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22-09-2023 | Original Article

Assessment of cognitive function and sleep–wake rhythms in community-dwelling older adults

Authors: Masato Okuda, Akiko Noda, Kunihiro Iwamoto, Nozomi Hishikawa, Seiko Miyata, Fumihiko Yasuma, Toshiaki Taoka, Norio Ozaki, Julie A. Suhr, Soichiro Miyazaki

Published in: Sleep and Biological Rhythms

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Abstract

Disruption of the circadian rhythm and sleep–wake cycles is a consequence of aging and is associated with the cognitive decline and many neurodegenerative conditions. We investigated the bedtime, wake-up time, sleep timing (midpoint between bedtime and wake-up time), and sleep timing standard deviation (SD) using the actigraphy among 80 consecutive volunteers aged ≥ 60 years. Global cognitive function and executive function of detailed cognitive domains were evaluated using the mini-mental state examination (MMSE) and Wisconsin card sorting test (WCST) and subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The category achievement (CA), total errors (TE), perseverative errors of Nelson (PEN), non-perseverative errors (NPE), and difficulties in maintaining set (DMS) on the WCST were significantly correlated with sleep timing SD (CA: r = − 0.276, p = 0.013, TE: r = 0.311, p = 0.005, PEN: r = 0.241, p = 0.032, NPE: r = 0.250, p = 0.025, DMS: r = 0.235, p = 0.036), but not with the MMSE score. Multiple regression analyses with the stepwise forward selection method including age, ESS score, bedtime, sleep timing, and sleep timing SD, revealed that the ESS score, and sleep timing SD were significant factors related to CA on the WCST (ESS score: β = − 0.322, p = 0.004; sleep timing SD: β = − 0.250, p = 0.022). Assessment of sleep–wake rhythms, daytime sleepiness, and cognitive function using the MMSE and WCST is valuable for the prediction of cognitive decline in the geriatric population.
Literature
1.
go back to reference Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol. 2014;13(10):1017–28. CrossRefPubMed Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol. 2014;13(10):1017–28. CrossRefPubMed
2.
go back to reference Hofman MA, Swaab DF. Living by the clock: the circadian pacemaker in older people. Ageing Res Rev. 2006;5(1):33–51. CrossRefPubMed Hofman MA, Swaab DF. Living by the clock: the circadian pacemaker in older people. Ageing Res Rev. 2006;5(1):33–51. CrossRefPubMed
4.
go back to reference Schmidt C, Peigneux P, Cajochen C. Age-related changes in sleep and circadian rhythms: impact on cognitive performance and underlying neuroanatomical networks. Front Neurol. 2012;3:118. CrossRefPubMedPubMedCentral Schmidt C, Peigneux P, Cajochen C. Age-related changes in sleep and circadian rhythms: impact on cognitive performance and underlying neuroanatomical networks. Front Neurol. 2012;3:118. CrossRefPubMedPubMedCentral
6.
go back to reference Xiao Q, Shadyab AH, Rapp SR, et al. Rest-activity rhythms and cognitive impairment and dementia in older women: results from the Women’s Health Initiative. J Am Geriatr Soc. 2022;70(10):2925–37. CrossRefPubMed Xiao Q, Shadyab AH, Rapp SR, et al. Rest-activity rhythms and cognitive impairment and dementia in older women: results from the Women’s Health Initiative. J Am Geriatr Soc. 2022;70(10):2925–37. CrossRefPubMed
7.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98. CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98. CrossRefPubMed
8.
go back to reference Alvarez JA, Emory E. Executive function and the frontal lobes: a meta-analytic review. Neuropsychol Rev. 2006;16(1):17–42. CrossRefPubMed Alvarez JA, Emory E. Executive function and the frontal lobes: a meta-analytic review. Neuropsychol Rev. 2006;16(1):17–42. CrossRefPubMed
10.
11.
go back to reference Kondo T, Osugi S, Shimokata K, et al. Smoking and smoking cessation in relation to all-cause mortality and cardiovascular events in 25,464 healthy male Japanese workers. Circ J. 2011;75(12):2885–92. CrossRefPubMed Kondo T, Osugi S, Shimokata K, et al. Smoking and smoking cessation in relation to all-cause mortality and cardiovascular events in 25,464 healthy male Japanese workers. Circ J. 2011;75(12):2885–92. CrossRefPubMed
13.
