Associations of Sleep Quality, Anxiety, and Depression with Cognitive and Executive Functions among Community-Dwelling Women Aged ≥ 65 Years: A Cross-Sectional Study.

Ana Belén Parra-Díaz,Francisco Álvarez-Salvago,Agustín Aibar-Almazán,Fidel Hita-Contreras,Antonio Martínez-Amat,José Daniel Jiménez-García

doi:10.3390/healthcare9111599

Ana Belén Parra-Díaz, Francisco Álvarez-Salvago + Show 4 more

Open Access

https://doi.org/10.3390/healthcare9111599

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Abstract

(1) Background: The objective of this study was to evaluate the associations of sleep quality, anxiety, and depression with cognitive performance, executive functions, and verbal fluency among women aged ≥ 65 years; (2) Methods: A cross-sectional study was conducted on 241 women (72.52 ± 3.93 years). Cognitive performance (Mini-Mental State Examination) and impairment (Montreal Cognitive Assessment), verbal fluency (Isaacs test) and executive function (Trail Making Test), Sleep quality (Pittsburgh Sleep quality Index) and anxiety and depression (Hospital Anxiety and Depression Scale) were determined; (3) Results: The linear regression analysis indicated that anxiety, depression and age, were related to lower Mini-Mental State Examination score (adjusted R2 = 0.306), and age, anxiety and daytime dysfunction were linked to reduced Montreal Cognitive Assessment score (adjusted R2 = 0.248). Age and daytime dysfunction were associated with worse verbal fluency (adjusted R2 = 0.094). Finally, sleep latency, sleep disturbances, the Pittsburgh Sleep quality Index total score were associated with longer times in TMT-A (adjusted R2 = 0.758) and TMT-B (adjusted R2 = 0.508); (4) Conclusions: Sleep quality was associated with cognitive performance, verbal fluency and executive functions. Besides, both anxiety and depression were related with cognitive performance, while only anxiety was linked to executive functions. As for confounders, age was associated with cognitive performance and verbal fluency.

Highlights

Our findings showed that poorer sleep quality was associated with worse cognitive performance and verbal fluency (PSQI daytime dysfunctions domain), and executive functions (PSQI total score, sleep latency domains, sleep disorders)
The results of this study initially revealed individual associations of both greater anxiety and depressive symptoms with a longer time in the Trail Making Test (TMT)-A and TMT-B tests, only anxiety remained related to the TMT-B in the linear regression analysis., while poor sleep quality outcomes remained as independent predictors with regard to the TMT-A
Higher levels of anxiety were related to lower executive functions and cognitive performance, while depression was only associated with the latter

Summary

Introduction

Some of the most common psychological problems in menopause are depression, described as the presence of an emotional state of sadness that is linked to other alterations causing discomfort and changes in the functionality of the person who suffers [6], and anxiety, that is defined as a feeling of fear or fear that can affect cognitive, behavioral and/or somatosensory levels in people [7] Both occur because productivity, functional capacity and personal self-satisfaction are diminished at this stage of life [8] and are associated with high comorbidity such as cognitive problems, insomnia and physical dysfunction [9,10]

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