Poor sleep is associated with impaired cognitive function in older women: The study of osteoporotic fractures

Terri Blackwell, Kristine Yaffe, Sonia Ancoli-Israel, Jennifer L. Schneider, Jane A. Cauley, Teresa A. Hillier, Howard A. Fink, Katie L. Stone

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338 Scopus citations


Background. The association between objectively measured sleep and cognition among community-dwelling elderly persons remains understudied. This observational, cross-sectional analysis examined this association. Methods. Results are from 2932 women (mean age 83.5 years) in the Study of Osteoporotic Fractures between 2002 and 2004. Cognitive function was measured by Mini-Mental State Examination (MMSE) and Trail Making B Test (Trails B). Cognitive impairment was denned as MMSE < 26 or Trails B > 278 seconds. Sleep parameters measured objectively using actigraphy included total sleep time, sleep efficiency, sleep latency, wake after sleep onset (WASO), and total nap time. Results. There were 305 women (10.6%) with MMSE < 26 and 257 women (9.3%) with Trails B > 278 seconds. Compared with women with sleep efficiency >70%, those with <70% had a higher risk of cognitive impairment (MMSE < 26 multivariate odds ratio [MOR]=1.61; 95% confidence interval [CI], 1.20-2.16; Trails B > 278 MOR=1.96; 95% CI, 1.43-2.67). Higher sleep latency was associated with higher risk of cognitive impairment (per half hour: MMSE < 26 MOR=1.23; 95% CI, 1.13-1.33; Trails B > 278 MOR=1.13; 95% CI, 1.04-1.24), as was higher WASO (per half hour: MMSE < 26 MOR=1.15; 95% CI, 1.06-1.23; Trails B > 278 MOR=1.24; 95% CI, 1.15-1.34). Women who napped >2 hours per day had a higher risk (MMSE < 26 MOR=1.42; 95% CI, 1.05-1.93; Trails B > 278 MOR=1.74; 95% CI, 1.26-2.40). There was no significant relationship for total sleep time. Conclusion. Objectively measured disturbed sleep was consistently related to poorer cognition, whereas total sleep time was not. This finding may suggest that it is disturbance of sleep rather than quantity that affects cognition.

Original languageEnglish (US)
Pages (from-to)405-410
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number4
StatePublished - Apr 2006

Bibliographical note

Funding Information:
ACKNOWLEDGMENTS This project is supported by National Institutes of Health grants AG05407, AR35582, AG05394, AR35584, AR35583, and AG08415. Dr. Yaffe is a Beeson Faculty Scholar in Aging and is supported by National Institute on Aging grant R01 AG021918.


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