Cognitive-friendly sleep patterns in older Adults:A cross-regional HCAP study

Sleep patterns, including daytime napping and nighttime sleep duration, have complex relationships with cognitive health, yet the nonlinear associations across diverse populations remain underexplored.

Utilizing harmonized cognitive assessment protocol from the China Health and Retirement Longitudinal Study (CHARLS-HCAP) and the Survey of Health, Ageing, and Retirement in Europe(SHARE-HCAP). Cognitive function was assessed based on Minimum Mental State Examination (MMSE), Brief Community Screening Instrument-Dementia (BCSID,10/66). Cognitive domains included orientation, memory, visuospatial, executive, and language function, measured via several protocols such as Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Trail Making Test A/B (TMT-A/B), number series and Symbol Digit Modalities Test (SDMT). Restricted cubic spline (RCS) models and multivariate regression were applied to assess the threshold effect.

In CHARLS, 4307 subjects were included and 2685 in SHARE. Chinese older adults napping rate is 66 % versus 31.51 % in Europe. In CHARLS, napping exhibited an inverted U-shaped relationship with cognitive function, with optimal nap duration at 42-50 min and sleep duration of 5.8-7 h. Although exhibiting similar inverted U-shaped trends, SHARE demonstrated distinct sleep pattern effects on cognition, particularly nap duration (35-40 min for naps; 6-6.7 h for sleep). Cross-regional studies reveal cognitively friendly sleep pattern, with Chinese older adults napping for 35-60 min and sleeping for 5-7 h, and European napping for 5-75 min, sleeping for 4-8 h.

Both napping and sleep duration exhibit nonlinear, domain-specific relationships with cognitive performance. Public health guidelines should emphasize association between sleep patterns and cognitive performance in older adults, with attention to the impact of lifestyle habits.