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Objective <p>This study investigated the relationship between sleep duration and cognitive decline trajectories among Chinese adults with age ≥ 45. Additionally, it examined whether baseline depression symptoms mediated the association between sleep duration and cognitive decline trajectories.</p> Methods <p>Data came from the China Health and Retirement Longitudinal Study (CHARLS), a nationally survey of Chinese adults. Total sleep duration was grouped into shorter (≤ 6&#xa0;h), normal (6–9&#xa0;h), and longer (&gt; 9&#xa0;h). Nighttime sleep duration was categorized as shorter (≤ 6&#xa0;h), normal (6–8&#xa0;h), and longer (&gt; 8&#xa0;h). Daytime nap duration was classified into no nap, shorter (≤ 0.5&#xa0;h), normal (0.5–1.5&#xa0;h), and longer (&gt; 1.5&#xa0;h). Cognitive decline trajectories were identified using a group-based trajectory model (GBTM). Depression symptoms, measured by baseline depression scores, were included as a potential mediating variable. Multinomial logistic regression models were applied to analyze the association between sleep duration and cognitive trajectories.</p> Results <p>A total of 4,094 respondents were included. Participants were classified into three trajectory groups: high-level stable (<i>n</i> = 1,278, 31.2%), moderate-level slow-decline (<i>n</i> = 2,089, 51.0%), and low-level rapid-decline (<i>n</i> = 727, 17.8%). Compared to the stable group, shorter total sleep duration was associated with both rapid-decline (<i>RRR</i>:1.510; 95%<i>CI</i>:1.079,2.114) and slow-decline (<i>RRR</i>:1.466; 95%<i>CI</i>:1.145,1.877) cognitive trajectories. Similarly, shorter nighttime sleep duration was associated with both rapid-decline (<i>RRR</i>:1.572; 95%<i>CI</i>: 1.089,2.271) and slow-decline (<i>RRR</i>:1.480; 95%<i>CI</i>:1.129,1.939) cognitive trajectories compared to the stable group. Baseline depression symptoms did not mediate these relationships (<i>P</i> &gt; 0.05).</p> Conclusions <p>Shorter total sleep duration (≤ 6&#xa0;h) and shorter nighttime sleep duration (≤ 6&#xa0;h) were significantly associated with cognitive decline trajectories. However, baseline depression symptoms did not mediate these relationships.</p>

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Association between sleep duration, depression and cognitive decline trajectories: findings from a prospective cohort study in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月1日

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  • Chenyu Li,
  • Xiaomin Wu,
  • Yu Li,
  • Meilin Zhang,
  • Luhan Zhang,
  • Chaohui Zhou,
  • Fei Ma

摘要

Objective

This study investigated the relationship between sleep duration and cognitive decline trajectories among Chinese adults with age ≥ 45. Additionally, it examined whether baseline depression symptoms mediated the association between sleep duration and cognitive decline trajectories.

Methods

Data came from the China Health and Retirement Longitudinal Study (CHARLS), a nationally survey of Chinese adults. Total sleep duration was grouped into shorter (≤ 6 h), normal (6–9 h), and longer (> 9 h). Nighttime sleep duration was categorized as shorter (≤ 6 h), normal (6–8 h), and longer (> 8 h). Daytime nap duration was classified into no nap, shorter (≤ 0.5 h), normal (0.5–1.5 h), and longer (> 1.5 h). Cognitive decline trajectories were identified using a group-based trajectory model (GBTM). Depression symptoms, measured by baseline depression scores, were included as a potential mediating variable. Multinomial logistic regression models were applied to analyze the association between sleep duration and cognitive trajectories.

Results

A total of 4,094 respondents were included. Participants were classified into three trajectory groups: high-level stable (n = 1,278, 31.2%), moderate-level slow-decline (n = 2,089, 51.0%), and low-level rapid-decline (n = 727, 17.8%). Compared to the stable group, shorter total sleep duration was associated with both rapid-decline (RRR:1.510; 95%CI:1.079,2.114) and slow-decline (RRR:1.466; 95%CI:1.145,1.877) cognitive trajectories. Similarly, shorter nighttime sleep duration was associated with both rapid-decline (RRR:1.572; 95%CI: 1.089,2.271) and slow-decline (RRR:1.480; 95%CI:1.129,1.939) cognitive trajectories compared to the stable group. Baseline depression symptoms did not mediate these relationships (P > 0.05).

Conclusions

Shorter total sleep duration (≤ 6 h) and shorter nighttime sleep duration (≤ 6 h) were significantly associated with cognitive decline trajectories. However, baseline depression symptoms did not mediate these relationships.