Cognitive, behavioral, and quality of life outcomes in cognitively unimpaired older persons with or without sleep complaints
Bibliographic record
Abstract
BACKGROUND: Changes in sleep are common in older persons and have been linked to higher dementia risk. The link between sleep complaints and early risk markers of Alzheimer's disease (AD), namely subjective changes in cognition and mild behavioral impairment (MBI), have not been fully explored. This study investigated associations between sleep complaints with cognitive and behavioral AD risk markers and quality of life (QoL) among cognitively unimpaired older persons. We hypothesized that older persons reporting sleep changes would also report more severe cognitive and behavioral changes, and poorer QoL. METHOD: Participants (n = 1395) were from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT) study. Sleep complaints were self-reported presence or absence of sleep disruption (symptoms of insomnia or sleep-related movement disorders), daytime sleepiness, sleep-disordered breathing, or prolonged sleep duration. Outcomes included the Everyday Cognition (ECog-II) scale, Mild Behavioral Impairment Checklist (MBI-C), and Quality of Life and Function (QFS-5) scale. Age, sex, years of education, marital status, and ethnocultural origin were balanced across exposure groups using inverse probability of treatment weighting. Negative binomial and bootstrapped linear regressions were used, as appropriate, to model sleep complaint (exposure) associations with ECog-II and MBI-C total scores, and QFS-5 mean scores (outcomes). RESULT: Participant characteristics are summarized in Table 1. Table 2 shows that all sleep complaints were associated with poorer everyday cognition, more severe MBI symptoms, and poorer QoL. However, excessive daytime sleepiness was generally the most strongly associated with the three outcomes with them having 1.50 (95%CI [1.40, 1.60]) and 2.29 (95%CI [2.10, 2.50]) times higher ECog-II and MBI-C score compared to participants without daytime sleepiness, and a 0.71 SD (95%CI [0.59, 0.82]) lower QFS-5 mean score. CONCLUSION: Sleep complaints, even among cognitively unimpaired older persons, are linked to cognitive and behavioral risk markers of AD, as well as poorer QoL. These findings provide further evidence that sleep complaints represent modifiable risk factors or may reflect a prodrome for AD, and may contribute to overall disease burden.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".