Ann D Cohen1, Yichen Jia2, Stephen Smagula1,3, Chung-Chou H Chang2,4, Beth Snitz5, Sarah B Berman5,6, Erin Jacobsen1, Mary Ganguli1,3. 1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania. 2. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 4. Department of Medicine, School of Medicine, University of Pittsburgh, Pennsylvania. 5. Department of Neurology, School of Medicine, University of Pittsburgh, Pennsylvania. 6. Clinical and Translational Science Institute, University of Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: Excessive daytime sleepiness is associated with chronic disorders of aging and mortality. Because longitudinal data are limited on the development of sleep disturbances and cognitive changes in older adults, we investigated the demographic, clinical, and cognitive predictors of self-reported daytime sleepiness over a period of 10 years. METHODS: We jointly modeled latent trajectories over time of sleepiness, cognitive domains, and informative attrition and then fit models to identify cognitive trajectories and baseline characteristics that predicted the trajectories of sleepiness. RESULTS: Three latent trajectory groups were identified: emerging sleepiness, persistent sleepiness, and consistently low daytime sleepiness accounting for attrition in all groups. Compared with low sleepiness, emerging sleepiness was significantly associated with declining attention and subjective memory complaints; persistent sleepiness was associated with lower baseline scores in all cognitive domains, declining language trajectory, and more subjective memory complaints. CONCLUSIONS: These findings suggest that persistent sleepiness and emerging daytime sleepiness are associated with cognitive decline and multiple morbidities, albeit more subtly in emerging daytime sleepiness. Furthermore, these data suggest that change in the cognitive domain of attention and subjective memory complaints may be early indicators of future sleep disturbance.
BACKGROUND:Excessive daytime sleepiness is associated with chronic disorders of aging and mortality. Because longitudinal data are limited on the development of sleep disturbances and cognitive changes in older adults, we investigated the demographic, clinical, and cognitive predictors of self-reported daytime sleepiness over a period of 10 years. METHODS: We jointly modeled latent trajectories over time of sleepiness, cognitive domains, and informative attrition and then fit models to identify cognitive trajectories and baseline characteristics that predicted the trajectories of sleepiness. RESULTS: Three latent trajectory groups were identified: emerging sleepiness, persistent sleepiness, and consistently low daytime sleepiness accounting for attrition in all groups. Compared with low sleepiness, emerging sleepiness was significantly associated with declining attention and subjective memory complaints; persistent sleepiness was associated with lower baseline scores in all cognitive domains, declining language trajectory, and more subjective memory complaints. CONCLUSIONS: These findings suggest that persistent sleepiness and emerging daytime sleepiness are associated with cognitive decline and multiple morbidities, albeit more subtly in emerging daytime sleepiness. Furthermore, these data suggest that change in the cognitive domain of attention and subjective memory complaints may be early indicators of future sleep disturbance.
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