Self-reported sleep disturbances are associated with poorer cognitive performance in older adults with hypertension: a multi-parameter risk factor investigation.
Author: Kohn JN1, Troyer E1, Guay-Ross RN1, Wilson K2, Walker A2, Spoon C2, Pruitt C2, Lyasch G1, Pung MA2, Milic M3, Redwine LS4, Hong S1,2
Affiliation:
1Department of Psychiatry, University of California, San Diego, USA.
2Department of Family Medicine and Public Health, University of California, San Diego, USA.
3Department of Medicine, University of California, San Diego, USA.
4College of Nursing, University of South Florida, Florida, USA.
Conference/Journal: Int Psychogeriatr.
Date published: 2019 Oct 24
Other:
Volume ID: 1-11 , Special Notes: doi: 10.1017/S1041610219001492. [Epub ahead of print] , Word Count: 335
OBJECTIVES: Given the evidence of multi-parameter risk factors in shaping cognitive outcomes in aging, including sleep, inflammation, cardiometabolism, and mood disorders, multidimensional investigations of their impact on cognition are warranted. We sought to determine the extent to which self-reported sleep disturbances, metabolic syndrome (MetS) factors, cellular inflammation, depressive symptomatology, and diminished physical mobility were associated with cognitive impairment and poorer cognitive performance.
DESIGN: This is a cross-sectional study.
SETTING: Participants with elevated, well-controlled blood pressure were recruited from the local community for a Tai Chi and healthy-aging intervention study.
PARTICIPANTS: One hundred forty-five older adults (72.7 ± 7.9 years old; 66% female), 54 (37%) with evidence of cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) score ≤24, underwent medical, psychological, and mood assessments.
MEASUREMENTS: CI and cognitive domain performance were assessed using the MoCA. Univariate correlations were computed to determine relationships between risk factors and cognitive outcomes. Bootstrapped logistic regression was used to determine significant predictors of CI risk and linear regression to explore cognitive domains affected by risk factors.
RESULTS: The CI group were slower on the mobility task, satisfied more MetS criteria, and reported poorer sleep than normocognitive individuals (all p < 0.05). Multivariate logistic regression indicated that sleep disturbances, but no other risk factors, predicted increased risk of evidence of CI (OR = 2.00, 95% CI: 1.26-4.87, 99% CI: 1.08-7.48). Further examination of MoCA cognitive subdomains revealed that sleep disturbances predicted poorer executive function (β = -0.26, 95% CI: -0.51 to -0.06, 99% CI: -0.61 to -0.02), with lesser effects on visuospatial performance (β = -0.20, 95% CI: -0.35 to -0.02, 99% CI: -0.39 to 0.03), and memory (β = -0.29, 95% CI: -0.66 to -0.01, 99% CI: -0.76 to 0.08).
CONCLUSIONS: Our results indicate that the deleterious impact of self-reported sleep disturbances on cognitive performance was prominent over other risk factors and illustrate the importance of clinician evaluation of sleep in patients with or at risk of diminished cognitive performance. Future, longitudinal studies implementing a comprehensive neuropsychological battery and objective sleep measurement are warranted to further explore these associations.
KEYWORDS: blood pressure; cognitive impairment; dementia; depressed mood; inflammation; metabolic syndrome; physical mobility; sleep
PMID: 31647051 DOI: 10.1017/S1041610219001492
BACK
