Browse > Article
http://dx.doi.org/10.14401/KASMED.2020.27.1.16

A Study on the Relationship between Sleep Quality and Cognitive Function in Community Elderly  

Oh, Youn-Kyoun (Department of Psychiatry, Gyeongsang National University Hospital)
Kim, Bong-Jo (Department of Psychiatry, Gyeongsang National University Hospital)
Park, Chul-Soo (Department of Psychiatry, Gyeongsang National University Hospital)
Lee, Cheol-Soon (Department of Psychiatry, Gyeongsang National University College of Medicine)
Cha, Bo-Seok (Department of Psychiatry, Gyeongsang National University Hospital)
Lee, So-Jin (Department of Psychiatry, Gyeongsang National University Hospital)
Lee, Dong-Yun (Department of Psychiatry, Gyeongsang National University College of Medicine)
Seo, Ji-Yeong (Department of Psychiatry, Gyeongsang National University Changwon Hospital)
Choi, Jae-Won (Department of Psychiatry, Gyeongsang National University Hospital)
Lee, Young-Ji (Department of Psychiatry, Gyeongsang National University Changwon Hospital)
Lee, Jae-Hon (Department of Psychiatry, Gyeongsang National University Hospital)
Lee, Youn-Jung (Department of Psychiatry, Gyeongsang National University Hospital)
Publication Information
Sleep Medicine and Psychophysiology / v.27, no.1, 2020 , pp. 16-23 More about this Journal
Abstract
Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.
Keywords
Aged; Clock drawing task 1; Cognition; Digit span test; Quality of sleep; Word list recall test;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Seidel S, Dal-Bianco P, Pablik E, Muller N, Schadenhofer C, Lamm C, et al. Depressive symptoms are the main predictor for subjective sleep quality in patients with mild cognitive impairment--a controlled study. PLoS One 2015;10:e0128139.   DOI
2 Shulman KI. Clock-drawing: is it the ideal cognitive screening test? Int J Geriatr Psychiatry 2000;15:548-561.   DOI
3 Shulman KI, Shedletsky R, Silver IL. The challenge of time: clockdrawing and cognitive function in the elderly. Int J Geristr Psychiatry 1986;1:135-140.   DOI
4 Siengsukon CF, Aldughmi M, Kahya M, Lynch S, Bruce J, Glusman M, et al. Individuals with mild MS with poor sleep quality have impaired visuospatial memory and lower perceived functional abilities. Disabil Health J 2018;11:116-121.   DOI
5 Specketer K, Zabetian CP, Edwards KL, Tian L, Quinn JF, Peterson-Hiller AL, et al. Visuospatial functioning is associated with sleep disturbance and hallucinations in nondemented patients with Parkinson's disease. J Clin Exp Neuropsychol 2019;41:803-813.   DOI
6 Steenland K, Karnes C, Seals R, Carnevale C, Hermida A, Levey A. Late-life depression as a risk factor for mild cognitive impairment or Alzheimer's disease in 30 US Alzheimer's disease centers. J Alzheimers Dis 2012;31:265-275.   DOI
7 Sunderland T, Hill JL, Mellow AM, Lawlor BA, Gundersheimer J, Newhouse PA, et al. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatr Soc 1989;37:725-729.   DOI
8 Talfournier J, Bitu J, Paquet C, Gobron C, Guillausseau PJ, Hugon J, et al. Relationship between blood pressure, cognitive function and education level in elderly patients with diabetes: a preliminary study. Diabetes Metab 2013;39:418-423.   DOI
9 Vaz Fragoso CA, Gill TM. Sleep complaints in community-living older persons: a multifactorial geriatric syndrome. J Am Geriatr Soc 2007;55:1853-1866.   DOI
10 Waters F, Bucks RS. Neuropsychological effects of sleep loss: implication for neuropsychologists. J Int Neuropsychol Soc 2011;17:571-586.   DOI
11 Welsh KA, Butters N, Mohs RC, Beekly D, Edland S, Fillenbaum G, et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology 1994;44:609-614.   DOI
12 Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Impact of diabetes on cognitive function among older Latinos: a population-based cohort study. J Clin Epidemiol 2003;56:686-693   DOI
13 Kuo HK, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, et al. Effect of blood pressure and diabetes mellitus on cognitive and physical functions in older adults: a longitudinal analysis of the advanced cognitive training for independent and vital elderly cohort. J Am Geriatr Soc 2005;53:1154-1161.   DOI
14 Kuo HK, Jones RN, Milberg WP, Tennstedt S, Talbot L, Morris JN, et al. Effect of blood pressure and diabetes mellitus on cognitive and physical functions in older adults: a longitudinal analysis of the advanced cognitive training for independent and vital elderly cohort. J Am Geriatr Soc 2005;53:1154-1161.   DOI
15 Lee JH, Kim SJ, Lee DY, Chou IH, Kim KW, Youn JC, et al. Relationship of sleep factors with neurocognitive function in normal elderly subjects and mild cognitive impairment (MCI) patients. J Korean Neuropsychiatr Assoc 2007;46:41-49.
