Sleep,Mild Cognitive Impairment,and Interventions for Sleep Improvement: An Integrative Review

Abstract

Sleep disturbance in mild cognitive impairment (MCI) is associated with progression to Alzheimer’s disease (AD), more severe AD symptoms, and worse health outcomes. The aim of this review was to examine the relationship between sleep and MCI, and the effectiveness of sleep improvement interventions for older adults with MCI or AD. An integrative review was conducted using four databases, and findings were analyzed using an iterative process. Findings from 24 studies showed that alterations in sleep increased the risk of MCI and that the sleep quality of individuals with MCI or AD was poorer than healthy controls. Changes in brain anatomy were also observed in healthy older adults with sleep disturbances. Examined interventions were shown to be effective in improving sleep. Screening for sleep disturbances in individuals with MCI/AD is crucial to mitigate neurodegenerative or neurobehavioral risks in this population.

Keywords

sleep quality sleep disturbances sleep interventions mild cognitive impairment (MCI)Alzheimer’s disease cognitive impairment older adults

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References

Alzheimer’s Association. (2020). Mild cognitive impairment. https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment

Alperin

Wiltshire

Lee

S. H.

Ramos

A. R.

Hernandez-Cardenache

Rundek

Cid

R. C.

Loewenstein

(2019). Effect of sleep quality on amnestic mild cognitive impairment vulnerable brain regions in cognitively normal elderly individuals. Sleep, 42(3), zsy254. https://doi.org/10.1093/sleep/zsy254

American Sleep Association. (2020). Stages of sleep: The sleep cycle. https://www.sleepassociation.org/about-sleep/stages-of-sleep/

Bademli

Lok

Canbaz

Lok

(2018). Effects of physical activity program on cognitive function and sleep quality in elderly with mild cognitive impairment: A randomized controlled trial. Perspectives in Psychiatric Care. https://doi.org/10.1111/ppc.12324

Burke

S. L.

Spadola

C. E.

Naseh

Burgess

Cadet

(2018). Mild cognitive impairment: Associations with sleep disturbance, apolipoprotein e4, and sleep medications. Sleep Medicine, 52, 168–176. https://doi.org/10.1016/j.sleep.2018.09.001

Cavuoto

M. G.

Kinsella

G. J.

Ong

Pike

K. E.

Nicholas

C. L.

(2019). Naturalistic measurement of sleep in older adults with amnestic mild cognitive impairment: Anxiety symptoms do not explain sleep disturbance. Current Alzheimer Research, 16(3), 233–242. https://doi.org/10.2174/1567205016666190301104645

Cipriani

Lucetti

Danti

Nuti

(2015). Sleep disturbances and dementia. Psychogeriatrics, 15(1), 65–74. https://doi.org/10.1111/psyg.12069

Cooke

J. R.

Ancoli-Israel

(2011). Normal and abnormal sleep in the elderly. Handbook of Clinical Neurology, 98, 653–665. https://doi.org/10.1016/B978-0-444-52006-7.00041-1

Csukly

Sirály

Fodor

Horváth

Salacz

Hidasi

Csibri

É.

Rudas

Szabó

. (2016). The differentiation of amnestic type MCI from the non-amnestic types by structural MRI. Frontiers in Aging Neuroscience, 8, 52. https://doi.org/10.3389/fnagi.2016.00052

10.

da Cruz Morello

A. N.

Lima

T. M.

Brandão

. (2017). Language and communication non-pharmacological interventions in patients with Alzheimer’s disease: A systematic review. communication intervention in Alzheimer. Dementia & Neuropsychologia, 11(3), 227–241. https://doi.org/10.1590/1980-57642016dn11-030004

11.

Dean

G. E.

Weiss

Morris

J. L.

Chasens

E. R.

(2017). Impaired sleep: A multifaceted geriatric syndrome. The Nursing Clinics of North America, 52(3), 387–404. https://doi.org/10.1016/j.cnur.2017.04.009

12.

Dias

B. L.

(2018). Older adults with Alzheimer’s disease: A systematic review about the occupational therapy intervention in changes of performance skills. Brazilian Journal of Occupational Therapy, 26(4), 926–942. https://doi.org/10.4322/2526-8910.ctoAR1066

13.

Diem

S. J.

Blackwell

T. L.

Stone

K. L.

Yaffe

Tranah

Cauley

J. A.

Ancoli-Israel

Redline

Spira

A. P.

Hillier

T. A.

Ensrud

K. E.

(2016). Measures of sleep–wake patterns and risk of mild cognitive impairment or dementia in older women. The American Journal of Geriatric Psychiatry, 24(3), 248–258. https://doi.org/10.1016/j.jagp.2015.12.002

14.

