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Clinical Manifestations.

Angel Garcia De La Garza1, Carol A Derby1,2, Qi Gao1

  • 1Albert Einstein College of Medicine, Bronx, NY, USA.

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

Sleep problems in older adults are linked to cognitive decline. This study found distinct sleep changes over five years in individuals with different cognitive trajectories, suggesting brain changes impact sleep.

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Area of Science:

  • Gerontology
  • Sleep Medicine
  • Cognitive Neuroscience

Background:

  • Sleep disturbances are prevalent in older adults and associated with cognitive impairment risk.
  • Longitudinal data on sleep changes and cognitive performance in this demographic are scarce.
  • Understanding these relationships is crucial for identifying early markers of cognitive decline.

Purpose of the Study:

  • To investigate if longitudinal sleep patterns, measured by actigraphy, differ across distinct cognitive trajectories in older adults.
  • To examine the association between changes in global cognition and changes in sleep parameters over time.

Main Methods:

  • Utilized data from 219 participants in the Einstein Aging Study, with a median follow-up of 4 years.
  • Actigraphy was used annually to assess sleep duration, wake after sleep onset (WASO), and sleep efficiency.
  • Latent class mixed-effects models identified cognitive trajectories (Consistently High, Medium, Declining) based on the telephone Montreal Cognitive Assessment (T-MoCA).

Main Results:

  • Three cognitive trajectory groups were identified: Consistently High (N=126), Medium (N=82), and Declining (N=11).
  • Significant differences were observed in longitudinal patterns of night-time sleep duration, WASO, and sleep efficiency across these cognitive groups (p < 0.001).
  • The declining cognitive group showed steeper decreases in sleep duration and greater improvements in WASO and efficiency compared to other groups.

Conclusions:

  • Actigraphy-based sleep changes over five years are distinct among older adults with different cognitive trajectories.
  • More pronounced sleep alterations in the declining cognitive group may indicate underlying neurodegenerative processes impacting sleep.
  • Further research with larger samples is needed to confirm these findings and their implications.