Login Register Cart 0
Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in Chinese
Research Article

Sleep-Wake Patterns and Cognition of Older Adults with Amnestic Mild Cognitive Impairment (aMCI): A Comparison with Cognitively Healthy Adults and Moderate Alzheimer’s Disease Patients

Author(s): Emma J. Wams, Gordon K. Wilcock, Russell G. Foster and Katharina Wulff*

Volume 14, Issue 10, 2017

Page: [1030 - 1041] Pages: 12

DOI: 10.2174/1567205014666170523095634

Price: $65

Abstract

Objective: Age-related cognitive impairment and the prevalence of neurodegenerative disease contribute to decreasing quality of life in affected individuals and their families as well as demand considerable societal responsibility. Sleep supports overall brain activity and contributes to both physical and mental health. As a result, sleep is an attractive target for exploring ways to promote health in accelerated cognitive aging. The aims of this study were to characterise cognitive performance and sleepwake behaviour in older adults with different degrees of cognitive impairment.

Methods: Cognitive ability in a variety of domains of amnestic mild cognitive impairment (aMCI) individuals, moderate AD patients and cognitively healthy adults was assessed with the Mini-Mental-State- Examination and five computerised tests (CANTABeclipse™). It was imperative to exclude mixed diagnosis, comorbidities (psychiatric, neurological, sleep disorders), anti-dementia medication, institutionalised subjects, and to study participants within their home to minimise confounders. Sleep profiles were assessed with the Jupiter Sleep Questionnaire and Pittsburgh Sleep Quality Index completed by participants and carers. Participants’ sleep-wake activity was monitored for three weeks using a wrist-worn actigraph and a semi-standardised diary. Groups were compared according to their diagnostic category and then pooled to correlate sleep data with cognitive performance.

Results: Mild cognitive impairment in aMCI individuals was reflected in domains of verbal and visuospatial memory but not attentional capacity or episodic memory. All self-reported and objective measures of sleep quality and sleep quantity of the aMCIs were within the normal range and comparable to those of cognitively healthy controls. Moderate AD patients scored significantly lower on all cognitive tests and had lower rest-activity amplitudes and distinctively longer nightly sleep periods that were not associated with sleep disorders, sleep medication or poor sleep efficiency. Self-rated and actigraphic quality of sleep was equally good (i.e. 90% sleep efficiency) in all groups.

Conclusion: This investigation is of clinical importance, because major confounding variables were excluded. The lack of comorbidities might be responsible for the absence of sundown syndrome and sleep disturbances commonly reported in AD patients. Whether there is interdependence between progressive decline in cognition and long sleep duration remains elusive. Future studies should address whether prolonged sleep at night and decreased day-time activity can be altered to delay the progression of cognitive decline.

Keywords: Sleep, rest-activity rhythms, aging, amnestic, dementia, cognition, CANTAB, actigraphy.

