Self‐reported and objectively assessed insomnia symptom severity and cognitive markers in dementia‐free older adults at‐risk for Alzheimer's disease
Bibliographic record
Abstract
BACKGROUND: We investigated whether insomnia may be associated with changes in cognition over time among older adults at elevated risk of Alzheimer's disease (AD). METHODS: We studied 348 dementia-free older adults (mean age: 65.74 ± 5.57; 72% female) from the PREVENT-AD cohort, all at elevated AD risk due to family history of AD. At baseline, a self-reported insomnia symptoms index was computed based on the Pittsburgh Sleep Quality Index (PSQI). The presence of insomnia symptoms was defined as sleep onset latency >30min ≥3 times/week OR sleep maintenance is difficult ≥3 times/week AND these sleep disturbances interfere with daily life. A subsample of 240 participants also underwent objective sleep assessments (7-day actigraphy). Difficulty with sleep maintenance on actigraphy was defined as ≥3 times/week with a wake after sleep onset >60min or a sleep efficiency <78% (1.5 SD of sample). Cognition was assessed both at baseline and yearly for a total follow-up of 7.15 years on average (SD: 2.40 years), and included measures of immediate and delayed memory, attention, and total score on the Repeatable Battery for Assessment of Cognitive Status (RBANS). First, baseline and longitudinal cognition scores were compared between 3 groups stratified for self-reported insomnia symptoms severity (i.e., 0, ≤1 and 2+ symptoms) using ANCOVAs. The same analyses were performed between 3 groups stratified for objectively defined insomnia symptoms. Finally, cognition scores were compared between 4 groups stratified by the severity of both self-reported and objective insomnia symptoms (i.e., no symptoms, only self-reported symptoms, only objective symptoms or both self-reported and objective symptoms). RESULTS: Individuals with ≥2 self-reported insomnia symptoms had higher baseline immediate and delayed memory scores than individuals with ≤1 insomnia symptoms (p = 0.02, Figure 1A; p = 0.02, Figure 1B). Actigraphy-indicating ≥2 insomnia symptoms had higher longitudinal delayed memory scores than individuals with ≤1 insomnia symptom (p = 0.02, Figure 1C). Individuals whose insomnia symptoms were observed only with actigraphy had the greatest longitudinal delayed memory scores (p = 0.01, Figure 1D). CONCLUSION: Counterintuitively, in individuals at elevated risk of AD, more self-reported and objective insomnia symptoms were associated with better cognitive scores. This may reflect protective lifestyle factors that improve cognition but also disrupt sleep patterns and sleep satisfaction.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".