Short or Long Sleep Duration Is Associated with Memory Impairment in Older Chinese: the Guangzhou Biobank Cohort Study

Lin, Xu; Jiang, CQ; Lam, TH; B, Liu; Jin, Yinlong; Zhu, Tiehong; Zhang, WS; Cheng, Kang; Thomas, GN

doi:10.1093/sleep/34.5.575

Cited by 143 publications

(134 citation statements)

References 29 publications

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“…20,21 Sleep deprivation degrades the peak circadian drive for wakefulness over time and affects neural processing, resulting in the destabilization of the wake state and overall neurocognitive function. The negative impact of these neurocognitive effects are particularly evident in the prefrontal cortex, the area of the brain related to attention and working memory abilities.…”

Section: Discussionmentioning

confidence: 99%

“…22 Previous studies have also found that long sleep duration may contribute to variation in cognitive test performance, as was observed in the present study. 4,21 Long sleep duration may simply reflect the presence of sleep disorders or other illnesses. These individuals may require more time in bed to feel rested and therefore report longer sleep durations.…”

Section: Discussionmentioning

confidence: 99%

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Associations between Sleep Duration, Sleep Quality, and Cognitive Test Performance among Older Adults from Six Middle Income Countries: Results from the Study on Global Ageing and Adult Health (SAGE)

Gildner

Liebert

Kowal

et al. 2014

Journal of Clinical Sleep Medicine

170

143

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Background: Alterations in sleep architecture are common among older adults. Previous studies have documented associations between sleep duration, sleep quality, and cognitive performance in older individuals, yet few studies have examined these trends using population-based samples from non-Western societies. The present cross-sectional study uses nationally representative datasets from six countries to test several hypotheses related to sleep patterns and cognitive function. Methods: Data were drawn from the fi rst wave of the World Health Organization's study on global ageing and adult health (SAGE), a longitudinal study using samples of older adults (≥ 50 years old) in 6 middle-income countries (China, Ghana, India, Russian Federation, South Africa, and Mexico). Selfreport data provided information on sleep quality and sleep duration over the previous 2 nights, and 5 cognitive tests (immediate and delayed verbal recall, forward and backward digit span, and verbal fl uency) were used to create a composite z-score of cognitive performance. Results: Individuals with intermediate sleep durations(> 6-9 h/night) exhibited signifi cantly higher cognitive scores than individuals with short sleep (0-6 h/night; p < 0.001) or long sleep duration (> 9 h/night; p < 0.001). Self-reported sleep quality was positively correlated with cognitive z-score (p < 0.05). Signifi cant sex differences were observed; men generally had higher sleep quality and cognitive scores, while women reported longer sleep durations. Discussion: This study documented positive correlations between cognitive scores and sleep quality, and between cognitive z-scores and intermediate sleep duration. These fi ndings are clinically important given the growing rates of dementia and aging populations globally. Keywords: cognitive function, aging, sleep duration, sleep quality, dementia Citation: Gildner TE, Liebert MA, Kowal P, Chatterji S, Snodgrass JJ. Associations between sleep duration, sleep quality, and cognitive test performance among older adults from six middle income countries: results from the study on global ageing and adult health (SAGE). J Clin Sleep Med 2014;10(6):613-621.http://dx.doi.org/10.5664/jcsm.3782 S C I E N T I F I C I N V E S T I G A T I O N SD etrimental changes in sleep duration and quality are more common with increasing age.1,2 These alterations include a phase advance in circadian rhythms, thought to be the result of deterioration in the suprachiasmatic nuclei region of the brain. Older adults also report an increased occurrence of sleep disorders associated with disrupted and fragmented sleep patterns. These conditions often reduce slow wave sleep (SWS) and REM sleep, the deepest and most restorative sleep stages. Disruption to SWS and REM sleep can lead to increased daytime sleepiness and a decreased ability to handle stress. Age-related changes in sleep may contribute to cognitive decline among older individuals, yet this issue has not been extensively studied. Both short and long sleep duration have been linked to reduced...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Associations between Sleep Duration, Sleep Quality, and Cognitive Test Performance among Older Adults from Six Middle Income Countries: Results from the Study on Global Ageing and Adult Health (SAGE)

Gildner

Liebert

Kowal

et al. 2014

Journal of Clinical Sleep Medicine

170

143

View full text Add to dashboard Cite

show abstract

“…Some reported poor cognition in older persons sleeping for longer duration (Faubel et al 2009;Benito-Leon et al 2009;Schmutte et al 2007) while others demonstrated the opposite (Ohayon and Vecchierini 2005;Tworoger et al 2006). Kronholm et al (2009), furthermore, has revealed an inverted U-shaped relationship between sleep duration and cognitive function in the general population, while Xu et al (2011) have recently reported a similar relationship in older adults. While the duration or quantity of sleep is significant, the quality of sleep may be related to cognitive decline too.…”

