A New Piece of Evidence on the Relationships of Sleep, Cognition and Later Life Disabilities

By Rifat Alam

Healthy aging has become a pressing concept due to the current increase in life expectancy around the world. However, this trend initiates more disabilities, risk of diseases, and dementia affecting quality of life of aging demographics. Functional ability, the capacity to perform activities of daily living, is one of the key indicators of quality of life and studying the predictors impacting functional abilities is crucial.

Sleep disorder is an important predictor of functional disability that remains understudied and needs more exploration. Besides, sleep problems are frequent in advancing age and can co-occur with cognitive decline; thus, it is important to explore the interplay that might exist between sleep, level of cognitive performance, and functional status/abilities. In this study, we utilized 3,179 data from the National Health and Nutrition Examination Survey (NHANES) to understand if the combined effect of sleep disorder and low cognitive performance on functional disabilities in later life is exacerbating the difficulties to perform activities of independent living.

There are several domains of physical functionality and limitations in one or more of these domains can lead to overall functional disabilities. Activities of daily living, the skills to care for oneself independently, instrumental activities of daily living, actions that allow individuals to live independently, and leisure and social activities keeping persons socially and psychologically active are the domains to assess a person’s level of functional status/abilities. Our study found sleep disorder to be associated with all these domains of functionality. In addition, sleep disorder in combination with low cognitive performance was found to be significantly associated with functional disabilities. More importantly, we found sleep disorders worsen functional disabilities of the older adults having low cognitive performance compared to the older adults who had no cognitive issues.

The interplay of sleep disorder, cognitive decline and functional disabilities revealed in this study assist healthcare providers to identify high-risk older adults and make treatment decisions. Irreversible human aging can be optimized through the promotion of healthy lifestyles and behaviors with an emphasis on appropriate sleeping habits and cognitive inspired activities. Additionally, development of sustainable health policies and public health interventions is necessary to care for older adults with diagnosed sleep disorder and cognitive decline.

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Article Details
Relationships of low cognitive performance and sleep disorder with functional disabilities among older adults
Rifat Alam, Laura Quintero Silva, Nilufer Jahan, Wojtek Chodzko-Zajko, Babatope Ogunjesa, Ana Selzer Ninomiya, Andiara Schwingel
First published on December 6, 202
DOI: 10.1177/08982643221143221
Journal of Aging and Health

About the Author

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Rifat Alam is a PhD Student in Community Health at University of Illinois Urbana-Champaign. Her research explores factors of healthy aging with a special focus on cognitive health and speaks for health equity among the historically underrepresented groups in the United States.