go back to reference Umemura S, Arima H, Arima S, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res. 2019;42(9):1235–481. CrossRefPubMed Umemura S, Arima H, Arima S, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res. 2019;42(9):1235–481. CrossRefPubMed
14.
go back to reference Takegami M, Suzukamo Y, Wakita T, et al. Development of a Japanese version of the Epworth Sleepiness Scale (JESS) based on item response theory. Sleep Med. 2009;10(5):556–65. CrossRefPubMed Takegami M, Suzukamo Y, Wakita T, et al. Development of a Japanese version of the Epworth Sleepiness Scale (JESS) based on item response theory. Sleep Med. 2009;10(5):556–65. CrossRefPubMed
15.
go back to reference Doi Y, Minowa M, Uchiyama M, et al. Psychometric assessment of subjective sleep quality using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) in psychiatric disordered and control subjects. Psychiatry Res. 2000;97(2–3):165–72. CrossRefPubMed Doi Y, Minowa M, Uchiyama M, et al. Psychometric assessment of subjective sleep quality using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) in psychiatric disordered and control subjects. Psychiatry Res. 2000;97(2–3):165–72. CrossRefPubMed
16.
go back to reference Cole RJ, Kripke DF, Gruen W, et al. Automatic sleep/wake identification from wrist activity. Sleep. 1992;15(5):461–9. CrossRefPubMed Cole RJ, Kripke DF, Gruen W, et al. Automatic sleep/wake identification from wrist activity. Sleep. 1992;15(5):461–9. CrossRefPubMed
17.
go back to reference Youngstedt SD, Kripke DF, Elliott JA, Klauber MR. Circadian abnormalities in older adults. J Pineal Res. 2001;31(3):264–72. CrossRefPubMed Youngstedt SD, Kripke DF, Elliott JA, Klauber MR. Circadian abnormalities in older adults. J Pineal Res. 2001;31(3):264–72. CrossRefPubMed
18.
go back to reference O’Bryant SE, Humphreys JD, Smith GE, et al. Detecting dementia with the mini-mental state examination in highly educated individuals. Arch Neurol. 2008;65(7):963–7. PubMedPubMedCentral O’Bryant SE, Humphreys JD, Smith GE, et al. Detecting dementia with the mini-mental state examination in highly educated individuals. Arch Neurol. 2008;65(7):963–7. PubMedPubMedCentral
19.
go back to reference Banno M, Koide T, Aleksic B, et al. Wisconsin card sorting test scores and clinical and sociodemographic correlates in Schizophrenia: multiple logistic regression analysis. BMJ Open. 2012;2(6): e001340. CrossRefPubMedPubMedCentral Banno M, Koide T, Aleksic B, et al. Wisconsin card sorting test scores and clinical and sociodemographic correlates in Schizophrenia: multiple logistic regression analysis. BMJ Open. 2012;2(6): e001340. CrossRefPubMedPubMedCentral
20.
go back to reference Walsh CM, Blackwell T, Tranah GJ, et al. Weaker circadian activity rhythms are associated with poorer executive function in older women. Sleep. 2014;37(12):2009–16. CrossRefPubMedPubMedCentral Walsh CM, Blackwell T, Tranah GJ, et al. Weaker circadian activity rhythms are associated with poorer executive function in older women. Sleep. 2014;37(12):2009–16. CrossRefPubMedPubMedCentral
21.
go back to reference Tranah GJ, Blackwell T, Stone KL, et al. Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women. Ann Neurol. 2011;70(5):722–32. CrossRefPubMedPubMedCentral Tranah GJ, Blackwell T, Stone KL, et al. Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older women. Ann Neurol. 2011;70(5):722–32. CrossRefPubMedPubMedCentral
22.
go back to reference Goshiki T, Miyahara M. Effects of individual differences and irrelevant speech on WCST and STROOP test. Psychologia. 2008;51:28–45. CrossRef Goshiki T, Miyahara M. Effects of individual differences and irrelevant speech on WCST and STROOP test. Psychologia. 2008;51:28–45. CrossRef
23.
go back to reference Kokudai Y, Honma M, Masaoka Y, et al. Cascade process mediated by left hippocampus and left superior frontal gyrus affects relationship between aging and cognitive dysfunction. BMC Neurosci. 2021;22(1):75. CrossRefPubMedPubMedCentral Kokudai Y, Honma M, Masaoka Y, et al. Cascade process mediated by left hippocampus and left superior frontal gyrus affects relationship between aging and cognitive dysfunction. BMC Neurosci. 2021;22(1):75. CrossRefPubMedPubMedCentral
24.
