An Epidemiologic Study of Disparities in Sleep and Cognition in Older Adults (DISCO)

项目总结 在种族/少数民族群体中，尤其是非裔美国人/黑人，睡眠时间和质量更差 和西班牙裔/拉丁裔。睡眠受损与认知功能受损有关，这是一种 老年人生活质量差和残疾的主要原因。认知功能受损和 阿尔茨海默氏症也更常见于种族/少数民族群体，包括黑人和 拉美裔/拉丁裔，导致这些群体在福祉和寿命方面存在更大差距。给定 在老年人保持认知功能的重要性方面，我们建议研究 来自三个种族/民族的450名老年人(≥65岁)的队列，以更好地了解 这些睡眠差异，并了解睡眠在认知功能差异和 阿尔茨海默病的风险。界定睡眠不足的相关性和睡眠对认知的贡献 在种族/民族多样性样本中的作用是确定每个样本中的可修改因素的第一步 对睡眠和认知功能有贡献的种族/民族。睡眠不足与 心血管功能不良，包括血压升高和脑白质比率升高 大脑顶区正常组织的高信号。睡眠不足也与 在实验和观察性研究中，胰岛素抵抗和糖尿病风险增加。大脑体积小 血管疾病和胰岛素抵抗是认知功能受损和 阿尔茨海默氏症，因此我们将检查这些测量是否在睡眠和睡眠之间的联系中起中介作用 和认知功能。我们将招收150名非西班牙裔黑人，150名非西班牙裔白人和150名 无严重认知障碍的西班牙裔/拉丁裔。我们将评估习惯性睡眠、认知功能、胰岛素 基线和24个月后的阻力和脑小血管功能。我们将确定 心理社会和身体健康对老年人睡眠差距的贡献。我们还将确定 睡眠不足是否在一定程度上调节了种族/民族认知功能的差异在两年内下降。 最后，我们将测试大脑小血管疾病和胰岛素抵抗是否是潜在的机制。 睡眠不足与老年人认知功能下降有关。此应用程序与目标保持一致 美国国立卫生研究院睡眠障碍研究计划“识别…”生活方式因素…增加睡眠和睡眠的风险 昼夜节律紊乱及其在共病发生和发病机制中的作用 疾病和残疾。“如果睡眠不足是老年人认知能力下降的一个重要原因 成人，开发新的疗法，行为干预和/或方法，以增加使用和 坚持现有疗法以改善老年人的睡眠，特别是针对特定需求的疗法 对种族/族裔少数群体的歧视，可能会对公共卫生产生重大影响，并有助于消除差异。

PROJECT SUMMARY Sleep duration and quality is worse among racial/ethnic minority groups, particularly African Americans/blacks and Hispanic/Latinos. Impaired sleep has been associated with detriments in cognitive function, which is a major cause of poor quality of life and disability among older adults. Impaired cognitive function and Alzheimer’s Disease are also more often observed in racial/ethnic minority groups, including blacks and Hispanic/Latinos, leading to greater disparities in well-being and longevity among these groups. Given the importance of maintaining cognitive function at older ages, we propose to examine sleep disparities among a cohort of 450 older adults (≥65 years) from three racial/ethnic groups to understand better the correlates of these sleep disparities and to understand the role sleep plays in disparities in cognitive function and Alzheimer’s disease risk. Defining the correlates of inadequate sleep and the contribution of sleep to cognitive function in a racial/ethnically diverse sample is the first step towards identifying modifiable factors within each racial/ethnic group contributing to sleep and cognitive function. Inadequate sleep has been associated with adverse cardiovascular function, including higher blood pressure and elevated ratio of white matter hyperintensities to normal tissue in the parietal region of the brain. Inadequate sleep has also been associated with increased insulin resistance and diabetes risk in experimental and observational studies. Cerebral small vessel disease and insulin resistance are risk factors for the development of impaired cognitive function and Alzheimer’s disease and thus we will examine whether these measures mediate associations between sleep and cognitive function. We will enroll 150 non-Hispanic blacks, 150 non-Hispanic whites and 150 Hispanic/Latinos without severe cognitive impairment. We will assess habitual sleep, cognitive function, insulin resistance and cerebral small vessel function at baseline and 24 months later. We will determine the contribution of psychosocial and physical well-being to sleep disparities in older adults. We will also determine whether inadequate sleep partially mediates racial/ethnic differences in cognitive function decline over 2 years. Finally, we will test whether cerebral small vessel disease and insulin resistance are potential mechanisms linking inadequate sleep to declines in cognitive function in older adults. This application aligns with the goals of the NIH Sleep Disorders Research Plan to “Identify … lifestyle factors … contributing to the risk of sleep and circadian disorders and disturbances, and their role in the development and pathogenesis of co-morbid diseases, and disability.” If inadequate sleep is a significant correlate of greater cognitive decline among older adults, the development of novel therapies, behavioral interventions and/or methods to increase use and adherence to existing therapies to improve sleep in older adults, particularly ones tailored to the specific needs of racial/ethnic minorities, could have a significant impact on public health and help to eliminate disparities.