Do sleep complaints contribute to age-related cognitive decline?

Ellemarije Altena, Jennifer R. Ramautar, Ysbrand D. Van Der Werf, Eus J.W. Van Someren
Progress in Brain Research. 2010-01-01; : 181-205
DOI: 10.1016/b978-0-444-53702-7.00011-7

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1. Prog Brain Res. 2010;185:181-205. doi: 10.1016/B978-0-444-53702-7.00011-7.

Do sleep complaints contribute to age-related cognitive decline?

Altena E(1), Ramautar JR, Van Der Werf YD, Van Someren EJ.

Author information:
(1)Department Sleep and Cognition, Netherlands Institute for Neuroscience (NIN),
an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam,
The Netherlands.

The cognitive changes that occur with ageing are usually referred to as
‘age-related cognitive decline’. The most pronounced changes may be found in the
executive functions that require integrity of the prefrontal cortical circuitry.
With age, sleep also changes profoundly, with more sleep fragmentation, earlier
awakenings and less slow wave sleep as its main features. Interestingly,
experimental sleep deprivation studies in healthy young adults showed a
particularly consistent effect on executive functions, suggesting that sleep
problems might contribute to the cognitive changes accompanying older age. We
here investigate this possibility by reviewing reports on age-related and
insomnia-related changes in cognition and brain function and structure, as found
in studies investigating subjective complaints, objective functioning in everyday
life, neuropsychological assessment, psychometry, structural and functional
magnetic resonance imaging, electroencephalography, positron emission tomography
and transcranial magnetic stimulation. The chapter focuses on the ‘normal’
age-related sleep changes that are experienced as insomnia – that is,
fragmentation of sleep, more superficial sleep, more wake after sleep onset and
earlier awakenings – rather than on specific sleep disturbances as
sleep-disordered breathing, restless legs or periodic limb movements during
sleep, for all of which the risk increases with age. It turned out that
relatively few studies directly addressed the question whether elderly with
different degrees of sleep complaints are differentially affected by ‘age-related
cognitive decline’. Still, several similarities between age-related and
insomnia-related cognitive and brain changes are apparent, notably with respect
to performance requiring integrity of the prefrontal cortical system. We suggest
that at least part of what we regard as age-related changes may, in fact, be due
to poor sleep, which is in some cases a treatable condition. Further research
directly comparing aged good sleepers versus aged insomniacs will need to
elucidate how sleep disturbances are involved in the cognitive, structural and
functional changes observed with increasing age. The findings suggest that
discrimination of subtypes of poor sleep at high age will aid in understanding
the mechanisms by which it affects cognition and brain function.

Copyright © 2010 Elsevier B.V. All rights reserved.

DOI: 10.1016/B978-0-444-53702-7.00011-7
PMID: 21075240 [Indexed for MEDLINE]

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