Relationships between sleep apnea and insomnia with cognition among Latinos in the National Alzheimer’s Coordinating Center (NACC)

Abstract

AbstractBackgroundSleep difficulties (e.g., sleep apnea, insomnia) have been associated with worse late life cognitive health and increased risk for dementia. However, the role of sleep, a potentially modifiable factor, in cognitive aging is understudied among Hispanics/Latinos/Latinxs (henceforth Latinos)—a group that faces dementia disparities. Therefore, we examined the relationships between sleep difficulties and cognition in this population using data from the National Alzheimer’s Coordinating Center (NACC).MethodParticipants included 1,633 Latinos (64% females) ages 21 to 98 years old from the NACC (funded by NIA/NIH Grant U24 AG072122). This analysis used data collected at 35 ADRCs from 2015‐2022. Exposures included history of self‐reported and/or clinically assessed sleep apnea (n = 261) and hyposomnia/insomnia (n = 384). Outcomes were concurrent cognitive scores from tests of learning, memory, semantic fluency, processing speed, confrontation naming, and executive functioning. Covariates included age, sex, education, heritage (e.g., Cuban), cognitive status, and body mass index. General linear models separately tested the associations between sleep difficulties with cognition in crude and fully‐adjusted models. Additionally, we examined whether sex, age, or heritage modified these associations.ResultsSleep apnea was associated with faster processing speed, and insomnia was associated with worse confrontation naming in crude but not fully‐adjusted models. In fully adjusted models, sex modified the associations of both sleep apnea and insomnia with semantic fluency. Specifically, men without sleep apnea had worse semantic fluency than all other groups; no other group differences emerged. Females in either insomnia group had better semantic fluency than men in either insomnia group, and women without insomnia had marginally better semantic fluency than women with insomnia. Older age (continuous) was associated with worse executive functioning, specifically working memory, among individuals with insomnia to a greater extent than those without insomnia. Heritage did not modify associations between sleep difficulties with cognition.ConclusionConsistent with previous, we found that sleep measures were associated with cognition in this group of Latinos from a wide age‐range. Our findings were specific to semantic fluency and varied based on demographic factors (e.g., sex). Future studies should examine the relationships between sleep with longitudinal change in cognition in this underserved community.