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

Rogers-Soeder TS, Blackwell T, Yaffe K, Ancoli-Israel S, Redline S, Cauley JA, Ensrud KE, Paudel M, Barrett-Connor E, LeBlanc E, Stone K, Lane NE, Tranah G, Osteoporotic Fractures in Men Study Research Group. Rest-Activity Rhythms and Cognitive Decline in Older Men: The Osteoporotic Fractures in Men Sleep Study. Journal of the American Geriatrics Society. 2018 Nov 1; 66(11):2136-2143.

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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.




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