{Reference Type}: Journal Article
{Title}: Sleep-wake behaviors associated with cognitive performance in middle-aged participants of the Hispanic Community Health Study/Study of Latinos.
{Author}: Smagula SF;Zhang G;Krafty RT;Ramos A;Sotres-Alvarez D;Rodakowski J;Gallo LC;Lamar M;Gujral S;Fischer D;Tarraf W;Mossavar-Rahmani Y;Redline S;Stone KL;Gonzalez HM;Patel SR;
{Journal}: Sleep Health
{Volume}: 10
{Issue}: 4
{Year}: 2024 Aug 30
{Factor}: 4.207
{DOI}: 10.1016/j.sleh.2024.02.002
{Abstract}: <B>OBJECTIVE: </B>Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance.<BR><B>METHODS: </B>The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2years later (mean age=54.9, standard deviation= 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions.<BR><B>RESULTS: </B>In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility.<BR><B>CONCLUSIONS: </B>The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.