0313 The Role of Objective Sleep on Subjective and Objective Cognition in Older Adults with Insomnia: A Pilot Study

Abstract

Abstract Introduction Cognitive complaints and objective cognitive dysfunction are common in aging populations, but findings regarding associations between them are inconclusive. Given age-related sleep changes [more lighter-staged sleep, reduced sleep efficiency (SE)], and known relationships between insomnia complaints and cognitive dysfunction, this pilot tested whether polysomnographic sleep moderates associations between subjective and objective cognition in older adults with insomnia complaints. Methods Older adults with insomnia complaints (N=37, Mage=68.9, SD=6.23, 20 women) completed one night of polysomnography (Sleep Profiler-PSG2TM) and the NIH Toolbox [Pattern Comparison (processing speed), Dimensional Change Card Sort (cognitive flexibility), Stroop (attention and inhibition), and Sternberg (working memory). Additionally, participants completed the Cognitive Failures Questionnaire (subscores CFQ-memory, CFQ-distractibility CFQ-blunders computed). Multiple regressions examined if polysomnographic sleep (SE, %N1, %N3) moderated associations between subjective/objective cognition, controlling for apnea-hypopnea index and depression. Results %N1 moderated associations between Sternberg performance and CFQ-memory (R2=.13, p=.03), CFQ-distractibility (R2=.20 p=.01) and CFQ-blunders (R2=.19 p=.02). At highest %N1, worse working memory was associated with less complaints in memory (β=16.4, p=.03), distractibility (β=12.4, p=.009) and blunders (β=15.3, p=.02). Additionally, %N1 (R2=.14, p=.02) and SE (R2=.17, p=.02) moderated the association between dimensional change performance and CFQ-distractibility. At lowest %N1, worse cognitive flexibility was associated with more distractibility complaints (β=-988.8, p=.02), while at highest %N1, worse cognitive flexibility was associated with less distractibility complaints (β=3881.4, p=.02). At lowest SE, worse cognitive flexibility was associated with less distractibility complaints (β=2354.0 p=.02), while at highest SE, worse cognitive flexibility was associated with more distractibility complaints (β=-1414.1 p=.03). Conclusion Preliminary findings suggest in older adults with insomnia complaints, greater time spent in lighter-staged sleep and more sleep fragmentation may exacerbate discrepancies in the objective/subjective cognition relationship, while less time spent in lighter-staged sleep and less sleep fragmentation may converge the objective/subjective relationship. Objective sleep should be considered when understanding discrepancies between subjective reports versus neuropsychological/objective cognition profiles. Prospective studies with larger samples examining how sleep impacts the trajectory of subjective/objective cognition in aging are warranted. Support (If Any) This research was made possible by an award (PI:Curtis) from the American Academy of Sleep Medicine Foundation, a foundation of the American Academy of Sleep Medicine.