- Older adults who are excessively sleepy during the day or have significant sleep issues are at higher risk for a pre-dementia condition called motoric cognitive risk syndrome (MCR).
- MCR, characterized by a slower walking speed and some memory issues, was found to be more likely in a cohort of people over 65 who met the criteria of “poor sleepers,” with excessive daytime sleepiness and a lack of enthusiasm for activities during the day.
- While there was not a causal relationship established, the association between sleep issues and MCR warranted more study, experts say, and people in middle age with similar sleep disturbances should address them early.
Older adults who are excessively sleepy during the day or have significant sleep issues are at higher risk for a pre-dementia condition called motoric cognitive risk syndrome (MCR), according to a new study published in Neurology, the medical journal of the American Academy of Neurology.
MCR, characterized by a slower walking speed and some memory issues, was found to be more likely in a cohort of people over 65 who met the criteria of “poor sleepers,” with excessive daytime sleepiness and a lack of enthusiasm for activities during the day. While there is no direct causal relationship, the authors note that the association warrants further study.
Researchers at Albert Einstein College of Medicine in the Bronx, New York, studied a cohort of 445 participants with an average age of 76 who did not have dementia. At the outset of the study, the participants took questionnaires about their sleep habits that involved the following:
- waking in the night and unable to fall back asleep
- delays in falling asleep in under half an hour
- temperature-related sleep difficulties
- medications they used to fall or stay asleep
They were also asked about daytime fatigue, including an inability to stay awake during social activities, meals, or while driving, their levels of enthusiasm about completing activities during the day, and memory issues. With a treadmill, researchers noted participants’ walking speed and then tested it once a year for an average of three years.
A total of 177 people were characterized as “poor sleepers,” while 268 met the definition of “good sleepers.” At the study’s outset, 42 people had motoric cognitive risk syndrome, and 36 more people developed it over the course of the study. When adjusted for other factors like age, depression, and other health conditions, researchers established that people with excessive daytime sleepiness and a lack of enthusiasm for daytime activities were more than three times more likely to develop MCR than those without the same sleep-related problems.
While fatigue is a natural part of aging, the study established a difference between that type of tiredness and a type of sleepiness that indicates more significant problems, Dr. Verna Porter, MD, board certified neurologist and director of the Dementia, Alzheimer’s Disease and Neurocognitive Disorders at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, told Medical News Today.
“Regular age-related fatigue might involve feeling tired after physical exertion or a long day. In contrast, the sleep issues studied here include excessive daytime sleepiness (falling asleep during meals or social activities) and a marked lack of enthusiasm for daily tasks,” Dr. Porter said. “These issues go beyond normal tiredness, indicating potential underlying sleep disturbances (e.g., sleep apnea or chronic insomnia), which are more concerning and linked to cognitive changes.”
The study’s limitation is that participants reported their own sleep information. It is possible they may not have remembered everything accurately.
Dr. Porter explained that while the study was primarily focused on people with an average age of 76, chronic sleep disturbances like sleep apnea or insomnia have long-term consequences for cognitive health.
“For younger people, especially those in middle age, sleep issues (e.g., excessive daytime sleepiness, fragmented sleep patterns, undiagnosed sleep apnea) might increase the risk of future cognitive decline. Research suggests that sleep disturbances in midlife, such as chronic insomnia or sleep apnea, could contribute to neurodegenerative changes that manifest as dementia later in life.
Although the study didn’t specify a precise age, studies show that sleep disorders in people as early as their 40s or 50s may be early indicators or risk factors for cognitive decline in their later years.”
She also noted that people in middle age can take action to get better sleep and protect their cognitive abilities, such as prioritizing sleep hygiene, managing stress using mindfulness, yoga, or cognitive behavioral therapy, exercising regularly, and addressing sleep disorders early.
“If sleep apnea or insomnia develops in middle age, it’s important to seek treatment promptly. For example, untreated/undertreated sleep apnea can not only increase the risk for cerebrovascular/cardiovascular disease but can also increase the risk for future dementia (e.g., Alzheimer’s disease),” Dr. Porter said.
Dr. Steve Allder, consultant neurologist at Re:Cognition Health, echoed this sentiment, saying that it was important to address sleep issues earlier in life.
“A pattern of poor sleep in middle age may increase the risk of dementia years later if it contributes to other health issues like cardiovascular disease or inflammation, both of which are linked to cognitive decline.
People in middle age can take several steps to reduce the risk of future sleep problems. Regular exercise, a balanced diet, stress management and good sleep hygiene practices, such as establishing consistent bedtimes, creating a comfortable sleep environment and limiting screen time before bed, are all valuable habits. Addressing any sleep disturbances early on, like sleep apnea or chronic insomnia, can also help mitigate long-term cognitive risks.”
Dr. Porter recommended a diet rich in fruits, vegetables, and omega-2 fatty acids to enhance the quality of sleep and improve cognitive function. However, she also emphasized the importance of exercise in cognitive Health, regulating sleep patterns, and reducing daytime fatigue.
“Moderate-intensity physical activity, such as walking, swimming, or yoga, for at least 150 minutes a week. Strength training exercises can also help maintain muscle mass and improve sleep quality,” Dr. Porter said.
“Older adults should aim for 7-8 hours of sleep per night. However, sleep efficiency (the percentage of time spent asleep versus in bed) is also important. Improving sleep quality by addressing sleep disturbances and creating a healthy routine is essential for maintaining cognitive health,” she added.
