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Depressive symptoms and cognitive decline in aging: is sleep a possible modulator?

  • Andre C. Boin, Universidade Federal de Sao Pauloandre.c.boin@gmail.com
  • Camila Hirotsu, Sao Paulo, Brazil, Monica Levy Andersen, Sao Paulo, Brazil and Sergio Tufik, Sao Paulo, Brazil
Submitted September 08, 2014

We applaud Wilson et al. on their longitudinal research showing a novel model for cognitive decline in which depressive symptoms may play an essential role. [1] We would like to suggest the importance of sleep as a factor that also contributes in this depression-cognitive relationship.

Sleep could be an important confounding factor for cognitive evaluation in elderly population, since evidence has shown that both acute and chronic sleep deprivation may lead to deterioration in cognitive performance. [2] Moreover, sleep architecture changes across aging: sleep efficiency, percentage of slow wave sleep, and REM sleep decrease gradually. [3] Aging itself increases the risk of some sleep disorders, such as insomnia, which, in turn, is related to both depression and cognition. [4]

Recently a study showed that sleep plays an important role in the clearance of brain beta-amyloid protein, [5] and the possibility that such impairment across a lifespan closely relates to cognitive decline. Thus, the assessment of sleep would be essential in this research. Sleep evaluation is important in further protocol design since it may modulate the neuropathological manifestations of dementia.

1. Wilson RS, Capuano AW, Boyle PA, et al. Clinical-pathologic study of depressive symptoms and cognitive decline in old age. Neurology 2014;83:702-709.

2. Lo JC, Groeger JA, Santhi N, et al. Effects of partial and acute total sleep deprivation on performance across cognitive domains, individuals and circadian phase. PLoS One 2012;7:e45987.

3. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255-1273

4. Koffel EA, Koffel JB, Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep Med Rev Epub 2014 May 14.

5. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science 2013;342:373-377.

For disclosures, contact the editorial office at journal@neurology.org.

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Neurology | Print ISSN:0028-3878
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