go back to reference Okazaki T, Saeki S, Hachisuka K. Adolescent normative data on simple neuropsychological tests for cognitive behavioral disorders: mini-mental state examination, trail making test, Wisconsin card sorting test-KFS version and Miyake’s verbal paired-associate learning test. Jpn J Rehabil Med. 2013;50(12):962–70 ( In Japanese). CrossRef Okazaki T, Saeki S, Hachisuka K. Adolescent normative data on simple neuropsychological tests for cognitive behavioral disorders: mini-mental state examination, trail making test, Wisconsin card sorting test-KFS version and Miyake’s verbal paired-associate learning test. Jpn J Rehabil Med. 2013;50(12):962–70 ( In Japanese). CrossRef
25.
go back to reference Gabelle A, Gutierrez LA, Jaussent I, et al. Excessive sleepiness and longer nighttime in bed increase the risk of cognitive decline in frail elderly subjects: the MAPT-sleep study. Front Aging Neurosci. 2017;9:312. CrossRefPubMedPubMedCentral Gabelle A, Gutierrez LA, Jaussent I, et al. Excessive sleepiness and longer nighttime in bed increase the risk of cognitive decline in frail elderly subjects: the MAPT-sleep study. Front Aging Neurosci. 2017;9:312. CrossRefPubMedPubMedCentral
26.
go back to reference Carvalho DZ, St Louis EK, Boeve BF, et al. Excessive daytime sleepiness and fatigue may indicate accelerated brain aging in cognitively normal late middle-aged and older adults. Sleep Med. 2017;32:236–43. CrossRefPubMed Carvalho DZ, St Louis EK, Boeve BF, et al. Excessive daytime sleepiness and fatigue may indicate accelerated brain aging in cognitively normal late middle-aged and older adults. Sleep Med. 2017;32:236–43. CrossRefPubMed
27.
go back to reference Carvalho DZ, St Louis EK, Knopman DS, et al. Association of excessive daytime sleepiness with longitudinal β-amyloid accumulation in elderly persons without dementia. JAMA Neurol. 2018;75(6):672–80. CrossRefPubMedPubMedCentral Carvalho DZ, St Louis EK, Knopman DS, et al. Association of excessive daytime sleepiness with longitudinal β-amyloid accumulation in elderly persons without dementia. JAMA Neurol. 2018;75(6):672–80. CrossRefPubMedPubMedCentral
28.
go back to reference Blackwell T, Yaffe K, Ancoli-Israel S, et al. Poor sleep is associated with impaired cognitive function in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2006;61(4):405–10. CrossRefPubMed Blackwell T, Yaffe K, Ancoli-Israel S, et al. Poor sleep is associated with impaired cognitive function in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2006;61(4):405–10. CrossRefPubMed
30.
go back to reference Okuda M, Noda A, Iwamoto K, et al. Effects of long sleep time and irregular sleep-wake rhythm on cognitive function in older people. Sci Rep. 2021;11(1):7039. CrossRefPubMedPubMedCentral Okuda M, Noda A, Iwamoto K, et al. Effects of long sleep time and irregular sleep-wake rhythm on cognitive function in older people. Sci Rep. 2021;11(1):7039. CrossRefPubMedPubMedCentral
31.
go back to reference Blackwell T, Yaffe K, Ancoli-Israel S, et al. Associations between sleep architecture and sleep-disordered breathing and cognition in older community-dwelling men: the osteoporotic fractures in men sleep study. J Am Geriatr Soc. 2011;59(12):2217–25. CrossRefPubMedPubMedCentral Blackwell T, Yaffe K, Ancoli-Israel S, et al. Associations between sleep architecture and sleep-disordered breathing and cognition in older community-dwelling men: the osteoporotic fractures in men sleep study. J Am Geriatr Soc. 2011;59(12):2217–25. CrossRefPubMedPubMedCentral
32.
go back to reference Kato K, Noda A, Yasuma F, et al. Effects of sleep-disordered breathing and hypertension on cognitive function in elderly adults. Clin Exp Hypertens. 2020;42(3):250–6. CrossRefPubMed Kato K, Noda A, Yasuma F, et al. Effects of sleep-disordered breathing and hypertension on cognitive function in elderly adults. Clin Exp Hypertens. 2020;42(3):250–6. CrossRefPubMed
Metadata
Title
Assessment of cognitive function and sleep–wake rhythms in community-dwelling older adults
Authors
Masato Okuda
Akiko Noda
Kunihiro Iwamoto
Nozomi Hishikawa
Seiko Miyata
Fumihiko Yasuma
Toshiaki Taoka
Norio Ozaki
Julie A. Suhr
Soichiro Miyazaki
Publication date
22-09-2023
Publisher
Springer Nature Singapore
Published in
Sleep and Biological Rhythms
Print ISSN: 1446-9235
Electronic ISSN: 1479-8425
DOI
https://doi.org/10.1007/s41105-023-00491-z