The Association between Excessive Daytime Sleepiness and Cognitive Impairment in Older Adults
Bibliographic record
Abstract
BACKGROUND: Previous research has focused on the relationship between excessive daytime sleepiness (EDS) and the risk of developing dementia. However, limited evidence investigates the effects of EDS on domain-specific cognitive functions or the associations between various sleepiness situations from the Epworth Sleepiness Scale (ESS) and cognitive performance. This study aims to examine the relationships between EDS, different ESS sleepiness situations, and cognitive function in community-dwelling older adults. METHOD: This study (2015-2022) included 377 non-demented older adults from the Taiwan Initiative for Geriatric Epidemiological Research, with biennial follow-up since 2011. Cognitive function was assessed repeatedly using the Taiwanese version of the Montreal Cognitive Assessment for global cognition and neuropsychological tests for domain-specific cognition, including memory, attention, executive function, and language. EDS was measured by the ESS at baseline (2015-2017) with a total score of 24 and a cutoff point of 11. The presence of a specific ESS sleepiness situation was defined as participants scoring 1 on any individual ESS situation. A generalized linear mixed model was applied to investigate the associations between EDS and cognitive performance. RESULT: Participants had a mean age of 75.7 and 55.2% of women. We found that one unit increment of baseline ESS score at baseline was associated with poorer performance of memory (β: -0.03, 95% CI: -0.05, -0.001) but associated with better performance of executive functions (β: 0.01, 95% CI: 0.0005, 0.03) over time. Regarding specific ESS sleepiness situations, over time, dozing while lying down to rest was associated with poorer global cognition (β: -0.21, 95% CI: -0.37, -0.06), and dozing when sitting and talking to someone was associated with poorer memory (β: -0.32, 95% CI: -0.50, -0.13). Conversely, dozing while sitting and reading, watching television, sitting quietly after a meal without alcohol, or as a passenger in a car for an hour or more without stopping was associated with better executive function (β: 0.06 to 0.16) over time. No significant association was found between the existence of EDS and cognition over time. CONCLUSION: EDS and specific sleepiness situations demonstrated mixed associations with cognition, including poor performance of global cognition and memory but improved performance of executive function over time.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".