Associations Between Measures of Sleep Health and Cognitive Function in Older Adults

Abstract

ObjectivesPrior research has identified associations between sleep health and cognitive function. Our aim was to investigate multiple domains of sleep health and their associations with cognitive function in a diverse sample of older adults.

MethodsThese data are from an observational study in Chicago, USA, that enrolled adults aged 55 years and older without cognitive impairment at baseline and followed a subset for up to 2 years. Sleep was measured with 7 days of wrist actigraphy and we examined sleep duration (amount), sleep fragmentation (an index of restlessness and sleep quality), sleep start time and sleep regularity (based on the within-subject standard deviation of sleep start time)..

Participants also completed tasks from the NIH Toolbox to estimate fluid cognition and the Trail Making Test (Trails B) to assess attention and processing speed. A subset of participants was examined at a follow-up visit that included only the NIH Toolbox assessment.

ResultsOur sample included 324 participants (63.6% women, 37.3% African American/Black, 13.6% Hispanic/Latino). Greater sleep fragmentation and less sleep regularity were associated with worse fluid cognition and Trails B scores (all p<.01). Longer sleep duration and earlier sleep start times were associated with better performance on Trails B. No sleep measures were associated with change in the fluid cognition score over an average of 1.9 years (n=133).

DiscussionThese findings support a cross-sectional association between cognitive function and multiple domains of sleep health, including duration, quality, timing and regularity, in a diverse sample of older adults.

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BibTeX RIS

BibTeX

@misc{knutson2026associations,
  title = {{Associations Between Measures of Sleep Health and Cognitive Function in Older Adults}},
  author = {K. L. Knutson and K. Harrington and S. J. Alexandria and P. C. Zee and M. R. Carnethon},
  howpublished = {medRxiv},
  year = {2026},
  month = sep,
  doi = {10.64898/2026.09.21.26363558},
  url = {https://www.medrxiv.org/content/10.64898/2026.09.21.26363558v1},
  note = {CC BY},
}

RIS

TY  - UNPB
TI  - Associations Between Measures of Sleep Health and Cognitive Function in Older Adults
AU  - K. L. Knutson
AU  - K. Harrington
AU  - S. J. Alexandria
AU  - P. C. Zee
AU  - M. R. Carnethon
PY  - 2026
DA  - 2026/09/21
PB  - medRxiv
DO  - 10.64898/2026.09.21.26363558
UR  - https://www.medrxiv.org/content/10.64898/2026.09.21.26363558v1
AB  - ObjectivesPrior research has identified associations between sleep health and cognitive function. Our aim was to investigate multiple domains of sleep health and their associations with cognitive function in a diverse sample of older adults.  MethodsThese data are from an observational study in Chicago, USA, that enrolled adults aged 55 years and older without cognitive impairment at baseline and followed a subset for up to 2 years. Sleep was measured with 7 days of wrist actigraphy and we examined sleep duration (amount), sleep fragmentation (an index of restlessness and sleep quality), sleep start time and sleep regularity (based on the within-subject standard deviation of sleep start time)..  Participants also completed tasks from the NIH Toolbox to estimate fluid cognition and the Trail Making Test (Trails B) to assess attention and processing speed. A subset of participants was examined at a follow-up visit that included only the NIH Toolbox assessment.  ResultsOur sample included 324 participants (63.6% women, 37.3% African American/Black, 13.6% Hispanic/Latino). Greater sleep fragmentation and less sleep regularity were associated with worse fluid cognition and Trails B scores (all p<.01). Longer sleep duration and earlier sleep start times were associated with better performance on Trails B. No sleep measures were associated with change in the fluid cognition score over an average of 1.9 years (n=133).  DiscussionThese findings support a cross-sectional association between cognitive function and multiple domains of sleep health, including duration, quality, timing and regularity, in a diverse sample of older adults.
ER  -

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