Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline
Abstract INTRODUCTION The prevalence of poor sleep quality and sleep apnea differs by race and ethnicity and may contribute to racial disparities in cognitive aging. We investigated whether sleep quality and sleep apnea risk were associated with cognitive function and decline and whether the associa...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/trc2.12441 |
| _version_ | 1797242819971121152 |
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| author | Ruijia Chen Jingxuan Wang Annie M. Pederson Aric A. Prather Andrew K. Hirst Sarah Ackley Emily Hokett Kristen M. George Dan Mungas Elizabeth Rose Mayeda Paola Gilsanz Sebastien Haneuse Rachel A. Whitmer M. Maria Glymour |
| author_facet | Ruijia Chen Jingxuan Wang Annie M. Pederson Aric A. Prather Andrew K. Hirst Sarah Ackley Emily Hokett Kristen M. George Dan Mungas Elizabeth Rose Mayeda Paola Gilsanz Sebastien Haneuse Rachel A. Whitmer M. Maria Glymour |
| author_sort | Ruijia Chen |
| collection | DOAJ |
| description | Abstract INTRODUCTION The prevalence of poor sleep quality and sleep apnea differs by race and ethnicity and may contribute to racial disparities in cognitive aging. We investigated whether sleep quality and sleep apnea risk were associated with cognitive function and decline and whether the associations differed by race/ethnicity. METHODS Participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE; N = 1690; mean age: 75.7 years) study, a cohort of Asian, Black, Latino, and White participants, completed a modified Pittsburgh Sleep Quality Index assessing subjective sleep quality, latency, duration, disturbances, sleep medication use, and daytime dysfunction. Sleep apnea risk was measured by questions about snoring, tiredness, and whether apnea was observed. Executive function and verbal episodic memory were assessed at three time points over an average of 2.7 years with the Spanish and English Neuropsychological Assessment Scale. We fit linear mixed‐effect models and stratified analyses by race/ethnicity. RESULTS Higher sleep apnea risk was associated with faster declines in verbal episodic memory (β̂sleep apnea = −0.02, 95% confidence interval [CI], −0.04, −0.001) but not in executive function. Poorer sleep quality was associated with lower levels of and faster decline in executive function but not in verbal episodic memory. Race/ethnicity modified these associations: compared to estimated effects among White participants, poorer global sleep quality (β̂sleep*time = −0.02, 95% CI, −0.02, −0.01) was associated with larger effects on decline in executive function among Black participants. Estimated effects of some individual sleep quality components were also modified by race/ethnicity; for example, sleep medication use was associated with faster declines in executive function (β̂sleep*time = −0.05, 95% CI, −0.07, −0.03) and verbal episodic memory β̂sleep*time = −0.04, 95% CI, −0.07, −0.02) among Black participants compared to White participants. DISCUSSION Observational evidence indicates sleep quality is a promising target for addressing racial/ethnic disparities in cognitive aging, especially among Black older adults. Highlights Sleep apnea risk was associated with faster declines in verbal episodic memory but not executive function among all participants. Global sleep quality was associated with lower levels of and faster decline in executive function but not verbal episodic memory among all participants. Black older adults were particularly susceptible to the estimated adverse cognitive impacts of global sleep quality, particularly the use of sleep medication. |
| first_indexed | 2024-04-24T18:45:17Z |
| format | Article |
| id | doaj.art-68ac5a47f0b84adabe15e655dc8e2d7b |
| institution | Directory Open Access Journal |
| issn | 2352-8737 |
| language | English |
| last_indexed | 2024-04-24T18:45:17Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj.art-68ac5a47f0b84adabe15e655dc8e2d7b2024-03-27T07:00:57ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372024-01-01101n/an/a10.1002/trc2.12441Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive declineRuijia Chen0Jingxuan Wang1Annie M. Pederson2Aric A. Prather3Andrew K. Hirst4Sarah Ackley5Emily Hokett6Kristen M. George7Dan Mungas8Elizabeth Rose Mayeda9Paola Gilsanz10Sebastien Haneuse11Rachel A. Whitmer12M. Maria Glymour13Department of Epidemiology School of Public Health Boston University Boston Massachusetts USADepartment of Epidemiology and Biostaistics University of California, San Francisco San Francisco California USADepartment of Epidemiology School of Public Health Boston University Boston Massachusetts