« Previous Next »
[1]
Swaab DF, Fliers E, Partiman TS. The suprachiasmatic nucleus of the human brain in relation to sex, age and senile dementia. Brain Res 342(1): 37-44. (1985).
[2]
Stopa EG, Volicer L, Kuo-Leblanc V, Harper D, Lathi D, Tate B, et al. Pathologic evaluation of the human suprachiasmatic nucleus in severe dementia. J Neuropathol Exp Neurol 58(1): 29-39. (1999).
[3]
Zhou Y, Richardson JS, Mombourquette MJ, Weil JA. Free radical formation in autopsy samples of Alzheimer and control cortex. Neurosci Lett 195(2): 89-92. (1995).
[4]
Harper DG, Stopa EG, Kuo-Leblanc V, McKee AC, Asayama K, Volicer L, et al. Dorsomedial SCN neuronal subpopulations subserve different functions in human dementia. Brain 131(Pt 6): 1609-17. (2008).
[5]
Harper DG, Stopa EG, McKee AC, Satlin A, Fish D, Volicer L. Dementia severity and lewy bodies affect circadian rhythms in Alzheimer disease. Neurobiol Aging 25(6): 771-81. (2004).
[6]
Lim AS, Ellison BA, Wang JL, Yu L, Schneider JA, Buchman AS, et al. Sleep is related to neuron numbers in the ventrolateral preoptic/intermediate nucleus in older adults with and without Alzheimer’s disease. Brain 137(Pt 10): 2847-61. (2014).
[7]
Bliwise DL, Watts RL, Watts N, Rye DB, Irbe D, Hughes M. Disruptive nocturnal behavior in Parkinson’s disease and Alzheimer’s disease. J Geriatr Psychiatry Neurol 8(2): 107-10. (1995).
[8]
Prinz PN, Vitaliano PP, Vitiello MV, Bokan J, Raskind M, Peskind E, et al. Sleep, EEG and mental function changes in senile dementia of the Alzheimer’s type. Neurobiol Aging 3(4): 361-70. (1982).
[9]
Cipriani GL, Carlesi C, Danti S, Nuti A. Sundown syndrome and dementia. Eur Geriatr Med 6(4): 375-80. (2015).
[10]
Vitiello MV, Borson S. Sleep disturbances in patients with Alzheimer’s disease: epidemiology, pathophysiology and treatment. CNS Drugs 15(10): 777-96. (2001).
[11]
Gallagher-Thompson D, Brooks JO, Bliwise D, Leader J, Yesavage JA. The relations among caregiver stress, “sundowning” symptoms, and cognitive decline in Alzheimer’s disease. J Am Geriatr Soc 40(8): 807-10. (1992).
[12]
Volicer L, Harper DG, Manning BC, Goldstein R, Satlin A. Sundowning and circadian rhythms in Alzheimer’s disease. Am J Psychiatry 158(5): 704-11. (2001).
[13]
Evans LK. Sundown syndrome in institutionalized elderly. J Am Geriatr Soc 35(2): 101-8. (1987).
[14]
Spira AP, Gamaldo AA, An Y, Wu MN, Simonsick EM, Bilgel M, et al. Self-reported sleep and beta-amyloid deposition in community-dwelling older adults. JAMA Neurol 70(12): 1537-43. (2013).
[15]
Hu Z, Wu L, Jia J, Han Y. Advances in longitudinal studies of amnestic mild cognitive impairment and Alzheimer’s disease based on multi-modal MRI techniques. Neurosci Bull 30(2): 198-206. (2014).
[16]
Jungwirth S, Zehetmayer S, Hinterberger M, Tragl KH, Fischer P. The validity of amnestic MCI and non-amnestic MCI at age 75 in the prediction of Alzheimer’s dementia and vascular dementia. Internl Psychoger 24(6): 959-66. (2012).
[17]
Jack CR Jr, Slomkowski M, Gracon S, Hoover TM, Felmlee JP, Stewart K, et al. MRI as a biomarker of disease progression in a therapeutic trial of milameline for AD. Neurology 60(2): 253-60. (2003).
[18]
Petersen RC, Caracciolo B, Brayne C, Gauthier S, Jelic V, Fratiglioni L. Mild cognitive impairment: a concept in evolution. J Intern Med 275(3): 214-28. (2014).
[19]
Westerberg CE, Lundgren EM, Florczak SM, Mesulam MM, Weintraub S, Zee PC, et al. Sleep influences the severity of memory disruption in amnestic mild cognitive impairment: results from sleep self-assessment and continuous activity monitoring. Alzheimer Dis Assoc Disord 24(4): 325-33. (2010).