Djonlagic

Aeschbach

Harrison

S. L.

Dean

Yaffe

Ancoli-Israel

Stone

Redline

(2018). Associations between quantitative sleep EEG and subsequent cognitive decline in older women. Journal of Sleep Research, 28(3), e12666. https://doi.org/10.1111/jsr.12666

15.

D’Rozario

A. L.

Chapman

J. L.

Phillips

C. L.

Palmer

J. R.

Hoyos

C. M.

Mowszowski

Duffy

S. L.

Marshall

N. S.

Benca

Mander

Grunstein

R. R.

Naismith

S. L.

(2020). Objective measurement of sleep in mild cognitive impairment: A systematic review and meta-analysis. Sleep Medicine Reviews, 52, 101308. https://doi.org/10.1016/j.smrv.2020.101308

16.

Duke Clinical Research Institute. (2020). Beers criteria medication list. https://dcri.org/beers-criteria-medication-list/

17.

Falck

R. S.

Davis

J. C.

Best

J. R.

Chan

L. C.

Wyrough

A. B.

Bennett

K. J.

Backhouse

Liu-Ambrose

(2020). Effect of a multimodal lifestyle intervention on sleep and cognitive function in older adults with probable mild cognitive impairment and poor sleep: A randomized clinical trial. Journal of Alzheimer’s disease: JAD, 76(1), 179–193. doi.org/10.3233/JAD-200383

18.

Garrard

(2017). Health sciences literature review made easy: The matrix method. Jones & Bartlett Learning.

19.

Gooneratne

N. S.

Vitiello

M. V.

(2014). Sleep in older adults: Normative changes, sleep disorders, and treatment options. Clinics in Geriatric Medicine, 30(3), 591–627. https://doi.org/10.1016/j.cger.2014.04.007

20.

Grundman

Petersen

R. C.

Ferris

S. H.

Thomas

R. G.

Aisen

P. S.

Bennett

D. A.

Foster

N. L.

Clifford

C. R.

Jr. Galasko

D. R.

Doody

Kaye

Sano

Mohs

Gauthier

Kim

H. T.

Jin

Schultz

A. N.

Schafer

Mulnard

. . . Thal

L. J.

(2004). Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials. Archives of Neurology, 61(1), 59–66. https://doi.org/10.1001/archneur.61.1.59

21.

Hayes

T. L.

Riley

Mattek

Pavel

Kaye

J. A.

(2014). Sleep habits in mild cognitive impairment. Alzheimer Disease and Associated Disorders, 28(2), 145–150. https://doi.org/10.1097/WAD.0000000000000010

22.

Hita-Yanez

Atienza

Cantero

J. L.

(2013). Polysomnographic and subjective sleep markers of mild cognitive impairment. Sleep, 36(9), 1327–1334. https://doi.org/10.5665/sleep.2956

23.

Hita-Yanez

Atienza

Gil-Neciga

Cantero

J. L.

(2012). Disturbed sleep patterns in elders with mild cognitive impairment: The role of memory decline and ApoE epsilon 4 genotype. Current Alzheimer Research, 9(3), 290–297. https://doi.org/10.2174/156720512800107609

24.

Hot

Rauchs

Bertran

Denise

Desgranges

Clochon

Eustache

(2011). Changes in sleep theta rhythm are related to episodic memory impairment in early Alzheimer’s disease. Biological Psychology, 87(3), 334–339. https://doi.org/10.1016/j.biopsycho.2011.04.002

25.

Zhang

Tan

Chen

(2017). Sleep disturbance in mild cognitive impairment: A systematic review of objective measures. Neurological Sciences, 38(8), 1363–1371. https://doi.org/10.1007/s10072-017-2975-9

26.

Iber

Ancoli-Israel

Chesson

A. L.

Quan

S. F.

(2007). The AASM manual for the scoring of sleep and associated events: Rules, terminology and technical specifications (Vol. 1). American Academy of Sleep Medicine.

27.

Kabeshita

Adachi

Matsushita

Kanemoto

Sato

Suzuki

Yoshiyama

Shimomura

Yoshida

Shimizu

Matsumoto

Mori

Kashibayashi

Tanaka

Hatada

Hashimoto

Nishio

Komori

Tanaka

. . . Kazui

(2017). Sleep disturbances are key symptoms of very early stage Alzheimer disease with behavioral and psychological symptoms: A Japan multi-center cross-sectional study (J-BIRD). International Journal of Geriatric Psychiatry, 32(2), 222–230. https://doi.org/10.1002/gps.4470

28.

Kirova

Bays

R. B.

Lagalwar

(2015). Working memory and executive function decline across normal aging, mild cognitive impairment, and Alzheimer’s disease. BioMed Research International. https://doi.org/10.1155/2015/748212

29.