USADepartment of Psychiatry and Behavioral Sciences University of California San Francisco California USADivision of Research Kaiser Permanente Northern California Oakland California USADepartment of Epidemiology School of Public Health Boston University Boston Massachusetts USADepartment of Neurology Columbia University New York New York USADepartment of Public Health Sciences University of California Davis California USADepartment of Neurology University of California Davis California USADepartment of Epidemiology Fielding School of Public Health University of California Los Angeles California USADivision of Research Kaiser Permanente Northern California Oakland California USADepartment of Biostatistics Harvard T.H. Chan School of Public Health Boston Massachusetts USADepartment of Public Health Sciences University of California Davis California USADepartment of Epidemiology School of Public Health Boston University Boston Massachusetts USAAbstract INTRODUCTION The prevalence of poor sleep quality and sleep apnea differs by race and ethnicity and may contribute to racial disparities in cognitive aging. We investigated whether sleep quality and sleep apnea risk were associated with cognitive function and decline and whether the associations differed by race/ethnicity. METHODS Participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE; N = 1690; mean age: 75.7 years) study, a cohort of Asian, Black, Latino, and White participants, completed a modified Pittsburgh Sleep Quality Index assessing subjective sleep quality, latency, duration, disturbances, sleep medication use, and daytime dysfunction. Sleep apnea risk was measured by questions about snoring, tiredness, and whether apnea was observed. Executive function and verbal episodic memory were assessed at three time points over an average of 2.7 years with the Spanish and English Neuropsychological Assessment Scale. We fit linear mixed‐effect models and stratified analyses by race/ethnicity. RESULTS Higher sleep apnea risk was associated with faster declines in verbal episodic memory (β̂sleep apnea = −0.02, 95% confidence interval [CI], −0.04, −0.001) but not in executive function. Poorer sleep quality was associated with lower levels of and faster decline in executive function but not in verbal episodic memory. Race/ethnicity modified these associations: compared to estimated effects among White participants, poorer global sleep quality (β̂sleep*time = −0.02, 95% CI, −0.02, −0.01) was associated with larger effects on decline in executive function among Black participants. Estimated effects of some individual sleep quality components were also modified by race/ethnicity; for example, sleep medication use was associated with faster declines in executive function (β̂sleep*time = −0.05, 95% CI, −0.07, −0.03) and verbal episodic memory β̂sleep*time = −0.04, 95% CI, −0.07, −0.02) among Black participants compared to White participants. DISCUSSION Observational evidence indicates sleep quality is a promising target for addressing racial/ethnic disparities in cognitive aging, especially among Black older adults. Highlights Sleep apnea risk was associated with faster declines in verbal episodic memory but not executive function among all participants. Global sleep quality was associated with lower levels of and faster decline in executive function but not verbal episodic memory among all participants. Black older adults were particularly susceptible to the estimated adverse cognitive impacts of global sleep quality, particularly the use of sleep medication.https://doi.org/10.1002/trc2.12441cognitive declinecognitive functionracesleep apneasleep quality |
| spellingShingle | Ruijia Chen Jingxuan Wang Annie M. Pederson Aric A. Prather Andrew K. Hirst Sarah Ackley Emily Hokett Kristen M. George Dan Mungas Elizabeth Rose Mayeda Paola Gilsanz Sebastien Haneuse Rachel A. Whitmer M. Maria Glymour Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline Alzheimer’s & Dementia: Translational Research & Clinical Interventions cognitive decline cognitive function race sleep apnea sleep quality |
| title | Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| title_full | Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| title_fullStr | Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| title_full_unstemmed | Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| title_short | Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| title_sort | evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline |
| topic | cognitive decline cognitive function race sleep apnea sleep quality |
| url | https://doi.org/10.1002/trc2.12441 |
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