Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition

Alfonso J Alfini¹, Junyeon Won², Lauren R Weiss^{2

3}, Casandra C Nyhuis⁴, Vadim Zipunnikov⁵, Adam P Spira^{6

7

8}, Teresa Liu-Ambrose^{9

10

11}, Alexander J Shackman^{3

12

13}, J Carson Smith^{2

3

13}

Affiliations

¹ National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20817, USA.
² Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA.
³ Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA.
⁴ Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
⁵ Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁷ Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
⁹ Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
¹⁰ Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
¹¹ Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada.
¹² Department of Psychology, University of Maryland, College Park, MD 20742, USA.
¹³ Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA.

PMID: 36291294
PMCID: PMC9599432
DOI: 10.3390/brainsci12101360

Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition

Alfonso J Alfini et al. Brain Sci. 2022.

. 2022 Oct 7;12(10):1360.

doi: 10.3390/brainsci12101360.

Authors

Affiliations

¹ National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20817, USA.
² Department of Kinesiology, University of Maryland School of Public Health, College Park, MD 20742, USA.
³ Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742, USA.
⁴ Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
⁵ Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁶ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁷ Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
⁸ Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
⁹ Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
¹⁰ Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
¹¹ Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC V5Z 1M9, Canada.
¹² Department of Psychology, University of Maryland, College Park, MD 20742, USA.
¹³ Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742, USA.

PMID: 36291294
PMCID: PMC9599432
DOI: 10.3390/brainsci12101360

Abstract

The objective of this study was to understand the associations of sleep and cardiorespiratory fitness with hippocampal volume and global cognition among older adults (n = 30, age = 65.8 years, female = 73.3%). Wrist actigraphy provided objective measures of nighttime sleep including sleep duration, average wake bout length (WBL; sleep disturbance), and wake-to-sleep transition probability (WTSP; sleep consolidation). Cardiorespiratory fitness was quantified via cycle exercise using a modified heart rate recovery approach. Magnetic resonance imaging was used to determine hippocampal volume and the Mini-Mental State Examination was used to assess global cognition. Fitness moderated associations of sleep with hippocampal volume and cognitive performance, whereby the association of WBL-an index of poor sleep-with hippocampal atrophy was stronger among less-fit individuals, and the association of sleep duration with cognitive performance was stronger among more-fit individuals. Across the fitness levels, a longer WBL was associated with lower cognitive performance, and a higher WTSP-an index of more consolidated sleep-was associated with greater hippocampal volume. Sleep and fitness were unrelated to the volume of an amygdala control region, suggesting a degree of neuroanatomical specificity. In conclusion, higher cardiorespiratory fitness may attenuate sleep disturbance-related hippocampal atrophy and magnify the cognitive benefits of good sleep. Prospective studies are needed to confirm these findings.

Keywords: actigraphy; aging; brain volume; heart rate recovery; sleep.

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Conflict of interest statement

A.J.A. contributed to this article as a graduate student at the University of Maryland and as an employee of the Johns Hopkins University. The views expressed are his own and do not necessarily represent the views of the NIH or United States Government. L.R.W. is a consultant to Booze Allen. A.P.S. received payment for serving as a consultant for Merck and received honoraria from Springer Nature Switzerland AG for Guest Editing Special Issues of Current Sleep Medicine Reports. T.L.A. is a Canada Research Chair (Tier 2) in Physical Activity, Mobility, and Cognitive Neuroscience.

Figures

**Figure 1**
Participant recruitment, screening, exclusion, and enrollment between 2016 and 2018.

**Figure 2**
Volumetric Regions of Interest (ROIs). Bilateral hippocampus (purple) and bilateral amygdala control region (gold). Brain image and ROI visualization were generated using MRIcroGL [51].

**Figure 3**
**Relations between sleep, fitness, and hippocampal volume in older adults.** (a) Cardiorespiratory fitness (HRR_M) moderates the adverse association between wake bout length (WBL) and hippocampal volume. Bars depict standardized regression coefficients (β) for the sleep × fitness interaction (controlling for mean-centered age) for more-fit (*blue*) and less-fit (*red*) individuals. Among less-fit individuals (*red*), longer WBL is associated with smaller hippocampal volume. This association was not significant for more-fit individuals (*blue*). Error bars depict standard error. (b) Across fitness groups, greater sleep consolidation (WSTP) is associated with increased hippocampal volume (controlling for mean-centered age). X and Y axes reflect the standardized residual values for sleep consolidation (WSTP) and hippocampal volume, respectively. Dotted lines indicate the 95% confidence interval.

**Figure 4**
**Relations between sleep, fitness, and global cognition in older adults.** Cardiorespiratory fitness (HRR_M) moderates the positive association between sleep duration and global cognition. Bars depict standardized regression coefficients (β) for the sleep × fitness interaction (controlling for mean-centered age) for more-fit (*blue*) and less-fit (*red*) individuals. Among more-fit individuals (*blue*), longer sleep duration is associated with better global cognition. This association was not significant for less-fit individuals (*red*). Error bars depict standard error.

See this image and copyright information in PMC

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Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition

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Cardiorespiratory Fitness as a Moderator of Sleep-Related Associations with Hippocampal Volume and Cognition

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Abstract

Conflict of interest statement

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