0627 The Effects of Insomnia Therapy on Depression, Anxiety, and Daily Functioning in Individuals with Insomnia and Mild Cognitive Impairment
Bibliographic record
Abstract
Abstract Introduction Insomnia is common in older adults with and without mild cognitive impairment (MCI), and is associated with worse neuropsychiatric symptoms (NPS) and impaired daily functioning. Evidence suggests treating insomnia may resolve some of these difficulties in cognitively normal adults. However, little is known about the effects of improving sleep on these domains in older adults with MCI. Methods We examined whether MCI status moderates the improvements of a behavioral intervention for insomnia on NPS and daily functioning. 125 adults (mean age=69.18, 34.4% male) with insomnia (38 with MCI as determined by a Montreal Cognitive Assessment; MoCA score < 26) completed the Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and five domains (activity, vigilance, intimacy, productivity, and social) of the Functional Outcomes of Sleep Questionnaire (FOSQ) before (BL) and after (ETX) completing either the behavioral, cognitive, or combined components of Cognitive Behavioral Therapy for Insomnia (CBT-I). Linear mixed effects models were used to determine the effect of MCI status, time, and an MCI-by-time interaction on NPS and daily functioning while covarying for sex. Results Treatment improved BDI (p<0.001), BAI (p<0.001), ISI (p<0.001), productivity (p<0.008), activity (p<0.001), social functioning (p=0.014), and FOSQ total score (p=0.015) regardless of MCI status at ETX compared to BL. Treatment did not significantly improve vigilance (p=0.154) or intimacy (p=0.439). There was a significant MCI-by-time interaction for the FOSQ social domain (p=0.041) with MCI participants showing greater improvements in social functioning compared to non-MCI participants. There were no other significant MCI-by-time interactions. Conclusion These findings suggest insomnia therapy can similarly improve aspects of sleep-related daily functioning, insomnia severity, and NPS regardless of MCI. However, insomnia therapy may be more beneficial in improving social functioning for individuals with MCI. Support (If Any) NIMHR01MH101468-01; Mental Illness Research, Education, and Clinical Center (MIRECC) at the VAPAHCS
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".