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Clinical Manifestations.

Laura Stankeviciute1, Iris Bosch2,3, Fredrik Öhman4,5,6

  • 1Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Västra Götalands, Sweden.

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

Poor sleep quality is linked to worse memory performance in older adults, suggesting a connection between sleep and cognitive decline in preclinical Alzheimer's disease (AD). This highlights the importance of sleep for brain health.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Sleep Medicine

Background:

  • Sleep disturbances are common in Alzheimer's disease (AD), appearing early and potentially worsening pathology.
  • Poor subjective sleep quality correlates with AD biomarkers and cognitive deficits in cognitively unimpaired (CU) individuals.
  • Large-scale studies integrating digital cognitive assessments (DCAs), blood-based biomarkers (BBBs), and sleep data are limited.

Purpose of the Study:

  • To investigate the association between subjective sleep quality and cognitive performance using DCAs in older adults.
  • To explore the relationship between specific sleep parameters and memory function in a population-based cohort.

Main Methods:

  • The REAL AD study analyzed 748 CU older adults using the Pittsburgh Sleep Quality Index (PSQI) and remote digital memory assessments (neotivTrials app).
  • A Remote Digital Memory Composite (RDMC) score was derived from three visual memory tests.
  • Linear regression models assessed associations between PSQI components and RDMC, adjusting for covariates and performing sensitivity analyses for depression and anxiety.

Main Results:

  • Worse overall subjective sleep quality (PSQI Total Score) was significantly associated with lower RDMC performance (p=0.024).
  • Prolonged sleep latency and frequent sleep medication use were linked to poorer memory scores (p=0.04 and p<0.001, respectively).
  • These associations were reduced after accounting for depression and anxiety symptoms.

Conclusions:

  • Subjective sleep quality is associated with memory performance on digital cognitive tests in older adults.
  • Findings underscore the interplay between sleep and cognition in preclinical AD.
  • Further research integrating biomarkers and objective sleep data is needed to elucidate biological mechanisms and enhance early AD detection strategies.