[p3–520]: the Association Between Neighborhood Socio‐economic Status, Sleep Quality, and Cognitive Decline in the Health and Retirement Study
Year: 2017
Type: article
Abstract: Recent studies have reported associations between the residential environment and cognitive decline. These environmental characteristics may similarly have an effect on sleep quality, which is also associated with cognitive decline. We sought to evaluate the combined effects of neighborhood socio-economic status (NSES) and sleep quality on cognitive decline in a nationally representative cohort of older adults from the Health and Retirement Study (HRS). Participants from the HRS aged 65+ with DNA samples and multiple cognitive observations were included in the study. Cognition was evaluated biennially with the abbreviated Telephone Interview for Cognitive Status (TICS-m). A NSES index was developed based on 6 factors (unemployment, poverty, public assistance, education levels, income, and household characteristics). A sleep quality scale was developed based on self-reported trouble falling asleep, waking during the night, waking too early, and feeling rested. Covariates included age, sex, education, race, APOEε4 status, and self-reported hypertension, diabetes, history of any heart condition, and stroke, modeled as age-varying covariates. Random effects modeling was used to evaluate cognitive change over time in four groups of participants based on quartiles of NSES and sleep quality. Potential interactions between NSES and sleep were tested using these as continuous variables. NSES and sleep were each significantly associated with cognitive decline, and there was a modest but significant interaction (p=0.02) between the two. Models with participants in four groups of high/low sleep quality and high/low NSES revealed significant differences between high and low NSES (p<.001), and between high/low sleep quality among those with low NSES. Low sleep quality was more strongly associated with cognitive decline among participants with low NSES than those with high NSES, which had no significant difference. Differences between the four groups were driven primarily by differences in high vs low NSES. Both sleep and NSES were associated with cognitive decline in the HRS, but the association between sleep and cognition appeared stronger among those with low NSES. The association between low NSES, poor sleep quality, and cognitive decline was roughly equivalent to the association between APOE ε4 and cognitive decline.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2765195087