Abstract
Objective: The aim of this study was to analyze quantitative sleep changes and their implication on subjective cognitive decline (SCD). Objective sleep patterns were investigated by an actigraph and recorded at the baseline and 2-year after in order to examine specific sleep alterations in SCD.Background: Sleep disorders are very common among average elderly adults and an altered sleep pattern is known to be a risk factor for future development of mild cognitive impairment (MCI) and dementia. Recent studies have shown how sleep is objectively altered in average senior adults with SCD, without any other significant change in cognition and behavior or brain structure. Considering that both SCD and disrupted sleep are risk factors for future MCI and dementia, with sleep only as a modifiable risk factor, further research is required to deeply investigate the interaction between sleep and SCD.Methods: Among 70 community-dwelling elderly individuals who had been enrolled at baseline, 35 (64.6 ± 5.6 years, 15 M/20 F) underwent a complete neuropsychological battery and 1-week wrist actigraphy recording 2 years later during the follow-up stage. Individuals were divided into two groups according to their SCD Questionnaire (SCD-Q) score. Sleep hours, sleep efficiency and onset latency, napping and time awake after sleep onset (WASO) were collected. All individuals underwent structural magnetic resonance imaging (MRI) examination to exclude brain disorders. Data collection was performed at baseline and after 2 years at the follow-up phase.Results: A significantly different night sleep time between the two groups was observed: SCD showed a lower total sleep time (TST) than non-SCD subjects. Moreover, a total time spent in bed (TIB) was significantly lower in SCD subjects over 2 years of observation.Conclusions: Objective changes over time of the sleep pattern, specifically TIB and TST, are present in SCD individuals. The results of the study show that sleep alterations are common in SCD and underline the clinical importance of screening in order to assess sleep alterations as well as improve sleep in average adults with SCD complaints.
Highlights
Sleep disturbances are frequent symptoms in adults and are associated with various factors, including health-related quality of life, chronic diseases and mental health (Chen et al, 2014), sleep disorders are associated with age-related cognitive decline (Bliwise, 2004; Bliwise et al, 2005; Bishop et al, 2010; Mander et al, 2017; Génier Marchand et al, 2018)
Nine subjects were excluded due to periventricular and deep white matter (WM) damage, 20 subjects refused to participate because they were under the supervision of a neurologist not involved in the study, and six were missing neuropsychological or actigraphy data
Thirty-five subjects were enrolled for the follow-up study, 15 subjects for the SCD group (9 M/6 F; AGE 66.53–4.76; EDU 10.8, 3.14; SCD Questionnaire (SCD-Q) 9.66–2.6), and 20 subjects (14 F/6 M), for the non-SCD group (AGE 63.15–5.91; EDU 10.7–3.74; SCD-Q 3.7–1.6)
Summary
Sleep disturbances are frequent symptoms in adults and are associated with various factors, including health-related quality of life, chronic diseases and mental health (Chen et al, 2014), sleep disorders are associated with age-related cognitive decline (Bliwise, 2004; Bliwise et al, 2005; Bishop et al, 2010; Mander et al, 2017; Génier Marchand et al, 2018). Recent studies have shown how sleep is objectively altered in average senior adults with SCD, without any other significant change in cognition and behavior or brain structure Considering that both SCD and disrupted sleep are risk factors for future MCI and dementia, with sleep only as a modifiable risk factor, further research is required to deeply investigate the interaction between sleep and SCD
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