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. 2021 Oct 11;44(10):zsab119.
doi: 10.1093/sleep/zsab119.

Predicting incident dementia and mild cognitive impairment in older women with nonparametric analysis of circadian activity rhythms in the Study of Osteoporotic Fractures

Alexander B Posner  1   2 , Gregory J Tranah  1 , Terri Blackwell  1 , Kristine Yaffe  3   4   5   6 , Sonia Ancoli-Israel  7 , Susan Redline  8 , Yue Leng  4 , Jamie M Zeitzer  9   10   11 , Dorothy M Chen  1   2 , Katey R Webber  1   2 , Katie L Stone  1
Affiliations

Predicting incident dementia and mild cognitive impairment in older women with nonparametric analysis of circadian activity rhythms in the Study of Osteoporotic Fractures

Alexander B Posner et al. Sleep. .

Abstract

Study objectives: Disrupted daily rhythms are associated with mild cognitive impairment (MCI) and dementia. The specific nature of how rhythms and cognition are related, however, is unknown. We hypothesized characteristics from a nonparametric estimate of circadian rest-activity rhythm patterns would be associated to the development of MCI or dementia.

Methods: Wrist actigraphy from 1232 cognitively healthy, community-dwelling women (mean age 82.6 years) from the Study of Osteoporotic Fractures was used to estimate rest-activity patterns, including intradaily variability (IV), interdaily stability (IS), most active 10-hour period (M10), least active 5-hour period (L5), and relative amplitude (RA). Logistic regression examined associations of these predictors with 5-year incidence of MCI or dementia. Models were adjusted for potential confounders.

Results: Women with earlier sleep/wake times had higher risk of dementia, but not MCI, (early vs. average L5 midpoint: OR, 1.66; 95% CI, 1.08-2.55) as did women with smaller day/night activity differentials (low vs. high RA: OR, 1.96; 95% CI, 1.14-3.35). IV, IS, and M10 were not associated with MCI or dementia.

Conclusion: The timing and difference in day/night amplitude, but not variability of activity, may be useful as predictors of dementia.

Keywords: Study of Osteoporotic Fractures; aging; circadian rest-activity rhythms; circadian timing; dementia; mild cognitive impairment; nonparametric; prospective cohort; relative amplitude.

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Figures

Figure 1.
Figure 1.
Progression of participants.
Figure 2.
Figure 2.
Relative amplitude and cognitive status. Footnote: Activity levels and average relative amplitude (RA) over 72 hours for three individuals across clinical cognitive status categories.
See this image and copyright information in PMC

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