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Changes in Composite Sleep Health and Domain-Specific Cognitive Performance in a Community-Based Sample from Two Predominantly African American Neighborhoods in Pittsburgh, PA

Spenceley, Alex (2021) Changes in Composite Sleep Health and Domain-Specific Cognitive Performance in a Community-Based Sample from Two Predominantly African American Neighborhoods in Pittsburgh, PA. Master Essay, University of Pittsburgh.

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Significant evidence exists suggesting sleep health is critical for cognitive health in old age. However, both sleep and cognitive health change notably in late life. As such, identifying associations between longitudinal changes in multidimensional sleep health (SH) in older adults and domain-specific cognitive performance and may be critical for a complete understanding of aging’s effect on cognition. Comparing risk of cognitive impairment among those whose SH improved with those whose SH declined throughout the study may also show that longitudinal SH changes, rather than cross-sectional measures, are more relevant for risk of cognitive impairment.
Data for this analysis came from the PHRESHZzz and Think PHRESH studies – two ancillaries from the original PHRESH cohort that used a community-based random sampling strategy to enroll participants from two predominantly Black neighborhoods in Pittsburgh, PA. To analyze the association between changing SH and domain-specific cognitive performance, a multidimensional composite SH score was calculated using both subjective and objective measures of several sleep parameters (duration, efficiency, regularity, timing, and satisfaction). Changing SH was modelled using a linear mixed model with SH as the outcome of interest and time as the main predictor. Subject-specific changes in SH (∆SH) were modelled using the coefficients from a linear mixed model. These estimates of ∆SH were then included in a series of univariate linear regressions to determine the association between changing SH and cognition. Odds of cognitive impairment were also assessed using the direction of SH change as a predictor of clinically adjudicated cognitive impairment in a univariate logistic regression. Performance in the executive function (B = 1.67 (95% CI: .35, 3.12)), immediate memory (B = 1.42 (95% CI: .06, 2.84)), and language domains (B = 1.55 (95% CI: .23, 3.01)) were significantly associated with more positive ∆SH scores. The odds of cognitive impairment were lower in the SH improvement group (OR = .632 (95% CI: .37, 1.07) although this result was not statistically significant. The public health significance of this project lies in the underrepresented, underserved study population and the analysis of the relationship between sleep health and cognitive health in old age – two major public health issues.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Spenceley, Alexalex.spenceley@pitt.edualex.spenceley
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairRosso, Andreaalr143@pitt.edualr143UNSPECIFIED
Committee MemberWeinstein, Andreaweinsteinam2@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberTroxel, WendyWendy_Troxel@rand.orgUNSPECIFIEDUNSPECIFIED
Date: 31 August 2021
Date Type: Completion
Number of Pages: 63
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: No
Article Type: Research Article
Date Deposited: 31 Aug 2021 12:45
Last Modified: 31 Aug 2021 12:45


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