16 Lee JS, Lee SY. Effect on cognitive function in elderly people. The KJ-HSM 2015;9:201-210.   DOI
17 Lee JY, Dong Woo L, Cho SJ, Na DL, Hong Jin J, Kim SK, et al. Brief screening for mild cognitive impairment in elderly outpatient clinic: validation of the Korean version of the montreal cognitive assessment. J Geriatr Psychiatry Neurol 2008;21:104-110.   DOI
18 Li G, Tang H, Chen J, Qi X, Chen S, Ma J. Executive and visuospatial dysfunction in patients with primary restless legs syndrome/willis-ekbom disease: study of a chinese population. J Clin Sleep Med 2018;14:785-790.   DOI
19 Lindsay J, Laurin D, Verreault R, Hebert R, Helliwell B, Hill GB, et al. Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol 2002;156:445-453.   DOI
20 Lee JH, Kim SJ, Lee DY, Chou IH, Kim KW, Youn JC, et al. Relationship of sleep factors with neurocognitive function in normal elderly subjects and mild cognitive impairment (MCI) patients. J Korean Neuropsychiatr Assoc 2007;46:41-49.
21 Nakakubo S, Makizako H, Doi T, Tsutsumimoto K, Lee S, Lee S, et al. Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults. Geriatr Gerontol Int 2017;17:1823-1828.   DOI
22 Nebes RD, Buysse DJ, Halligan EM, Houck PR, Monk TH. Self-reported sleep quality predicts poor cognitive performance in healthy older adults. J Gerontol B Psychol Sci Soc Sci 2009;64:180-187.
23 Okereke OI, Kang JH, Cook NR, Gaziano JM, Manson JE, Buring JE, et al. Type 2 diabetes mellitus and cognitive decline in two large cohorts of community-dwelling older adults. J Am Geriatr Soc 2008;56:1028-1036.   DOI
24 Potvin O, Lorrain D, Forget H, Dube M, Grenier S, Preville M, et al. Sleep quality and 1-year incident cognitive impairment in community-dwelling older adults. Sleep 2012;35:491-499.   DOI
25 Potvin O, Lorrain D, Forget H, Dube M, Grenier S, Preville M, et al. Sleep quality and 1-year incident cognitive impairment in community-dwelling older adults. Sleep 2012;35:491-499.   DOI
26 Aloia MS, Ilniczky N, Di Dio P, Perlis ML, Greenblatt DW, Giles DE. Neuropsychological changes and treatment compliance in older adults with sleep apnea. J Psychosom Res 2003;54:71-76.   DOI
27 An KJ, Kim TH, Kim SJ, Jhoo JH, Lee JH. Relationship of neurocognitive function with the sleep-wake rhythm in mild cognitive impairment patients. J Korean Neuropsychiatr Assoc 2009;48:447-453.
28 Anderson C, Horne JA. Prefrontal cortex: links between low frequency delta EEG in sleep and neuropsychological performance in healthy, older people. Psychophysiology 2003;40:349-357.   DOI
29 Beeri MS, Schmeidler J, Sano M, Wang J, Lally R, Grossman H, et al. Age, gender, and education norms on the CERAD neuropsychological battery in the oldest old. Neurology 2006;67:1006-1010.   DOI
30 Benitez A, Gunstad J. Poor sleep quality diminishes cognitive functioning independent of depression and anxiety in healthy young adults. Clin Neuropsychol 2012;26:214-223.   DOI
31 Blackwell T, Yaffe K, Ancoli-Israel S, Redline S, Ensrud KE, Stefanick ML, et al. Association of sleep characteristics and cognition in older community-dwelling men: the MrOS sleep study. Sleep 2011;34:1347-1356.   DOI
32 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 2014;37:655-663.   DOI
33 우종인, 김기웅, 김성윤, 김주한, 우성일, 윤종철 등. 치매 진단평가를 위한 한국판 CERAD 평가집. 서울대학교출판부;2003
34 Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.   DOI
35 Cahn DA, Salmon DP, Monsch AU, Butters N, Wiederholt WC, Corey-Bloom J, et al. Screening for dementia of the alzheimer type in the community: the utility of the Clock Drawing Test. Arch Clin Neuropsychol 1996;11:529-539.   DOI
36 Choi H, Choi H. Verbal working memory and verbal memory's relationship to discourse comprehension in healthy elderly. Commun Sci Disord 2014;19:513-522.   DOI
37 Choi L, Joo SH, Lee CU, Paik IH. Association between global cortical atrophy, medial temporal atrophy, white matter hyperintensities and cognitive functions in Korean Alzheimer's disease patients. Korean J Biol Psychiatry 2015;22:140.
