Chronotype as a potential risk factor for cognitive decline: The mediating role of sleep quality and health behaviours in a 10-year follow-up study.

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The Journal of Prevention of Alzheimer's Disease Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI:10.1016/j.tjpad.2025.100168

A N Wenzler, A C Liefbroer, R C Oude Voshaar, N Smidt

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Abstract

Background: - With rising life expectancies and ageing populations worldwide, preserving cognitive health is an urgent global priority. Chronotype could be a potential risk factor for cognitive decline, potentially through mediators sleep quality, alcohol intake, physical activity, and smoking.

Methods: - This study used data from participants aged 40 years and older from the Lifelines cohort study (n = 23,798). Chronotype, assessed with the Munich ChronoType Questionnaire, was included as a continuous score of mid-point sleep corrected for sleep debt on workdays. Multiple linear regression examined the association between chronotype and cognitive decline, including moderation by age, educational attainment, and sex. The KHB-method was applied to test mediation by sleep quality, alcohol intake, physical activity, and smoking.

Outcomes: - Cognition was assessed with the Ruff Figural Fluency Test (RFFT), measuring non-verbal fluency and executive functioning. Cognitive decline was calculated by subtracting the RFFT sum score at baseline from the 10-year follow-up score.

Results: - Chronotype was associated with cognitive decline. Educational attainment, but not age or sex, moderated the relationship. No significant associations were observed in the low- (0.07, 95 % CI: -0.44, 0.57) or middle- (-0.41, 95 % CI: -0.88, 0.06) educational groups. In the high-educational group each one-hour increase in chronotype corresponded to a 0.80-point decline in cognition per decade (95 % CI: -1.34, -0.26). In this group, sleep quality and current smoking mediated 13.52 % and 18.64 % of the association, respectively.

Interpretation: - Chronotype was associated with greater decline in non-verbal fluency and executive functioning among higher educated participants, highlighting the importance of targeted prevention strategies.

Funding: - This work is part of the BIRD-NL consortium funded by the Dutch Medical Research Council, ZonMw (Dementia research program) project number:10,510,032,120,005.

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睡眠类型作为认知能力下降的潜在危险因素：一项10年随访研究中睡眠质量和健康行为的中介作用

背景：-随着世界范围内预期寿命的延长和人口老龄化，保持认知健康是一项紧迫的全球优先事项。睡眠类型可能是认知能力下降的潜在风险因素，可能通过调节睡眠质量、酒精摄入量、体育活动和吸烟。方法：本研究使用来自生命线队列研究（n = 23,798）的40岁及以上参与者的数据。使用慕尼黑睡眠类型问卷评估睡眠类型，并将其作为工作日睡眠债修正后的中点睡眠的连续评分。多元线性回归检验了时间类型和认知能力下降之间的关系，包括年龄、受教育程度和性别的调节。采用khb法测试睡眠质量、饮酒、体育活动和吸烟的中介作用。结果：用Ruff图形流畅性测试（RFFT）评估认知，测量非语言流畅性和执行功能。通过从10年随访评分中减去基线时的RFFT总评分来计算认知能力下降。结果：睡眠类型与认知能力下降有关。受教育程度，而不是年龄或性别，缓和了这一关系。在低教育水平（0.07,95% CI: -0.44, 0.57）或中等教育水平（-0.41,95% CI: -0.88, 0.06）组中未观察到显著相关性。在受过高等教育的一组中，时间型每增加一小时，认知能力每十年下降0.80点（95% CI: -1.34, -0.26）。在这一组中，睡眠质量和当前吸烟分别介导了13.52%和18.64%的关联。解释：在受过高等教育的参与者中，睡眠类型与非语言流畅性和执行功能的更大下降有关，这突出了有针对性的预防策略的重要性。这项工作是BIRD-NL联盟的一部分，由荷兰医学研究理事会资助，ZonMw（痴呆症研究计划）项目编号：10,510,032,120,005。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health

CiteScore

9.20

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0.00%

发文量

期刊介绍： The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.