Liang

Lin

Jia

Zhang

Hang

(2018). Comparison of multiple interventions for older adults with Alzheimer disease or mild cognitive impairment: A PRISMA-compliant network meta-analysis. Medicine, 97(20), 1–12. https://doi.org/10.1097/MD.0000000000010744

30.

Lucey

B. P.

McCullough

Landsness

E. C.

Toedebusch

C. D.

McLeland

J. S.

Zaza

A. M.

Fagan

A. M.

McCue

Xiong

Morris

J. C.

Benzinger

T. L. S.

Holtzman

D. M.

(2019). Reduced non-rapid eye movement sleep is associated with tau pathology in early Alzheimer’s disease. Science Translational Medicine, 11(474), eaau6550. https://doi.org/10.1126/scitranslmed.aau6550. https://doi.org/10.1126/scitranslmed.aau6550

31.

McGrath

M. J.

Cohen

D. B.

(1978). REM sleep facilitation of adaptive waking behavior: A review of the literature. Psychological Bulletin, 85(1), 24–57. https://doi.org/10.1037/0033-2909.85.1.24

32.

McKinnon

A. C.

Beath

A. P.

Naismith

S. L.

(2019). Relationships between sleep quality, depressive symptoms and MCI diagnosis: A path analysis. Journal of Affective Disorders, 256, 26–32. https://doi.org/10.1016/j.jad.2019.05.045

33.

Miner

Kryger

M. H.

(2017). Sleep in the aging population. Sleep Medicine Clinics, 12(1), 31–38. https://doi.org/10.1016/j.jsmc.2016.10.008

34.

Moher

Shamseer

Clarke

Ghersi

Liberati

Petticrew

Shekelle

Stewart

L. A.

, & PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1–9. https://doi.org/10.1186/2046-4053-4-1

35.

Naismith

S. L.

Mowszowski

(2018). Sleep disturbance in mild cognitive impairment: A systematic review of recent findings. Current Opinion in Psychiatry, 31(2), 153–159. https://doi.org/10.1097/YCO.0000000000000397

36.

Naismith

S. L.

Pye

Terpening

Lewis

Bartlett

(2019). “Sleep well, think well” group program for mild cognitive impairment: A randomized controlled pilot study. Behavioral Sleep Medicine, 17(6), 778–789. https://doi.org/10.1080/15402002.2018.1518223

37.

Naismith

S. L.

Rogers

N. L.

Hickie

I. B.

Mackenzie

Norrie

L. M.

Lewis

S. J. G.

(2010). Sleep well, think well: Sleep-wake disturbance in mild cognitive impairment. Journal of Geriatric Psychiatry and Neurology, 23(2), 123–130. https://doi.org/10.1177/0891988710363710

38.

Naismith

S. L.

Rogers

N. L.

Lewis

S. J. G.

Diamond

Terpening

Norrie

Hickie

I. B.

(2011). Sleep disturbance in mild cognitive impairment: Differential effects of current and remitted depression. Acta Neuropsychiatrica, 23(4), 167–172. https://doi.org/10.1111/j.1601-5215.2011.00555.x

39.

National Sleep Foundation. (2020). How much sleep do we really need? https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need

40.

Papalambros

N. A.

Weintraub

Chen

Grimaldi

Santostasi

Paller

K. A.

Zee

P. C.

Malkani

R. G.

(2019). Acoustic enhancement of sleep slow oscillations in mild cognitive impairment. Annals of Clinical and Translational Neurology, 6(7), 1191–1201. https://doi.org/10.1002/acn3.796

41.

Peng

Lorenz

R. A.

Chang

(2019). Factors associated with sleep in family caregivers of individuals with dementia. Perspectives in Psychiatric Care, 55(1), 95–102. https://doi.org/10.1111/ppc.12307

42.

Peter-Derex

Yammine

Bastuji

Croisile

(2015). Sleep and Alzheimer’s disease. Sleep Medicine Reviews, 19, 29–38. https://doi.org/10.1016/j.smrv.2014.03.007

43.

Petersen

R. C.

(2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256(3), 183–194. https://doi.org/10.1111/j.1365-2796.2004.01388.x

44.

Pistacchi

Gioulis

Contin

Sanson

Marsala

S. Z.

(2014). Sleep disturbance and cognitive disorder: Epidemiological analysis in a cohort of 263 patients. Neurological Sciences, 35(12), 1955–1962. https://doi.org/10.1007/s10072-014-1870-x

45.

