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. 2018 Nov;66(11):2136-2143.
doi: 10.1111/jgs.15555. Epub 2018 Aug 23.

Rest-Activity Rhythms and Cognitive Decline in Older Men: The Osteoporotic Fractures in Men Sleep Study

Tara S Rogers-Soeder  1 , Terri Blackwell  2 , Kristine Yaffe  3 , Sonia Ancoli-Israel  4   5 , Susan Redline  6 , Jane A Cauley  7 , Kristine E Ensrud  8   9   10 , Misti Paudel  11 , Elizabeth Barrett-Connor  12 , Erin LeBlanc  13 , Katie Stone  2 , Nancy E Lane  1 , Greg Tranah  2 ; Osteoporotic Fractures in Men Study Research Group
Affiliations

Rest-Activity Rhythms and Cognitive Decline in Older Men: The Osteoporotic Fractures in Men Sleep Study

Tara S Rogers-Soeder et al. J Am Geriatr Soc. 2018 Nov.

Abstract

Objective: To examine rest-activity circadian rhythm (RAR) and cognitive decline in older men.

Design: Longitudinal.

Setting: Osteoporotic Fractures in Men (MrOS) and ancillary Outcomes of Sleep Disorders in Men (MrOS Sleep) studies.

Participants: MrOS and MrOS Sleep participants (N=2,754; mean age 76.0 ± 5.3).

Measurements: The Modified Mini-Mental State examination (3MS) was used to assess cognition at baseline (2003-05) and follow-up examinations (2005-06 and 2007-09). Wrist actigraphy was used to measure 24-hour activity counts at baseline. RAR variables included amplitude (strength of activity rhythm), mesor (mean activity level), pseudo F-statistic (overall circadian rhythm robustness), and acrophase (time of daily peak activity).

Results: After an average of 3.4 ± 0.5 years, men with lower amplitudes, mesors, and pseudo F-statistics had greater decline in 3MS performance (amplitude: -0.7 points Q1 vs -0.5 points Q4, p<.001; mesor: -0.5 points Q1 vs -0.2 points Q4, p=.01; pseudo F-statistic: -0.5 points Q1 vs -0.3 points Q4, p<.001). Lower amplitudes and pseudo-F statistics were associated with greater odds of clinically significant cognitive decline (≥5-point decrease) (amplitude Q1 vs. Q4: odds ratio (OR)=1.4, 95% confidence interval (CI)=1.0-1.9; pseudo-F statistic Q1 vs Q4: OR=1.4, 95% CI=1.0-1.9). Men with phase-advanced acrophase had greater odds of clinically significant cognitive decline (OR=1.8, 95% CI=1.2-2.8). Results were adjusted for multiple confounders.

Conclusion: Several parameters of disrupted RAR (lower amplitude, pseudo F-statistic, mesor, phase-advanced acrophase) were associated with greater cognitive decline in older community-dwelling men. These findings contribute to a growing body of evidence suggesting that altered RARs are associated with cognitive decline in older adults. J Am Geriatr Soc 66:2136-2143, 2018.

Keywords: cognitive decline; men; rest-activity rhythm.

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Conflict of interest statement

Conflicts of Interest: The authors report no conflicts of interest.

Figures

Figure 1:
Figure 1:
Progression of participants through the MrOS and MrOS Sleep studies Reasons for not including participants are given on the right. MrOS enrollment (March 2000-April 2002) Sleep Visit (December 2003-March 2005) MrOS Visit 2 (March 2005-May 2006) MrOS Visit 3 (March 2007-March 2009) 1RAR, rest-activity rhythm 2Technically adequate, ≥72 hours of continuous data collection 33MS, Modified Mini-Mental State examination
Figure 2:
Figure 2:
Changes in 3MS Score by amplitude (A), mesor (B), pseudo F-statistic (C) and acrophase (D) **Quartile 1 vs. quartile 4 (p≤0.001) *Quartile 1 vs. quartile 4 (p≤0.01) Footnotes: Figure 2 represents estimated longitudinal decline based on the model. Year 0 = Sleep Visit
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