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Int J Geriatr Psychiatry. 2016 Mar;31(3):247-55. doi: 10.1002/gps.4318. Epub 2015 Jun 15.

Daytime somnolence as an early sign of cognitive decline in a community-based study of older people.

Tsapanou A1, Gu Y1, O'Shea D1, Eich T1, Tang MX2,3, Schupf N1,4,2,5, Manly J1,2,5, Zimmerman M6, Scarmeas N1,4,2,5,7, Stern Y1,4,2,5.

Author information

1
Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA.
2
The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
3
Department of Biostatistics, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA.
4
The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
5
The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA.
6
Department of Psychology, Fordham University, Bronx, NY, USA.
7
National and Kapodistrian University of Athens Medical School, Athens, Greece.

Abstract

OBJECTIVE:

This study aimed to examine the association between self-reported sleep problems and cognitive decline in community-dwelling older people. We hypothesized that daytime somnolence predicts subsequent cognitive decline.

METHODS:

This is a longitudinal study in a 3.2-year follow-up, with 18-month intervals. The setting is the Washington Heights-Inwood Community Aging Project. There were 1098 participants, who were over 65 years old and recruited from the community. Sleep problems were estimated using five sleep categories derived from the RAND Medical Outcome Study Sleep Scale: sleep disturbance, snoring, awaken short of breath/with a headache, sleep adequacy, and daytime somnolence. Four distinct cognitive composite scores were calculated: memory, language, speed of processing, and executive functioning. We used generalized estimating equations analyses with cognitive scores as the outcome, and time, sleep categories and their interactions as the main predictors. Models were initially unadjusted and then adjusted for age, gender, education, ethnicity, depression, and apolipoprotein E-ε4 genotype.

RESULTS:

Increased daytime somnolence (including feeling drowsy/sleepy, having trouble staying awake, and taking naps during the day) was linked to slower speed of processing both cross-sectionally (B = -0.143, p = 0.047) and longitudinally (B = -0.003, p = 0.027). After excluding the demented participants at baseline, the results remained significant (B = -0.003, p = 0.021).

CONCLUSIONS:

Our findings suggest that daytime somnolence may be an early sign of cognitive decline in the older population.

KEYWORDS:

cognitive decline; daytime somnolence; older; speed of processing

PMID:
26081795
PMCID:
PMC5381157
DOI:
10.1002/gps.4318
[Indexed for MEDLINE]
Free PMC Article

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