38 Cohen-Zion M, Stepnowsky C, Johnson S, Marler M, Dimsdale JE, Ancoli-Israel S. Cognitive changes and sleep disordered breathing in elderly: differences in race. J Psychosom Res 2004;56:549-553.   DOI
39 Cooke JR, Ancoli-Israel S. Sleep and its disorders in older adults. Psychiatr Clin North Am 2006;29:1077-1093.   DOI
40 Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev 2011;21:41-53.   DOI
41 Driscoll HC, Serody L, Patrick S, Maurer J, Bensasi S, Houck PR, et al. Sleeping well, aging well: a descriptive and cross-sectional study of sleep in “successful agers” 75 and older. Am J Geriatr Psychiatry 2008;16:74-82.   DOI
42 Ferini-Strambi L, Galbiati A, Marelli S. Sleep microstructure and memory function. Front Neurol 2013;4:159.   DOI
43 Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18:425-432.   DOI
44 Goldman JG, Ghode RA, Ouyang B, Bernard B, Goetz CG, Stebbins GT. Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease. Parkinsonism Relat Disord 2013;19:806-811.   DOI
45 Guarnieri B, Adorni F, Musicco M, Appollonio I, Bonanni E, Caffarra P, et al. Prevalence of sleep disturbances in mild cognitive impairment and dementing disorders: a multicenter Italian clinical cross-sectional study on 431 patients. Dement Geriatr Cogn Disord 2012;33:50-58.   DOI
46 Hoch CC, Dew MA, Reynolds CF, 3rd, Monk TH, Buysse DJ, Houck PR, et al. A longitudinal study of laboratory- and diary-based sleep measures in healthy “old old” and “young old” volunteers. Sleep 1994;17:489-496.   DOI
47 Just MA, Carpenter PA. The psychology of reading and language comprehension, Allyn & Bacon;1987.
48 Kamel NS, Gammack JK. Insomnia in the elderly: cause, approach, and treatment. Am J Med 2006;119: 463-469.   DOI
49 Kamel NS, Gammack JK. Insomnia in the elderly: cause, approach, and treatment. Am J Med 2006;119:463-469.   DOI
50 Kang SH, Yoon IY, Lee SD, Kim T, Lee CS, Han JW, et al. Subjective memory complaints in an elderly population with poor sleep quality. Aging Ment Health 2017;21:532-536.   DOI
51 Karrasch M, Sinerva E, Gronholm P, Rinne J, Laine M. CERAD test performances in amnestic mild cognitive impairment and Alzheimer's disease. Acta Neurol Scand 2005;111:172-179.   DOI
52 Kee BS, Yoon JH, Kim SK. A preliminary study on the risk factors between vascular dementia and Alzheimer's dementia. J Korean Geriatr Psychiatry 1997;1:96.
53 Saint Martin M, Sforza E, Barthelemy JC, Thomas-Anterion C, Roche F. Does subjective sleep affect cognitive function in healthy elderly subjects? The Proof cohort. Sleep Med 2012;13:1146-1152.   DOI
54 Salmon DP, Lange KL. Cognitive screening and neuropsychological assessment in early Alzheimer's disease. Clin Geriatr Med 2001;17:229-254.   DOI
55 Kluger BM, Pedersen KF, Tysnes OB, Ongre SO, Oygarden B, Herlofson K. Is fatigue associated with cognitive dysfunction in early Parkinson's disease? Parkinsonism Relat Disord 2017;37:87-91.   DOI
56 Ku BD, Kim SG, Lee JY, Park KH, Shin JH, Kim KK, et al. Clinical practice guideline for dementia by Clinical Research Center for Dementia of South Korea. J Korean Med Assoc 2011;54:861-875.   DOI
57 Miller AA, Spencer SJ. Obesity and neuroinflammation: a pathway to cognitive impairment. Brain Behav Immun 2014;42:10-21.   DOI