November 08, 2024
2 min read
Key takeaways:
- Individuals who did not have good sleep had a higher risk of developing incident motoric cognitive risk syndrome.
- Those who reported excessive sleepiness and lower enthusiasm had a significant risk of MCR.
In a detailed study involving community-dwelling older adults, researchers found that poor sleep quality was a significant predictor not just of incident motoric cognitive risk syndrome, but also of increased physical and mental disability. This finding was documented in a recent issue of Neurology.
“Sleep disturbances and cognitive impairment frequently coexist in aging and the association between the two may be bidirectional,” emphasized Victoire Leroy, MD, PhD, of the department of neurology at Albert Einstein College of Medicine, and her colleagues. “Poor sleep quality has been shown to correlate with a heightened risk of dementia.”
Among older community-living adults, poor sleep quality indicated a markedly poorer physical and mental health status compared to their better-rested counterparts. Image: Adobe Stock
While sleep disturbances are linked to an increased risk of cognitive impairment, the research community has yet to confirm the specific associations between sleep quality and motoric cognitive risk syndrome (MCR), which is characterized by slow gait speed and cognitive complaints, according to Leroy and her team.
To explore this relationship, the researchers examined how sleep disturbances impacted both the incidence and prevalence of MCR among individuals aged 65 years and older, all residing within a community of similarly aged peers.
The study recruited a total of 445 adults, with a mean age of 75.9 years and comprising 57% women, all without dementia, from the Central Control of Mobility and Aging cohort. The analysis was conducted at Albert Einstein College of Medicine.
Participants were categorized into “good” sleepers (with scores of 5 or less) and “poor” sleepers (scores greater than 5) based on the widely-recognized 18-item Pittsburgh Sleep Quality Index (PSQI), which takes into account seven specific components of sleep quality.
To assess psychological health, symptoms of depression and anxiety were evaluated using the 30-item Geriatric Depression Scale and the Beck Anxiety Inventory, along with additional metrics focused on social and health concerns relevant to this demographic.
Data analysis used hazard models adjusted for age, sex, and educational background collectively, along with considerations for comorbidity index, Geriatric Depression Scale score, and overall cognitive functioning. This allowed for a comprehensive examination of the association between poor sleep quality and the prevalence of MCR at baseline across the study population.
The analyzed data revealed that participants categorized as poor sleepers had a 2.7 times higher risk of developing incident MCR in comparison to those classified as good sleepers; however, this association became less significant when controlling for depressive symptoms, resulting in an adjusted hazard ratio of 1.6.
Interestingly, the study found that among the components of PSQI, only those individuals reporting excessive sleepiness and lower levels of enthusiasm had a significantly increased risk of MCR in fully adjusted models, with a hazard ratio of 3.3. Furthermore, poor sleepers tended to be older, more frequently disabled, and exhibited a higher prevalence of depressive symptoms than their good-sleeping counterparts.
Conversely, the presence of prevalent MCR did not show a significant relationship with poor sleep quality.
“Our findings emphasize the need for an early screening of sleep disturbances as a potential preventive intervention for cognitive decline, whether depressive symptoms are present,” concluded Leroy and her colleagues.
**Interview with Dr. Victoire Leroy: Understanding the Link Between Sleep Quality and Motoric Cognitive Risk Syndrome**
**Interviewer:** Good day, Dr. Leroy! Thank you for joining us today to discuss your intriguing research on sleep disturbances and motoric cognitive risk syndrome (MCR).
**Dr. Leroy:** Thank you for having me! It’s a pleasure to share our findings.
**Interviewer:** Your study highlights a concerning connection between poor sleep and an increased risk of MCR in older adults. Can you elaborate on what MCR entails?
**Dr. Leroy:** Absolutely. Motoric cognitive risk syndrome is characterized by a combination of slow gait speed and cognitive complaints, like feelings of forgetfulness. It’s particularly concerning because it can herald more severe cognitive decline, often progressing to dementia.
**Interviewer:** You found that individuals with poor sleep quality are at a higher risk for developing MCR. What specific factors did you identify as indicators of poor sleep?
**Dr. Leroy:** Our research showed that long sleep duration, poor sleep quality, and the use of sleep medications were significantly associated with higher odds of developing MCR. Additionally, excessive sleepiness and lower enthusiasm in daily activities were linked to increased risks as well.
**Interviewer:** It sounds like sleep quality directly influences both cognitive and physical health. How did you measure sleep quality in your study?
**Dr. Leroy:** We utilized the Pittsburgh Sleep Quality Index, which assesses various factors to determine overall sleep quality. Participants were classified as “good” or “poor” sleepers based on their scores. This classification helped us gauge the impact of sleep on their health status.
**Interviewer:** With such a robust sample size of 445 community-dwelling older adults, what were some of the significant outcomes you observed?
**Dr. Leroy:** We found that those with poor sleep exhibited markedly poorer physical and mental health compared to their well-rested peers, reinforcing the idea that sleep disturbances are not just a nuisance; they can lead to debilitating health issues over time.
**Interviewer:** Your findings suggest a bidirectional relationship between sleep disturbances and cognitive impairment. Can you explain what you mean by that?
**Dr. Leroy:** Certainly! What we see is that poor sleep can lead to cognitive impairment, but at the same time, cognitive issues can disrupt sleep patterns. This cycle can create a self-perpetuating problem, especially in aging populations.
**Interviewer:** What do you believe are the implications of your research for the elderly community?
**Dr. Leroy:** Our findings underscore the importance of prioritizing sleep health as part of overall wellness in older adults. Ensuring better sleep may offer a preventive strategy against cognitive decline and allow for improved quality of life.
**Interviewer:** Dr. Leroy, thank you for this enlightening discussion. Your research certainly sheds light on an important aspect of health in older adults.
**Dr. Leroy:** Thank you! I appreciate the opportunity to share our work and highlight the necessity of good sleep in maintaining cognitive health.
