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Clinical Manifestations.

Hui Shi1, Yunyi Sun2, Derek B Archer3,4,5,6

  • 1Vanderbilt Memory and Alzheimer's Center, Nashville, TN, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Poor sleep health, including longer nighttime awakenings and irregular sleep, is linked to cognitive decline in older adults. These findings highlight sleep fragmentation as a potential indicator for memory and executive function changes over time.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Sleep Medicine

Background:

  • Poor sleep health is a modifiable risk factor for Alzheimer's disease and related dementias (ADRD).
  • Previous research often relied on self-reported sleep data or single sleep metrics.
  • This study examined objective, actigraphy-measured sleep health and cognitive trajectories over nine years.

Purpose of the Study:

  • To investigate the association between actigraphy-measured sleep health parameters and longitudinal cognitive changes in older adults.
  • To identify specific aspects of sleep health that may predict cognitive decline.
  • To explore potential novel indicators of sleep fragmentation related to cognitive performance.

Main Methods:

  • Utilized data from 553 participants in the Vanderbilt Memory and Aging Project (mean age 68.5 years).
  • ActiGraph GT9X accelerometers measured sleep duration, timing, regularity, efficiency, and fragmentation over 10 days.
  • Linear mixed-effects models assessed associations between baseline sleep measures and annual changes in memory, executive function, and language, adjusting for multiple covariates.

Main Results:

  • Longer nighttime awakenings correlated with annual declines in memory and language function.
  • Increased sleep duration and greater sleep irregularity were associated with worse memory and poorer executive function.
  • Sleep timing and irregularity were linked to annual declines in language function; no effect modification by age, sex, APOE, or cognitive status was observed.

Conclusions:

  • Multiple measures of poor sleep health are associated with significant 9-year cognitive declines in memory and performance.
  • Nighttime awakening duration emerges as a potential novel indicator of sleep fragmentation.
  • Further molecular and mechanistic research is warranted to understand the link between sleep fragmentation and cognitive decline.