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Causal effect of sleep disturbance on cognitive decline in older adults

Jiao, Yuanyuan (2018) Causal effect of sleep disturbance on cognitive decline in older adults. Master's Thesis, University of Pittsburgh. (Unpublished)

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Prior studies have shown that sleep disturbance is closely associated with cognitive decline in older adults. However, one cannot use standard regression models to verify the causal relationship between sleep disorder and cognitive dysfunction. In this study, by combining propensity score weighting and honest causal tree technique, we balanced baseline characteristics between individuals with and without a certain type of sleep disorder, effectively partitioned older adults into groups based on the baseline conditions, and estimated heterogeneity in sleep disturbance impacts on cognitive function. We analyzed the data collected from the first nine waves of an ongoing community-based cohort study and the propensity score weighting causal tree model showed the causal effect of sleep disturbance on cognitive decline in various types of sleep disorder and cognitive domains. Sleep disorders caused faster decline in the memory and visuospatial domains. In addition, these causal relationship showed different effects among people with different sociodemigraphic or baseline health conditions, including age, gender, self-reported general health, systolic blood pressure (BP), diastolic BP, exercise, subjective memory complaint, and other baseline cognitive domain scores. Our findings advance the knowledge in cognitive dysfunction among the elderly and allow us to validate sleep disturbance as a therapeutic target for treating cognitive decline in older adults.
PUBLIC HEALTH SIGNIFICANCE: Sleep deprivation and cognitive impairment are common among older adults yet the causal relationship between sleep disturbance and cognitive decline remains controversial. Causal tree method employed in this study directly clarified the causal effect of sleep deprivation on cognitive degeneration, thus improves our understanding of the underlying mechanisms for cognitive impairment among the elderly also helps clinicians with diagnosis and prognosis. In addition, the modifiable moderators examined in this study can help clinicians and public health practitioners find appropriate prevention and treatments for sleep disturbances.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Jiao, Yuanyuanyuj13@pitt.eduyuj13
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairChang, Chung-Chou
Committee MemberDing,
Committee MemberCheng,
Date: 8 August 2018
Date Type: Submission
Defense Date: 8 August 2018
Approval Date: 20 September 2018
Submission Date: 4 June 2018
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 63
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: sleep disturbance, cognitive decline, older adults
Date Deposited: 20 Sep 2018 21:20
Last Modified: 01 Sep 2020 05:15


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