Sleep Quality and Cognitive Function in the Elderly Population
Abstract
Background and Objective: Physiological process of sleep is considered as one of the influential factors of human’s health and mental functions, especially in the elderly. This research aimed at studying the association between sleep quality and the cognitive functions in the elderly population.
Materials and Methods: A total of 200 elderly people (65 years and older) who were the members of retirees associa-tion in Mashhad, Iran, participated in this cross-sectional study. The participants were asked to answer the questionnaire of Pittsburgh Sleep Quality Index (PSQI) and Montreal Cognitive Assessment (MoCA) test. Correlation between the total scores of PSQI and MoCA was evaluated by Pearson correlation coefficient. In order to predict the cognitive func-tion based on different aspects of PSQI, multiple regression analysis by hierarchical method was used after removing confounding variables.
Results: A significant association was found between PSQI and MoCA (P < 0.001, r = -0.55) suggesting that the com-ponents of use of sleeping medication (P < 0.001, r = -0.47), sleep disorders (P < 0.001, r = -0.37), sleep latency (P < 0.001, r = -0.34), subjective sleep quality (P < 0.001, r = -0.32), sleep duration (P < 0.001, r = -0.27), sleep effi-ciency (P < 0.001, r = -0.26), and daytime dysfunction (P < 0.001, r = -0.15) had significant negative correlation with cognitive function, and the four components of subjective sleep quality (P = 0.010, β = -0.15), sleep latency (P = 0.040, β = -0.13), sleep disorders (P = 0.010, β = -0.26), and use of sleeping medication (P = 0.010, β = -0.26) played a role in prediction of cognitive function in regression analysis.
Conclusion: Poor sleep quality, sleep latency, insomnia, sleep breathing disorder, and use of sleeping medication play a determining role in cognitive function of the elderly. Thus, taking care of the sleep health is necessary for the elderly.
2. Pakpour V, Zamanzadeh V, Salimi S, et al. The relationship between loneness and sleep quality in older adults in Tabriz. J Urmia Nurs Midwifery Fac 2017; 14: 906-17. [In Persian].
3. Liu H, Byles JE, Xu X, et al. Association between nighttime sleep and successful aging among older Chinese people. Sleep Med 2016; 22: 18-24.
4. Azri MA, Dahlan A, Masuri MG, et al. Sleep quality among older persons in institutions. Procedia Soc Behav Sci 2016; 234: 74-82.
5. Waller KL, Mortensen EL, Avlund K, et al. Subjective sleep quality and daytime sleepiness in late midlife and their association with age-related changes in cognition. Sleep Med 2016; 17: 165-73.
6. Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol 2014; 13: 1017-28.
7. Alessi CA, Martin JL. Sleep in older adults: Challenges and opportunities. Sleep Med Clin 2018; 13: xv-xviii.
8. Miner B, Kryger MH. Sleep in the aging population. Sleep Med Clin 2020; 15: 311-8.
9. MacLeod S, Musich S, Kraemer S, et al. Practical non-pharmacological intervention approaches for sleep problems among older adults. Geriatr Nurs 2018; 39: 506-12.
10. Bruce AS, Aloia MS. Sleep and cognition in older adults. Sleep Med Clin 2006; 1: 207-20.
11. Dzierzewski JM, Dautovich N, Ravyts S. Sleep and cognition in older adults. Sleep Med Clin 2018; 13: 93-106.
12. Tsapanou A, Gu Y, O'Shea DM, et al. Dataset on the associations between sleep quality/duration and cognitive performance in cognitively healthy older adults. Data Brief 2017; 14: 720-3.
13. Niu J, Han H, Wang Y, et al. Sleep quality and cognitive decline in a community of older adults in Daqing City, China. Sleep Med 2016; 17: 69-74.
14. Merlino G, Piani A, Gigli GL, et al. Daytime sleepiness is associated with dementia and cognitive decline in older Italian adults: A population-based study. Sleep Med 2010; 11: 372-7.
15. Foley D, Monjan A, Masaki K, et al. Daytime sleepiness is associated with 3-year incident dementia and cognitive decline in older Japanese-American men. J Am Geriatr Soc 2001; 49: 1628-32.
16. Saint Martin M, Sforza E, Barthelemy JC, et al. Does subjective sleep affect cognitive function in healthy elderly subjects? The Proof cohort. Sleep Med 2012; 13: 1146-52.
