Sleep · Aug 13, 2025

Sleep disturbance and cognitive trajectories among older adults with subjective cognitive decline: the roles of age and sleep treatment

By Huang J, Perrin NA, Spira AP et al.

STUDY OBJECTIVES: Growing evidence indicates that subjective cognitive decline, characterized by self-reported cognitive deterioration without measurable cognitive impairment, may be an early indicator of Alzheimer's Disease. This study investigated the association between baseline sleep disturbance and a 10-year trajectory of global cognitive performance in adults with subjective cognitive decline and examined if this association was moderated by age (50-64 years and ≥65 years) and sleep treatment. METHODS: Using six waves (2010-2020) of the Health and Retirement Study, we included individuals aged ≥50 years who reported subjective cognitive decline but had no objective cognitive impairment at baseline (2010) and had the final wave of cognitive data (N = 1372). Latent growth curve modeling was employed to examine the associations between self-reported sleep disturbance and cognitive trajectories from 2010 to 2020, controlling for sociodemographic and health-related factors. RESULTS: In the full sample, baseline sleep disturbance was not significantly associated with cognitive change. However, a significant interaction between sleep disturbance and age group was found (β = -0.04, 95% confidence interval [-0.08, -0.003]). Stratified analyses showed that poorer sleep was associated with faster cognitive decline in those aged ≥65 years (β = -0.04, 95% confidence interval [-0.07, -0.005]; n = 558), and using sleep treatment was associated with a reduced impact of sleep disturbance on cognitive decline (β = 0.31, 95% confidence interval [0.02, 0.60]). These associations were not significant in those aged 50-64 years (n = 814). CONCLUSIONS: Sleep disturbance was an independent risk factor of future cognitive decline in older adults ≥65 years with subjective cognitive decline. Sleep treatment may mitigate this decline, offering a potential intervention strategy.

doi.org/10.1093/sleep/zsaf234 Open access, accepted manuscript PubMed 40801286 Populations