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Sleep quality mediates the relationship between frailty and cognitive dysfunction in non-demented middle aged to older adults

Published online by Cambridge University Press:  22 April 2019

Sonya Kaur Open the ORCID record for Sonya Kaur [Opens in a new window] ,
Nikhil Banerjee ,
Michelle Miranda ,
Mitchell Slugh ,
Ni Sun-Suslow ,
Katalina F. McInerney ,
Xiaoyan Sun ,
Alberto R. Ramos ,
Tatjana Rundek  and
Ralph L. Sacco
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Sonya Kaur
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Nikhil Banerjee
Affiliation:
Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA Department of Psychology, University of Miami, Miami, FL, USA
Michelle Miranda
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Mitchell Slugh
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Ni Sun-Suslow
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
Katalina F. McInerney
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Xiaoyan Sun
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Alberto R. Ramos
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Tatjana Rundek
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
Ralph L. Sacco
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
Bonnie E. Levin*
Affiliation:
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
*
Correspondence should be addressed to: Bonnie E. Levin, Division of Neuropsychology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1336, Miami, FL 33136, USA. Phone: (305) 243 7529. Email: Blevin@med.miami.edu.
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Abstract

Objectives:

Frailty is associated with cognitive decline in older adults. However, the mechanisms explaining this relationship are poorly understood. We hypothesized that sleep quality may mediate the relationship between frailty and cognition.

Participants:

154 participants aged between 50-90 years (mean = 69.1 years, SD = 9.2 years) from the McKnight Brain Registry were included.

Measurements:

Participants underwent a full neuropsychological evaluation, frailty and subjective sleep quality assessments. Direct relationships between frailty and cognitive function were assessed using linear regression models. Statistical mediation of these relationships by sleep quality was assessed using nonparametric bootstrapping procedures.

Results:

Frailty severity predicted weaker executive function (B = −2.77, β = −0.30, 95% CI = −4.05 – −1.29) and processing speed (B = −1.57, β = −0.17, 95% CI = −3.10 – −0.16). Poor sleep quality predicted poorer executive function (B = −0.47, β = −0.21, 95% CI = −0.79 – −0.08), processing speed (B = −0.64, β = −0.28, 95% CI = −0.98 – −0.31), learning (B = −0.42, β = −0.19, 95% CI = −0.76 – −0.05) and delayed recall (B = −0.41, β = −0.16, 95% CI = −0.80 – −0.31). Poor sleep quality mediated the relationships between frailty severity and executive function (B = −0.66, β = −0.07, 95% CI = −1.48 – −0.39), learning (B = −0.85, β = −0.07, 95% CI = −1.85 – −0.12), delayed recall (B = −0.47, β = −0.08, 95% CI = −2.12 – −0.39) and processing speed (B = −0.90, β = −0.09, 95% CI = −1.85 – −0.20).

Conclusions:

Relationships between frailty severity and several cognitive outcomes were significantly mediated by poor sleep quality. Interventions to improve sleep quality may be promising avenues to prevent cognitive decline in frail older adults.

Keywords

Frailtycognitive functionsleep qualityolder adults
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 6: Issue Theme: Frailty, Cognition, and Mental Health , June 2019 , pp. 779 - 788
Copyright
© International Psychogeriatric Association 2019 

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