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

Aug 24, 2018Journal of the American Geriatrics Society

Daily Activity Patterns Linked to Thinking Decline in Older Men

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Abstract

Men with lower amplitudes and pseudo F-statistics exhibited a greater decline in cognitive performance over an average of 3.4 years.

Lower amplitudes, mesors, and pseudo F-statistics corresponded with a decline in cognitive performance on the Modified Mini-Mental State examination.
Specifically, men in the lowest quartile for amplitude experienced a decline of -0.7 points compared to -0.5 points for those in the highest quartile.
Odds of clinically significant cognitive decline (≥5-point decrease) were greater for men with lower amplitudes and pseudo-F statistics, with an odds ratio of 1.4 for both.
Men with a phase-advanced acrophase had an increased likelihood of significant cognitive decline, with an odds ratio of 1.8.
These associations remained significant after adjusting for various confounding factors.

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

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