Section: Introductionmentioning

confidence: 99%

Cognitive deficit is associated with phase advance of sleep–wake rhythm, daily napping, and prolonged sleep duration—a cross-sectional study in 2,947 community-dwelling older adults

Auyeung

Lee

Leung

et al. 2012

AGE

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This study aims to examine the phase advance of sleep-wake rhythm, napping habit, nocturnal sleep duration, prolonged sleep latency and insomnia and their relationship with cognitive function. This is a crosssectional study. Participants in this study are 2,947 community-dwelling adults older than 65 years old.Measurements of mini-mental examination (MMSE) score, go-to-bed time, wake-up time, nocturnal sleep duration, prolonged sleep latency, napping, and insomnia were done. The mean (standard deviation) nocturnal sleep hours was 7.96 (1.39) h. Twenty-one percent and 16.2% of the participants complained of prolonged sleep latency longer than 1 h and insomnia, respectively. Fiftysix percent of the participants napped once or more than once weekly. With advancing age, the participants reported longer sleep duration (p<0.001), went to bed earlier, and woke up earlier, which were significant both before and after adjustment. The participants who had lower MMSE score went to bed earlier and woke up earlier, which were statistically significant both before and after adjustment. An inverted U-shaped relationship was observed between MMSE score and napping frequency, p for tend 0.026.The MMSE score decreased when the sleep duration prolonged from 7 h to ≧10 h (p for trend 0.006). No trend was observed from the sleep duration <4 up to 7.9 h (p for trend 0.500). Modest ageindependent phase advance of the sleep-wake rhythm is associated with lower cognitive function. Whether this is a manifestation of early pre-clinical dementia and whether its recognition with early stabilization can slow cognitive decline remain elusive.

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“…1 Chronic insomnia, prolonged daytime sleepiness, and long sleeping have been associated with poorer cognitive function. [2][3][4][5][6] However, the contribution of sleep problems to the risk of dementia is poorly understood. Only 2 groups have examined this association.…”

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confidence: 99%

Long sleep duration in elders without dementia increases risk of dementia mortality (NEDICES)

et al. 2014

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Objective: To determine in a population-based study whether long sleep duration was associated with increased risk of dementia mortality. Methods:In this prospective, population-based study of 3,857 people without dementia aged 65 years and older (NEDICES [Neurological Disorders in Central Spain]), participants reported their daily sleep duration. The average daily total sleep duration was grouped into 3 categories: #5 hours (short sleepers), 6-8 hours (reference category), and $9 hours (long sleepers). Communitydwelling elders were followed for a median of 12.5 years, after which the death certificates of those who died were examined.Results: A total of 1,822 (47.2%) of 3,857 participants died, including 201 (11.0%) deaths among short sleepers, 832 (45.7%) among long sleepers, and 789 (43.3%) among those participants in the reference category. Of 1,822 deceased participants, 92 (5.1%) had a dementia condition reported on the death certificate (49 [53.3%] were long sleepers, 36 [39.1%] reported sleeping between 6 and 8 hours, and 7 [7.6%] were short sleepers). In an unadjusted Cox model, risk of dementia-specific mortality was increased in long sleepers (hazard ratio for dementia mortality in long sleepers 5 1.58, p 5 0.04) when compared with the reference group. In a Cox model that adjusted for numerous demographic factors and comorbidities, the hazard ratio for dementia mortality in long sleepers was 1.63 (p 5 0.03).Conclusions: Self-reported long sleep duration was associated with 58% increased risk of dementia-specific mortality in this cohort of elders without dementia. Future studies are required to confirm these findings.

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Short or Long Sleep Duration Is Associated with Memory Impairment in Older Chinese: the Guangzhou Biobank Cohort Study

Abstract: Short or long sleep duration was an important sleep-related factor independently associated with memory impairment and may be a useful marker for increased risk of cognitive impairment in older people.

Cited by 143 publications

References 29 publications

Associations between Sleep Duration, Sleep Quality, and Cognitive Test Performance among Older Adults from Six Middle Income Countries: Results from the Study on Global Ageing and Adult Health (SAGE)

Associations between Sleep Duration, Sleep Quality, and Cognitive Test Performance among Older Adults from Six Middle Income Countries: Results from the Study on Global Ageing and Adult Health (SAGE)

Cognitive deficit is associated with phase advance of sleep–wake rhythm, daily napping, and prolonged sleep duration—a cross-sectional study in 2,947 community-dwelling older adults

Long sleep duration in elders without dementia increases risk of dementia mortality (NEDICES)

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