Reda

Gorgoni

Lauri

Truglia

Cordone

Scarpelli

Mangiaruga

D’Atri

Ferrara

Lacidogna

Marra

Rossini

P. M.

De Gennaro

(2017). In search of sleep biomarkers of Alzheimer’s disease: K-complexes do not discriminate between patients with mild cognitive impairment and healthy controls. Brain Sciences, 7(5), 51. https://doi.org/10.3390/brainsci7050051

46.

Rozzini

Conti

M. Z.

Riva

Ceraso

Caratozzolo

Zanetti

Padovani

(2018). Non-amnestic mild cognitive impairment and sleep complaints: A bidirectional relationship? Aging Clinical and Experimental Research, 30(6), 661–668. https://doi.org/10.1007/s40520-017-0814-8

47.

Sanchez-Espinosa

M. P.

Atienza

Cantero

J. L.

(2014). Sleep deficits in mild cognitive impairment are related to increased levels of plasma amyloid-β and cortical thinning. NeuroImage, 98, 395–404. https://doi.org/10.1016/j.neuroimage.2014.05.027

48.

Seidel

Dal-Bianco

Pablik

Müller

Schadenhofer

Lamm

Klösch

Moser

Klug

Pusswald

Auff

Lehrner

(2015). Depressive symptoms are the main predictor for subjective sleep quality in patients with mild cognitive impairment–A controlled study. PloS One, 10(6), e0128139. https://doi.org/10.1371/journal.pone.0128139

49.

Shamseer

Moher

Clarke

Ghersi

Liberati

Petticrew

Shekelle

Stewart

L. A.

& PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ, 350(g7647), 1–25. https://doi.org/10.1136/bmj.g7647

50.

Sharifi

Heidari

Bromand

Binayi

Keshvari

(2019). The relationship between sleep quality and quality of life of retired elderly. Elderly Health Journal, 5(2), 79–83. https://doi.org/10.18502/ehj.v5i2.2153

51.

Tadokoro

Ohta

Hishikawa

Nomura

Wakutani

Takao

Omote

Takemoto

Yamashita

Abe

(2020). Discrepancy of subjective and objective sleep problems in Alzheimer’s disease and mild cognitive impairment detected by a home-based sleep analysis. Journal of Clinical Neuroscience, 74, P76-P80. https://doi.org/10.1016/j.jocn.2020.01.085

52.

Tan

S. L.

Storm

Reinwand

D. A.

Wienert

de Vries

Lippke

(2018). Understanding the positive associations of sleep, physical activity, fruit and vegetable intake as predictors of quality of life and subjective health across age groups: A theory based, cross-sectional web-based study. Frontiers in Psychology, 9, 1–13. https://doi.org/10.3389/fpsyg.2018.00977

53.

Vaz Fragoso

C. A.

Gill

T. M

. (2007). Sleep complaints in community-living older persons: A multifactorial geriatric syndrome. Journal of the American Geriatrics Society, 55(11), 1853–1866. https://doi.org/10.1111/j.1532-5415.2007.01399.x

54.

Westerburg

C. E.

Lundgren

E. M.

Florczak

S. M.

Mesulam

M. M.

Weintraub

Zee

P. C.

Paller

K. A.

(2010). Sleep influences the severity of memory disruption in amnestic mild cognitive impairment: Results from sleep self-assessment and continuous activity monitoring. Alzheimer Disease & Associated Disorders, 24(4), 325–333. https://doi.org/1097/WAD.0b013e3181e30846

55.

Whittemore

Knafl

(2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

56.

Wilckens

K. A.

Tudorascu

D. L.

Snitz

B. E.

Price

J. C.

Aizenstein

H. J.

Lopez

O. L.

Erickson

K. I.

Lopresti

B. J.

Laymon

C. M.

Minhas

Mathis

C. A.

Buysse

D. J.

Klunk

W. E.

Cohen

A. D.

(2018). Neurobiology of Aging, 71, 142–148. https://doi.org/10.1016/j.neurobiolaging.2018.07.011

57.

Mahendran

Rawtaer

Kua

Feng

(2017). Poor sleep quality is observed in mild cognitive impairment and is largely unrelated to depression and anxiety. Aging & Mental Health, 21(8), 823–828. https://doi.org/10.1080/13607863.2016.1161007

58.

Yuen

Rashidi-Ranjbar

Verhoeff

N. P. L. G.

Kumar

Gallagher

Flint

A. J.

Herrmann

Pollock

B. G.

Mulsant

B. H.

Rajji

T. K.

Voineskos

A. N.

Fischer

C. E.

Mah

, & PACt-MD Study Group. (2019). Association between sleep disturbances and medial temporal lobe volume in older adults with mild cognitive impairment free of lifetime history of depression. Journal of Alzheimer’s Disease, 69(2), 413–421. https://doi.org/10.3233/JAD-190160