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Alzheimer Dis Assoc Disord. 2019 Sep 26. doi: 10.1097/WAD.0000000000000351. [Epub ahead of print]

Sleep Quality and Cognitive Function in Type 1 Diabetes: Findings From the Study of Longevity in Diabetes (SOLID).

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Kaiser Permanente Northern California Division of Research, Oakland.
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel.
Department of Health Services, University of Washington, Seattle, WA.
Department of Public Health Science, University of California Davis School of Medicine, Davis, CA.



The objective was to examine the association between sleep quality and global and domain-specific cognitive function among older individuals with type 1 diabetes (T1D).


We evaluated 695 individuals with T1D aged 60 years or above who participated in the baseline assessment of the Study of Longevity in Diabetes (SOLID), which captured subjective sleep quality (Pittsburgh Sleep Quality Index) and global and domain-specific (language, executive function, episodic memory, and simple attention) cognitive function. Multivariable linear regressions estimated the associations between sleep quality quartiles and overall and domain-specific cognitive function adjusting for age, sex, race/ethnicity, education, depressive symptoms, and severe hypoglycemic episodes. Sensitivity analyses examined the associations between aspects of sleep quality and global cognitive function.


The worst sleep quality quartile was associated with lower global cognition (β=-0.08; 95% confidence interval: -0.17, -0.01) and lower executive function (β=-0.17, 95% confidence interval: -0.30, -0.03) compared with the best quartile of sleep quality adjusting for demographics and comorbidities. Sleep quality was not associated with language, episodic memory, or simple attention. Sleep medications and daytime dysfunction were most strongly associated with global cognition.


Our results suggest that sleep quality may be a modifiable risk factor for global cognitive function and executive function among elderly individuals with T1D.

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