BACKGROUND AND OBJECTIVES There is growing evidence that sleep disturbances are associated with cognitive impairment risk, but their association with the incidence of motoric cognitive risk syndrome (MCR)-a predementia syndrome characterized by slow gait speed and cognitive complaints-is unknown. We aimed to examine the association of sleep disturbances, overall and specific subtypes, with (1) incident and (2) prevalent MCR in older adults. METHODS Community-residing adults aged 65 years and older without dementia were recruited from population lists and included in Central Control of Mobility and Aging, a prospective cohort study, in Albert Einstein College of Medicine, Bronx, NY. We included participants with available data for MCR and Pittsburgh Sleep Quality Index (PSQI). MCR was defined as cognitive complaints reported on standardized questionnaires and slow gait speed as recorded on an electronic treadmill and was adjudicated at baseline and annual follow-up visits. Participants were divided into "good" sleepers (≤5) and "poor" sleepers (>5) based on an established PSQI cut score. Among participants without MCR at baseline, Cox proportional hazard models adjusted for (1) age, sex, and education and (2) further for comorbidity index, Geriatric Depression Scale score, and global cognitive score were used to examine the association of baseline sleep disturbances with MCR incidence. Association between poor sleep quality and prevalent MCR at baseline in the overall population was explored using multivariate logistic regression analysis. RESULTS 445 participants were included (56.9% women, mean age: 75.9 years [75.3; 76.5]). In MCR-free participants at baseline (n = 403), 36 developed incident MCR over a mean follow-up of 2.9 years. Poor sleepers had a higher risk of incident MCR (HR = 2.7 [1.2; 5.2]) compared with good sleepers, but this association was not significant after adjustment for depressive symptoms (adjusted hazard ratio [aHR] = 1.6 [0.7-3.4]). Among the 7 PSQI components, only sleep-related daytime dysfunction (excessive sleepiness and lower enthusiasm) showed a significant risk of MCR in fully adjusted models (aHR = 3.3 [1.5-7.4]). Prevalent MCR was not associated with poor sleep quality (OR [95% CI] = 1.1 [0.5-2.3]). DISCUSSION Overall poor sleep quality was associated with incident MCR, but not with prevalent MCR. Specifically, older adults with sleep-related daytime dysfunction are at increased risk of developing MCR. Further studies are needed to validate mechanisms of this relationship.

中文翻译：

---

睡眠障碍与社区居住老年人普遍和事件运动认知风险综合症的关联。


背景和目标 越来越多的证据表明睡眠障碍与认知障碍风险相关，但它们与运动认知风险综合征 （MCR） 的发生率相关——一种以缓慢的步态速度和认知主诉为特征的痴呆前期综合征——尚不清楚。我们旨在检查睡眠障碍、总体和特定亚型与老年人 （1） 事件和 （2） 普遍 MCR 的关联。方法 从人口名单中招募 65 岁及以上无痴呆的社区居民，并将其纳入纽约布朗克斯阿尔伯特爱因斯坦医学院的一项前瞻性队列研究活动和衰老的中央控制。我们纳入了具有 MCR 和匹兹堡睡眠质量指数 （PSQI） 可用数据的参与者。MCR 被定义为标准化问卷上报告的认知主诉和电子跑步机上记录的慢步态速度，并在基线和年度随访时进行裁决。参与者根据既定的 PSQI 分数分为“良好”睡眠者 （≤5） 和“差”睡眠者 （>5）。在基线时没有 MCR 的参与者中，使用 Cox 比例风险模型调整了 （1） 年龄、性别和教育程度，以及 （2） 进一步调整了合并症指数、老年抑郁量表评分和整体认知评分，以检查基线睡眠障碍与 MCR 发生率的关联。使用多变量 logistic 回归分析探讨总体人群中睡眠质量差与基线时患病率 MCR 之间的关联。结果 共纳入 445 名参与者 （56.9% 为女性，平均年龄： 75.9 岁 [75.3;76.5]）。在基线时无 MCR 的参与者 （n = 403） 中，36 人在平均 2.9 年的随访中发生了事件 MCR。 与睡眠良好的人相比，睡眠不佳的人发生 MCR 的风险更高 （HR = 2.7 [1.2; 5.2]），但在调整抑郁症状后，这种关联不显著 （调整后的风险比 [aHR] = 1.6 [0.7-3.4]）。在 7 个 PSQI 成分中，只有睡眠相关的日间功能障碍 （过度嗜睡和热情降低） 在完全调整的模型中显示 MCR 的显著风险 （aHR = 3.3 [1.5-7.4]）。患病率 MCR 与睡眠质量差无关 （OR [95% CI] = 1.1 [0.5-2.3]）。讨论 总体而言，睡眠质量差与发生 MCR 相关，但与普遍的 MCR 无关。具体来说，患有睡眠相关日间功能障碍的老年人患 MCR 的风险增加。需要进一步的研究来验证这种关系的机制。