17. Blackwell T, Yaffe K, Ancoli-Israel S, et al. Association of sleep characteristics and cognition in older community-dwelling men: The MrOS sleep study. Sleep 2011; 34: 1347-56.
18. Faul F, Erdfelder E, Buchner A, et al. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149-60.
19. Bahrami Einolgasi H, Khodabakhshi Koolaee A. Efficacy of group physical activity on sleep quality and quality of life among older adults in Kahrizak nursing home. Journal of Gerontology 2016; 1: 29-39. [In Persian].
20. Chehrehnegar N, Shams F, Zarshenas S, et al. Evaluating the reliability of the Montreal Cognitive Assessment Test and its agreement with Mini Mental State Examination among healthy elderly. Eur Geriatr Med 2013: S198.
21. Emsaki G, Molavi H, Chitsaz A, et al. Psychometric properties of the Montreal cognitive assessment (MOCA) in parkinson's disease patients in Isfahan. J Isfahan Med Sch 2011; 29: 1391-400. [In Persian].
22. Chen JC, Espeland MA, Brunner RL, et al. Sleep duration, cognitive decline, and dementia risk in older women. Alzheimers Dement 2016; 12: 21-33.
23. Cricco M, Simonsick EM, Foley DJ. The impact of insomnia on cognitive functioning in older adults. J Am Geriatr Soc 2001; 49: 1185-9.
24. Nebes RD, Buysse DJ, Halligan EM, et al. Self-reported sleep quality predicts poor cognitive performance in healthy older adults. J Gerontol B Psychol Sci Soc Sci 2009; 64: 180-7.
25. Yaremchuk K. Sleep Disorders in the Elderly. Clin Geriatr Med 2018; 34: 205-16.
26. Schmutte T, Harris S, Levin R, et al. The relation between cognitive functioning and self-reported sleep com-plaints in nondemented older adults: Results from the Bronx aging study. Behav Sleep Med 2007; 5: 39-56.
27. Potvin O, Lorrain D, Forget H, et al. Sleep quality and 1-year incident cognitive impairment in community-dwelling older adults. Sleep 2012; 35: 491-9.
28. Faubel R, Lopez-Garcia E, Guallar-Castillon P, et al. Usual sleep duration and cognitive function in older adults in Spain. J Sleep Res 2009; 18: 427-35.
29. Ramos AR, Dong C, Elkind MS, et al. Association between sleep duration and the mini-mental score: The Northern Manhattan study. J Clin Sleep Med 2013; 9: 669-73.
30. Xu L, Jiang CQ, Lam TH, et al. Short or long sleep duration is associated with memory impairment in older Chinese: The Guangzhou Biobank Cohort Study. Sleep 2011; 34: 575-80.
31. Ferrie JE, Shipley MJ, Akbaraly TN, et al. Change in sleep duration and cognitive function: Findings from the Whitehall II Study. Sleep 2011; 34: 565-73.
32. Virta JJ, Heikkila K, Perola M, et al. Midlife sleep characteristics associated with late life cognitive function. Sleep 2013; 36: 1533-41, 1541A.
33. Devore EE, Grodstein F, Duffy JF, et al. Sleep duration in midlife and later life in relation to cognition. J Am Geriatr Soc 2014; 62: 1073-81.
34. Haimov I, Hanuka E, Horowitz Y. Chronic insomnia and cognitive functioning among older adults. Behav Sleep Med 2008; 6: 32-54.
35. Spira AP, Blackwell T, Stone KL, et al. Sleep-disordered breathing and cognition in older women. J Am Geriatr Soc 2008; 56: 45-50.
36. Zimmerman ME, Aloia MS. Sleep-disordered breathing and cognition in older adults. Curr Neurol Neurosci Rep 2012; 12: 537-46.
37. Martin MS, Sforza E, Roche F, et al. Sleep breathing disorders and cognitive function in the elderly: An
8-year follow-up study. The proof-synapse cohort. Sleep 2015; 38: 179-87.
38. Saboor M. Elderly's medical therapy status. Salmand Iran J Ageing 2007; 2: 216-22. [In Persian].
39. Yaffe K, Laffan AM, Harrison SL, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 2011; 306: 613-9.
40. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol 2011; 10: 819-28.
Files | ||
Issue | Vol 5 No 1 (2020): Winter | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/jss.v5i1.4569 | |
Keywords | ||
Sleep hygiene; Cognition; Frail elderly |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |