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Clinical Manifestations.

Hannah M Wilks1, Matthew S Welhaf2, Andrew J Aschenbrenner2

  • 1Washington University in St. Louis, St. Louis, MO, USA.

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|December 24, 2025
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Summary
This summary is machine-generated.

Nightly sleep disruptions impact next-day cognition in older adults, especially APOE ε4 carriers. Smartphone assessments reveal subtle but significant effects, emphasizing multidimensional sleep and cognitive evaluations for Alzheimer

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Area of Science:

  • Neuroscience
  • Gerontology
  • Sleep Science
  • Cognitive Science

Background:

  • Technological advancements enable naturalistic assessment of cognition and sleep in daily life.
  • The impact of nightly sleep on next-day cognition in older adults at risk for Alzheimer's disease (AD) requires further investigation.
  • Novel smartphone-based methods can explore cognition, sleep, AD biomarkers, and genetic risk in cognitively normal older adults.

Purpose of the Study:

  • To examine the associations between daily cognition, sleep patterns, and Alzheimer's disease (AD) risk factors in cognitively normal older adults.
  • To investigate the influence of nightly sleep variations on subsequent-day cognitive performance.
  • To determine if genetic risk (APOE ε4) and AD biomarkers modify the sleep-cognition relationship.

Main Methods:

  • Utilized the Ambulatory Research in Cognition (ARC) smartphone application for daily assessment of associate memory, processing speed, and spatial working memory in 344 participants.
  • Assessed daily sleep satisfaction, alertness, timing, efficiency, and duration via self-report, creating daily and weekly sleep health composites.
  • Employed linear and generalized additive models, controlling for age, education, and gender, to analyze relationships between sleep deviations and cognition, including APOE ε4 status and AD biomarkers.

Main Results:

  • Nightly deviations from typical sleep were significantly associated with worse next-day cognition (p < 0.05).
  • This association was particularly pronounced in APOE ε4 carriers, indicating a heightened sensitivity to sleep disruptions.
  • No significant associations were found between weekly sleep and weekly cognition, and preclinical AD biomarker status did not alter the observed sleep-cognition relationships.

Conclusions:

  • High-frequency, multi-day smartphone assessments reveal that nightly sleep quality subtly affects next-day cognition in cognitively normal older adults.
  • APOE ε4 carriers exhibit a greater vulnerability to the cognitive consequences of sleep disturbances.
  • Findings underscore the importance of multidimensional sleep and cognitive assessments for identifying individuals at risk for Alzheimer's disease.