to continuously decline in older age (>60 years; Ohayon et al., ). Clustering of poor sleepers has shown that inefficient sleepers are mostly elderly people (Gadie, Shafto, Leng, Cam‐Can, & Kievit, ). Therefore, negative health consequences of low sleep efficiency that covary with ageing in later life require further investigation.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal sleep efficiency in the elderly and its association with health

Didikoglu

Maharani

Tampubolon

et al. 2019

Journal of Sleep Research

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The relationships between older age and sleep efficiency have traditionally been assessed using cross‐sectional studies that ignore changes within individuals as they age. This research examines the determinants of sleep efficiency, the heterogeneity in an individual's sleep efficiency trajectory across a period of up to 27 years in later life and its associations with health. The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort (n = 6,375; age 42–94 years) was used in this study. Depression and health data were collected using self‐report validated instruments (Cornell Medical Index, Beck Depression Inventory and Geriatric Depression Scale). Longitudinal sleep and sociodemographic data were collected using a study‐specific self‐report questionnaire. A mixed‐effect model was performed for sleep efficiency with adjustments for time‐invariant and time‐variant predictors. Latent class analysis was used to demonstrate subgroups of sleep efficiency trajectories and associations between sleep efficiency clusters and health history of the participants were investigated. Older adults have decreased sleep efficiency over time, with 18.6% decline between 40 and 100 years of age. Three sleep efficiency trajectory clusters were identified: high (32%), medium (50%) and low sleep efficiency (18%). Belonging to the high sleep efficiency cluster was associated with having lower prevalence of hypertension, circulatory problems, general arthritis, breathing problems and recurrent episodes of depression compared to the low efficiency cluster. Overall, ageing decreases sleep efficiency. However, there are detectable subgroups of sleep efficiency that are related to prevalence of different diseases.

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“…The Karolinska Sleep Questionnaire (KSQ) 46,47 was used for Betula and converted to PSQI (SI and 35 ). Although lifespan changes in sleep are pronounced 35,48 , mean changes as well as individual differences in change over a few years are rather small 17,49 and considered as negligible here. If multiple observations were available, the mean value was used.…”

Section: Methodsmentioning

confidence: 97%

Self-reported sleep problems are related to cortical thinning in aging but not memory decline and amyloid-β accumulation – results from the Lifebrain consortium

Fjell

Sørensen

Amlien

et al. 2020

Preprint

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BackgroundOlder persons with poor sleep are more likely to develop neurodegenerative disease, but the causality underlying this association is unclear. To move towards explanation, we examine whether sleep quality and quantity are similarly associated with brain changes across the adult lifespan.MethodsAssociations between self-reported sleep parameters (Pittsburgh Sleep Quality Index;PSQI) and longitudinal cortical change were tested using five samples from the Lifebrain consortium (n=2205, 4363 MRIs, 18-92 years). Analyses were augmented by considering episodic memory change, gene expression from the Allen Human Brain Atlas, and amyloid-beta (Aβ) accumulation (n=1980).ResultsPSQI components sleep problems and low sleep quality were related to thinning of the right lateral temporal cortex. The association with sleep problems emerged after 60 years, especially in regions with high expression of genes related to oligodendrocytes and S1 pyramidal neurons. BMI and symptoms of depression had negligible effects. Sleep problems were neither related to longitudinal change in episodic memory function nor to Aβ accumulation, suggesting that sleep-related cortical changes were independent of AD neuropathology and cognitive decline.ConclusionWorse self-reported sleep in later adulthood was associated with more cortical thinning in regions of high expression of genes related to oligodendrocytes and S1 pyramidal neurons, but not to Aβ accumulation or memory decline. The relationship to cortical brain change suggests that self-reported sleep parameters are relevant in lifespan studies, but small effect sizes, except for a few restricted regions, indicate that self-reported sleep is not a good biomarker of general cortical degeneration in healthy older adults.

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How are age-related differences in sleep quality associated with health outcomes? An epidemiological investigation in a UK cohort of 2406 adults

Cited by 162 publications

References 89 publications

Self-reported sleep relates to hippocampal atrophy across the adult lifespan – results from the Lifebrain consortium

Self-reported sleep relates to hippocampal atrophy across the adult lifespan – results from the Lifebrain consortium

Longitudinal sleep efficiency in the elderly and its association with health

Self-reported sleep problems are related to cortical thinning in aging but not memory decline and amyloid-β accumulation – results from the Lifebrain consortium

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