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Daytime sleepiness may be related to pre-dementia syndrome

Older people who are sleepy during the day or who lack enthusiasm for activities due to sleep problems may be more likely to develop a syndrome that can lead to dementia, according to a study published online Nov. 6, 2024. of Neurology®the medical journal of the American Academy of Neurology.

People with the syndrome walk slowly and report having some memory problems, although they do not have motor disabilities or dementia. This condition, called motor cognitive risk syndrome, can occur before dementia develops.

The study found that people with excessive daytime sleepiness and lack of enthusiasm to get things done were more likely to develop the syndrome than people without those sleep-related problems. The study does not prove that these sleep-related problems cause the syndrome, it only shows an association.

“Our findings emphasize the need to screen for sleep problems,” said study author Victoire Leroy, MD, PhD, of the Albert Einstein College of Medicine in the Bronx, New York. “There is a chance that people can get help with their sleep problems and prevent cognitive decline in the future.”

The study involved 445 people with an average age of 76 years who did not have dementia. Participants answered questionnaires about sleep at the start of the study. They were asked about memory problems and their walking speed on a treadmill was tested at the beginning of the study and then once a year for an average of three years.

The sleep assessment asked questions such as how often people had trouble sleeping because they woke up in the middle of the night, couldn’t fall asleep within 30 minutes, or felt too hot or cold, and whether they took medications to help them sleep. The question to assess for excessive daytime sleepiness is how often people have had trouble staying awake while driving, eating, or engaging in social activities. The question about enthusiasm raises the extent to which it has been difficult for people to maintain enough enthusiasm to get things done.

A total of 177 people met the definition of poor sleepers and 268 met the definition of good sleepers.

At the start of the study, 42 people had motor cognitive risk syndrome. Another 36 people developed the syndrome during the study.

Of those with excessive daytime sleepiness and lack of enthusiasm, 35.5% developed the syndrome, compared to 6.7% of people without these problems. Once the researchers adjusted for other factors that could affect the risk of the syndrome, such as age, depression and other health conditions, they found that people with excessive daytime sleepiness and lack of enthusiasm were more than three times more likely to develop the syndrome. syndrome than those who did not have these sleep-related problems.

“More research is needed to look at the relationship between sleep problems and cognitive decline and the role that motor cognitive risk syndrome plays,” Leroy said. “We also need studies to explain the mechanisms that link these sleep disorders to motor cognitive risk syndrome and cognitive decline.”

One limitation of the study is that participants reported their own information about sleep, so they may not have remembered everything accurately.

The study was supported by the National Institute on Aging.

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