[20]
Hayes TL, Riley T, Mattek N, Pavel M, Kaye JA. Sleep habits in mild cognitive impairment. Alzheimer Dis Assoc Disord 28(2): 145-50. (2014).
[21]
Westerberg CE, Mander BA, Florczak SM, Weintraub S, Mesulam MM, Zee PC, et al. Concurrent impairments in sleep and memory in amnestic mild cognitive impairment. J Int Neuropsychol Soc 18(3): 490-500. (2012).
[22]
Blackwell T, Yaffe K, Laffan A, Ancoli-Israel S, Redline S, Ensrud KE, et al. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. Sleep 37(4): 655-63. (2014).
[23]
Garcia-Alberca JM, Lara JP, Cruz B, Garrido V, Gris E, Barbancho MA. Sleep disturbances in Alzheimer’s disease are associated with neuropsychiatric symptoms and antidementia treatment. J Nerv Ment Dis 201(3): 251-7. (2013).
[24]
Eshkoor SA, Hamid TA, Nudin SS, Mun CY. Importance of hypertension and social isolation in causing sleep disruption in dementia. Am J Alzheimers Dis Other Demen 29(1): 61-6. (2014).
[25]
Sterniczuk R, Theou O, Rusak B, Rockwood K. Sleep disturbance is associated with incident dementia and mortality. Curr Alzheimer Res 10(7): 767-75. (2013).
[26]
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34(7): 939-44. (1984).
[27]
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3): 189-98. (1975).
[28]
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56(3): 303-8. (1999).
[29]
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire JAMA 282(18): 1737-44. (1999).
[30]
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J (Clin Res Ed) 292(6516): 344. (1986).
[31]
Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 4(2): 97-110. (1976).
[32]
Galasko D, Bennett D, Sano M, Ernesto C, Thomas R, Grundman M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 11(2): S33-9. (1997).
[33]
Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S. The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry 157: 853-9. (1990).
[34]
von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4): 344-9. (2008).
[35]
Questionnaire JMC-S. Jupiter Medical Centre-Sleep Questionnaire. Available from: http://a248.e.akamai.net/akamaicachetrustedpartner.com/docs/library/JupiterMedicalCentreMain2012/Content/sleepquestionnaire.pdf (2009).
[36]
Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28: 193-213. (1989).
[37]
Egerhazi A, Berecz R, Bartok E, Degrell I. Automated neuropsychological test battery (CANTAB) in mild cognitive impairment and in Alzheimer’s disease. Prog Neuropsychopharmacol Biol Psychiatry 31(3): 746-51. (2007).
[38]
Van Someren EJ, Kessler A, Mirmiran M, Swaab DF. Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients. Biol Psychiatry 41(9): 955-63. (1997).
[39]
Sokolove PG, Bushell WN. The chi square periodogram: its utility for analysis of circadian rhythms. J Theor Biol 72(1): 131-60. (1978).
[40]
Swainson R, Hodges JR, Galton CJ, Semple J, Michael A, Dunn BD, et al. Early detection and differential diagnosis of Alzheimer’s disease and depression with neuropsychological tasks. Dement Geriatr Cogn Disord 12(4): 265-80. (2001).
[41]
Iachini I, Iavarone A, Senese VP, Ruotolo F, Ruggiero G. Visuospatial memory in healthy elderly, AD and MCI: a review. Curr Aging Sci 2(1): 43-59. (2009).
[42]
Alichniewicz KK, Brunner F, Klunemann HH, Greenlee MW. Structural and functional neural correlates of visuospatial information processing in normal aging and amnestic mild cognitive impairment. Neurobiol Aging 33(12): 2782-97. (2012).
[43]
Alescio-Lautier B, Michel BF, Herrera C, Elahmadi A, Chambon C, Touzet C, et al. Visual and visuospatial short-term memory in mild cognitive impairment and Alzheimer disease: role of attention. Neuropsychologia 45(8): 1948-60. (2007).
