NeuroVoices: Christian Agudelo, MD, on Sleep’s Impact on Cognitive Decline

Stuart SchlossmanMemory (Cognition)

The Evelyn F. McKnight Neurocognitive Scholar at the University of Miami Miller School of Medicine detailed his study on the correlations between sleep and cognitive decline in middle-aged Hispanics.

Christian Agudelo, MD

Results from a recently published collaborative national study of middle-aged Hispanic adults identified a link between poor sleep patterns and cognitive decline. Over the 7-year study period, researchers found that taking longer to fall asleep was associated with lower measures of verbal learning, verbal memory, and other cognitive functions.

University of Miami Miller School of Medicine researchers, including lead author Christian Agudelo, MD, found that longer sleep durations were also associated with a decline in cognitive function, while taking naps was associated with less decline in memory function. Agudelo, the Evelyn F. McKnight Neurocognitive Scholar, hopes the study can serve as an important reminder that sleep should be taken as seriously as some of the other pillars of health such as diet and exercise.

Though the study does not demonstrate a causal relationship between sleep and cognitive decline, it does indicate a correlation. In this NeuroVoices segment, Agudelo provides background of his findings, including the importance of diversifying patient populations in clinical trial settings, raising awareness of cognitive effects from poor sleep, and whether future studies looking at other age populations might be on the way.

NeurologyLive: How did you go about conducting this study?

Christian Agudelo, MD: The first thing I’m going to say is that I’m in a fortunate position where this data was made available to me when I arrived at my faculty and got to reap the benefit of other scientists. The Hispanic Community Health study is this ongoing, longitudinal, observational study of Hispanic Latino adults in the US and the purpose is to understand the health of this population in the US. From that monumental effort, different investigators looked at different aspects of health. From this study, we looked at a couple thousand individuals, measuring both their sleep and cognitive function, with the idea of trying to identify what aspects of sleep can predict cognitive health or cognitive decline in middle age.

Would you say the higher risk of dementia in Hispanics plays a factor into your results? Would the next steps be to see if there is similar effect in other populations?

The fact that Hispanic Americans and Latin Americans are more prone to dementia is an interesting concept, especially when you think about the diverse genetic pool of Hispanic Latin Americans in this country. Someone that’s from Chiapas, Mexico, is probably very genetically distinct from someone that’s from Buenos Aires, Argentina. That’s a 10-hour flight. From that perspective, when we look at the demographic as a model, it’s difficult to understand. That’s why studied like this exist; to sort of begin to uncover what’s going on. The study was the first to my knowledge that looked at middle age. There is no other demographic that we know that’s looked at sleep and middle age in this way.

Should we look at other demographics? Absolutely. Should other longitudinal studies that have access to middle aged white adults have that question asked for them? Absolutely. Same with Black Americans, Men, Asian Americans, and other groups. We need to study everybody. In doing so, we’ll identify the things that are unique to certain ethnic and racial groups. On top of that, we’ll also find commonalities from a human standpoint.

Is the importance of sleep undersold? Especially now that there is an effect on cognitive function.

Health is like a 3-legged stool. Maybe there’s more legs, but we don’t know. Two of them, are exercise and diet, which are both quite entrenched. Everyone globally accepts that these things are important for your health, especially for your brain health. Sleep is like the redheaded stepchild of this tripod. It is definitely as important as the other 2. As a society, we’ve definitely diminished it. Even in medical training, you power through, you have these ridiculous call schedules, you pay no attention to your circadian function, and pay no mind to what this modern work structure does to our long-term health. Studies like this really point to the reality that sleep does matter. It matters way earlier than you think. Despite not seeing a causal effect, the study points to the idea that what you do in middle age, which starts as early as your 30s, can affect you down the line.

Should cognitive care and sleep disorder care be crossed over more?

Yes, absolutely. It is important to understand and identify sleep issues early, including things like sleep apnea, where something like 80% of the people with sleep apnea go undiagnosed. That’s detrimental. Especially when I see a 60-year-old man coming into the clinic, claiming he’s a little tired, says his wife tells him he snores, we treat him, and then he’s like ‘wow, I just wasted the last 40 years of my life. I didn’t know I could feel this good.’ That’s just sleep apnea, must less known than just regular sleep hygiene. We have to incorporate it into our approach to treatment of neurodegenerative diseases in general, and preventative health as well.

What are your thoughts on conducting a study with younger folks?

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