CNN —
If you frequently feel drowsy during your everyday activities as you age, it could be more than just a nuisance; recent research suggests that this persistent fatigue might signal a heightened risk for developing a condition that could eventually lead to dementia. This finding comes from a new study published in the esteemed journal Neurology.
In the findings, among participants grappling with excessive daytime sleepiness and a noticeable lack of energy, an alarming 35.5% went on to develop motoric cognitive risk syndrome (MCR), compared to just 6.7% of individuals who did not report these particular issues. This stark contrast underscores the potential risks linked with sleep quality in older adults.
Motoric cognitive risk syndrome is characterized by a notably slow walking speed and subjective memory complaints in older adults who do not yet have dementia or a mobility impairment. Those with MCR face more than double the risk of progressing to dementia, a condition that was first identified in 2013.
“Previous studies have shown a link between sleep disorders and the risk of dementia,” stated Dr. Victoire Leroy, the first author of the study and an assistant professor of geriatric medicine at Tours University Hospital in France. This connection emphasizes the importance of understanding the repercussions of sleep-related issues.
However, many of the previous scientific explorations of this connection primarily assessed it at a singular point in time. Moreover, the relationship between various quality-of-sleep factors and pre-dementia syndromes remains under-explored, prompting Leroy and her research team to delve deeper into this vital area.
“Establishing the relationship between sleep dysfunction and MCR risk is important because early intervention may offer the best hope for preventing dementia,” the researchers emphasized, highlighting the need for proactive measures in managing sleep health.
The study’s conclusions are based on a diverse group of 445 adults, with an average age of 76, who were recruited from Westchester County, New York, as part of the Central Control of Mobility and Aging study. This comprehensive research initiative examines cognitive processes and brain functions involved in aging and mobility. Participants were assessed on treadmills to document their initial walking patterns and were followed up annually between 2011 and 2018.
To enrich their findings, the researchers meticulously gathered yearly data on participants’ perceptions of their sleep quality and quantity for the two weeks leading up to their assessments. They focused on seven components of the Pittsburgh Sleep Quality Index, capturing detailed information about subjective sleep quality, the time taken to fall asleep, total sleep duration, sleep efficiency, disturbances during slumber, the use of sleep medication, and daytime dysfunction that indicated difficulties staying awake or a lack of enthusiasm for daily tasks.
The research may encourage both physicians and patients to engage in more open discussions regarding sleep patterns while also closely considering walking speed when diagnosing early signs of cognitive impairments, according to Dr. Richard Isaacson, who is the director of research at the Institute for Neurodegenerative Diseases in Florida, though he was not directly involved in the study.
Despite the valuable insights this study provides, it does have some notable limitations, as Dr. Tara Spires-Jones, a professor of neurodegeneration at the University of Edinburgh, pointed out in an email correspondence.
“The sleep measurements were self-reported, not measured by a scientist, and these self-reports could be biased by people with memory issues,” Spires-Jones explained, highlighting crucial aspects for further investigation. She also noted that the participant pool was predominantly white and smaller when compared to similar studies encompassing only a single-point analysis, suggesting that future research could validate these findings more robustly.
Because motoric cognitive risk syndrome is a relatively new classification, experts, including Isaacson, acknowledge that there is still much to uncover regarding its causes and physiological impacts on the body, an endeavor made challenging by the current lack of defining pathological biomarkers for MCR.
It remains unclear why, amongst the seven components of sleep assessed, daytime dysfunction was the only factor significantly associated with the risk of MCR. Experts have speculated that one might expect the other six components, such as sleep quality and duration, to also influence daytime performance.
Spires-Jones added that it is crucial to consider the possibility of reverse causation in the link between daytime dysfunction and MCR risk, where early changes in the brain due to dementia may disrupt an individual’s sleep patterns, rather than sleep disturbances being the primary cause of cognitive decline.
Scientific research has established that sleep disturbances, including REM sleep behavior disorder, can act as early indicators of various conditions, such as Lewy body dementia or Parkinson’s disease, showcasing the intricate relationship between sleep health and neurodegenerative diseases, according to Isaacson.
Dr. Leroy pointed out that the findings serve as a valuable reminder of the critical importance of sleep in maintaining overall health and mitigating risks associated with cognitive decline as we age.
For individuals who struggle with sleep issues, consulting with healthcare providers is essential. They may also want to complete a sleep questionnaire, and consider whether a sleep study, performed at home or in a clinical setting, could prove beneficial.
“There are numerous treatments available today, including both pharmacological and non-pharmacological approaches, tailored to the specific issues identified,” Isaacson noted. “Addressing and treating sleep disturbances can lead to significant benefits for brain health and aid in dementia prevention over the long run.”
Moreover, employing additional strategies to safeguard brain health as you age can be beneficial.
“Adopting a healthy lifestyle—one that prioritizes nutritious eating, maintaining a healthy body weight, engaging both the body and brain in regular activities, and addressing any hearing loss—are all critical steps toward enhancing brain resilience while likely reducing the risk of developing dementia,” Spires-Jones emphasized.
“It’s important to clarify that individuals with dementia are not to be blamed solely for their lifestyle choices,” she noted, cautioning against oversimplifying the complex nature of dementia risks. “Current estimates suggest that less than half of dementia risk can be attributed to modifiable lifestyle factors, with the remainder likely linked to genetic predispositions.”
Nevertheless, considering the potential for lifestyle changes to influence risk, alongside the expanding field of medical research and treatment options, Spires-Jones expressed cautious optimism for the future of dementia prevention.
For those already facing mobility challenges, proactive measures to prevent falls can play a crucial role in maintaining safety. Recommended interventions may include evaluations from physical and occupational therapists, along with practical home adaptations, such as the installation of grab bars in bathrooms, decluttering living spaces, and utilizing night lights to enhance visibility at night.
According to experts, integrating these lifestyle habits can create a synergistic effect on brain health, potentially mitigating the effects of aging and cognitive decline. They emphasize the importance of a holistic approach where sleep health, physical activity, and nutrition work together to support overall well-being.
the relationship between sleep quality and cognitive health is profound and multifaceted. Enhanced understanding of this connection can empower individuals and healthcare providers to prioritize effective sleep health management as a critical component of cognitive care and overall health strategies for aging populations.
