SLEEP AND COGNITION IN OLDER MEN
Association of Sleep Characteristics and Cognition in Older Community-Dwelling Men: the MrOS Sleep Study
Terri Blackwell, MA1; Kristine Yaffe, MD2; Sonia Ancoli-Israel, PhD3; Susan Redline, MD, MPH4; Kristine E. Ensrud, MD MPH5; Marcia L. Stefanick, PhD6; Alison Laffan, PhD1; Katie L. Stone, PhD1
1Research Institute, California Pacific Medical Center, San Francisco, CA
; 2Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco, CA and the San Francisco VA Medical Center
; 3Department of Psychiatry, University of California, San Diego, La Jolla, CA
; 4Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
; 5Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine and Division of Epidemiology – Community Health, University of Minnesota, Minneapolis, MN
; 6Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA
To examine the association of objectively and subjectively measured sleep characteristics with cognition in older men.
A population-based cross-sectional study.
6 centers in the United States.
3,132 community-dwelling older men (mean age 76.4 ± 5.6 years).
Measurements and Results:
Objectively measured sleep predictors from wrist actigraphy were total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO). Subjective sleep predictors were self-reported poor sleep (Pittsburgh Sleep Quality Index [PSQI] > 5), excessive daytime sleepiness (EDS, Epworth Sleepiness Scale Score > 10), and TST. Cognitive outcomes were measured with the Modified Mini-Mental State examination (3MS), the Trails B test, and the Digit Vigilance Test (DVT). After adjustment for multiple potential confounders, WASO was modestly related to poorer cognition. Compared to those with WASO < 90 min, men with WASO ≥ 90 min took 6.1 sec longer to complete the Trails B test and had a 0.9-point worse 3MS score, on average (P < 0.05). Actigraphically measured long sleepers had a slightly worse 3MS score compared to those with 7-8 h of sleep, but had similar Trails B and DVT completion times. Compared to those who self-reported sleeping 7-8 h, long sleepers (> 8 h) on average took 8.6 sec more to complete the Trails B test, had a 0.6-point worse 3MS score, and took 46 sec longer to complete the DVT (P < 0.05). PSQI and EDS were not independently related to cognitive outcomes.
There were modest cross-sectional associations of WASO and self-reported long sleep with cognition among older community-dwelling men. EDS and PSQI were not related to cognition.
Blackwell T; Yaffe K; Ancoli-Israel S; Redline S; Ensrud KE; Stefanick ML; Laffan A; Stone KL. Association of sleep characteristics and cognition in older community-dwelling men: the MrOS Sleep Study. SLEEP 2011;34(10):1347-1356.