Excessive Sleepiness is Predictive of Cognitive Decline in the Elderly
Open Access
- 1 September 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Sleep
- Vol. 35 (9), 1201-1207
- https://doi.org/10.5665/sleep.2070
Abstract
To examine the association of sleep complaints reported at baseline (insomnia complaints and excessive daytime sleepiness (EDS)) and medication, with cognitive decline in community-dwelling elderly. An 8-yr longitudinal study. The French Three-City Study. There were 4,894 patients without dementia recruited from 3 French cities and having a Mini-Mental Status Examination (MMSE) score ≥ 24 points at baseline. Questionnaires were used to evaluate insomnia complaints (poor sleep quality (SQ), difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA)), EDS, and sleep medication at baseline. Cognitive decline was defined as a 4-point reduction in MMSE score during follow-up at 2, 4, and 8 yr. Logistic regression models were adjusted for sociodemographic, behavioral, physical, and mental health variables, and apolipoprotein E genotype. EDS independently increased the risk of cognitive decline (odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.02-1.56), especially for those patients who also developed dementia during the follow-up period (OR = 1.39, 95% CI = 1.00-1.97). The number of insomnia complaints and DMS were negatively associated with MMSE cognitive decline (OR = 0.77, 95% CI = 0.60-0.98 for 3-4 complaints, OR = 0.81, 95% CI = 0.68-0.96, respectively). The 3 other components of insomnia (SQ, DIS, EMA) were not significantly associated with MMSE cognitive decline. Our results suggest that EDS may be associated independently with the risk of cognitive decline in the elderly population. Such results could have important public health implications because EDS may be an early marker and potentially reversible risk factor of cognitive decline and onset of dementia.Keywords
This publication has 37 references indexed in Scilit:
- Excessive daytime sleepiness and vascular events: The Three City StudyAnnals of Neurology, 2011
- Insomnia and Daytime Sleepiness Are Risk Factors for Depressive Symptoms in the ElderlySleep, 2011
- Circadian activity rhythms and risk of incident dementia and mild cognitive impairment in older womenAnnals of Neurology, 2011
- Insomnia Symptoms in Older Adults: Associated Factors and Gender DifferencesAmerican Journal of Geriatric Psychiatry, 2011
- Excessive Daytime Sleepiness Is an Independent Risk Indicator for Cardiovascular Mortality in Community-Dwelling ElderlyStroke, 2009
- Self-Reported Sleep Quality Predicts Poor Cognitive Performance in Healthy Older AdultsThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2009
- Predictive Value of Rapid Decline in Mini Mental State Examination in Clinical Practice for Prognosis in Alzheimer’s DiseaseDementia and Geriatric Cognitive Disorders, 2008
- Determinants of excessive daytime sleepiness in a French community‐dwelling elderly populationJournal of Sleep Research, 2007
- Daytime Sleepiness Is Associated with 3-Year Incident Dementia and Cognitive Decline in Older Japanese-American MenJournal of the American Geriatrics Society, 2001
- The CES-D ScaleApplied Psychological Measurement, 1977