[44]
Summers MJ, Saunders NL. Neuropsychological measures predict decline to Alzheimer’s dementia from mild cognitive impairment. Neuropsychology 26(4): 498-508. (2012).
[45]
Benedict C, Byberg L, Cedernaes J, Hogenkamp PS, Giedratis V, Kilander L, et al. Self-reported sleep disturbance is associated with Alzheimer’s disease risk in men. Alzheimers Dement 11(9): 1090-7. (2015).
[46]
Spira AP, Chen-Edinboro LP, Wu MN, Yaffe K. Impact of sleep on the risk of cognitive decline and dementia. Curr Opin Psychiatry 27(6): 478-83. (2014).
[47]
Peter-Derex L, Yammine P, Bastuji H, Croisile B. Sleep and Alzheimer’s disease. Sleep Med Rev 19C: 29-38. (2015).
[48]
Elcombe EL, Lagopoulos J, Duffy S, Lewis SJ, Norrie L, Hickie IB, et al. Hippocampal volume in older adults at risk of cognitive decline: the role of sleep, vascular risk, and depression. J Alzheimers Dis 44(4): 1279-90. (2015).
[49]
Smith RA, Lack LC, Lovato N, Wright H. The relationship between a night’s sleep and subsequent daytime functioning in older poor and good sleepers. J Sleep Res 24(1): 40-6. (2015).
[50]
Kay DB, Buysse DJ, Germain A, Hall M, Monk TH. Subjective–objective sleep discrepancy among older adults: associations with insomnia diagnosis and insomnia treatment. J Sleep Res 24(1): 32-9. (2015).
[51]
Moe KE, Vitiello MV, Larsen LH, Prinz PN. Sleep/wake patterns in Alzheimer’s disease: relationships with cognition and function. J Sleep Res 4(1): 15-20. (1995).
[52]
Kline CE, Zielinski MR, Devlin TM, Kripke DF, Bogan RK, Youngstedt SD. Self-reported long sleep in older adults is closely related to objective time in bed. Sleep Biol Rhythms 8(1): 42-51. (2010).
[53]
Most EI, Aboudan S, Scheltens P, Van Someren EJ. Discrepancy between subjective and objective sleep disturbances in early- and moderate-stage Alzheimer disease. Am J Geriatr Psychiatry 20(6): 460-7. (2012).
[54]
Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG. Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep 22(2): S366-72. (1999).
[55]
Grandner MA, Drummond SP. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev 11(5): 341-60. (2007).
[56]
Auyeung TW, Lee JS, Leung J, Kwok T, Leung PC, Woo J, et al. Cognitive deficit is associated with phase advance of sleep-wake rhythm, daily napping, and prolonged sleep duration--a cross-sectional study in 2,947 community-dwelling older adults. Age (Dordr) 35(2): 479-86. (2013).
[57]
Miller MA, Wright H, Ji C, Cappuccio FP. Cross-sectional study of sleep quantity and quality and amnestic and non-amnestic cognitive function in an ageing population: the English Longitudinal Study of Ageing (ELSA). PLoS One 9(6)e100991 (2014).
[58]
Loerbroks A, Debling D, Amelang M, Sturmer T. Nocturnal sleep duration and cognitive impairment in a population-based study of older adults. Int J Geriatr Psychiatry 25(1): 100-9. (2010).
[59]
Ramos AR, Dong C, Elkind MS, Boden-Albala B, Sacco RL, Rundek T, et al. Association between sleep duration and the mini-mental score: the Northern Manhattan study. J Clin Sleep Med 9(7): 669-73. (2013).
[60]
Benito-Leon J, Louis ED, Bermejo-Pareja F. Cognitive decline in short and long sleepers: a prospective population-based study (NEDICES). J Psychiatr Res 47(12): 1998-2003. (2013).
[61]
Benito-Leon J, Louis ED, Villarejo-Galende A, Romero JP, Bermejo-Pareja F. Long sleep duration in elders without dementia increases risk of dementia mortality (NEDICES). Neurology 83(17): 1530-7. (2014).

Rights & Permissions Print Cite
Article Metrics
94
14
2
1
© 2024 Bentham Science Publishers | Privacy Policy