Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T13:53:49.173Z Has data issue: false hasContentIssue false
  • English
  • Français

Importance of social relationships in the association between sleep duration and cognitive function: data from community-dwelling older Singaporeans

Published online by Cambridge University Press:  15 June 2017

Grand H.-L. Cheng Open the ORCID record for Grand H.-L. Cheng [Opens in a new window] ,
Angelique Chan  and
June C. Lo
Grand H.-L. Cheng*
Affiliation:
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
Angelique Chan
Affiliation:
Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore Department of Sociology, National University of Singapore, Singapore
June C. Lo
Affiliation:
Centre for Cognitive Neuroscience, Duke-NUS Medical School, Singapore
*
Correspondence should be addressed to: Grand H.-L. Cheng, PhD, Centre for Ageing Research and Education, Duke-NUS Medical School, 8 College Road, 169857Singapore. Phone: +65-6601-5301; Fax: +65-6534-8632. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Aging is accompanied by cognitive decline that is escalated in older adults reporting extreme sleep duration. Social relationships can influence health outcomes and thus may qualify the association between sleep duration and cognitive function. The present study examines the moderating effects of marital status, household size, and social network with friends and relatives on the sleep–cognition association among older adults.

Methods:

Data (N = 4,169) came from the Social Isolation, Health, and Lifestyles Survey, a nationally representative survey of community-dwelling older Singaporeans (≥ 60 years). Sleep duration and social relationships were self-reported. Cognitive function was assessed with the Short Portable Mental Status Questionnaire.

Results:

Regression analysis revealed that the inverted U-shaped association between sleep duration and cognitive function was less profound among older adults who were married (vs. unmarried) and those who had stronger (vs. weaker) social networks. In contrast, it was more prominent among individuals who had more (vs. fewer) household members.

Conclusions:

Being married and having stronger social networks may buffer against the negative cognitive impact of extreme sleep duration. But larger household size might imply more stress for older persons, and therefore strengthen the sleep duration–cognitive function association. We discuss the potential biological underpinnings and the policy implications of the findings. Although our findings are based on a large sample, replication studies using objective measures of sleep duration and other cognitive measures are needed.

Keywords

sleep durationcognitionmarital statushousehold sizesocial network
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 6: Social Health , June 2018 , pp. 893 - 901
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This paper is prepared for the special issue Social Health of International Psychogeriatrics.

Grand Cheng and Angelique Chan have made equal contribution to the paper.

References

Ang, S. and Malhotra, R. (2016). Association of received social support with depressive symptoms among older males and females in Singapore: is personal mastery an inconsistent mediator? Social Science & Medicine, 153, 165–173. doi: 10.1016/j.socscimed.2016.02.019.Google Scholar
Bassuk, S. S., Glass, T. A. and Berkman, L. F. (1999). Social disengagement and incident cognitive decline in community-dwelling elderly persons. Annals of Internal Medicine, 131, 165–173. doi: 10.7326/0003-4819-131-3-199908030-00002.CrossRefGoogle ScholarPubMed
Brannon, L., Feist, J. and Updegraff, J. A. (2014). Health Psychology: An Introduction to Behavior and Health. Belmont, CA: Wadsworth/Cengage Learning.Google Scholar
Brewster, G. S., Varrasse, M. and Rowe, M. (2015). Sleep and cognition in community-dwelling older adults: a review of literature. Healthcare (Basel), 3, 1243–1270. doi: 10.3390/healthcare3041243.Google Scholar
Carstensen, L. L. (2006). The influence of a sense of time on human development. Science, 312, 1913–1915. doi: 10.1126/science.1127488.Google Scholar
Chan, A., Malhotra, C., Malhotra, R. and Ostbye, T. (2011). Living arrangements, social networks and depressive symptoms among older men and women in Singapore. International Journal of Geriatric Psychiatry, 26, 630–639. doi: 10.1002/gps.2574.Google Scholar
Cohen, J., Cohen, P., West, S. G. and Aiken, L. S. (2002). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Mahwah, NJ: L. Erlbaum Associates.Google Scholar
Enders, C. K. (2010). Applied Missing Data Analysis. New York, NY: Guilford Press.Google Scholar
Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196, 129–136. doi: 10.1126/science.847460.Google Scholar
Faubel, R., Lopez-Garcia, E., Guallar-Castillon, P., Graciani, A., Banegas, J. R. and Rodriguez-Artalejo, F. (2009). Usual sleep duration and cognitive function in older adults in Spain. Journal of Sleep Research, 18, 427–435. doi: 10.1111/j.1365-2869.2009.00759.x.Google Scholar
Fillenbaum, G. G., Landerman, L. R. and Simonsick, E. M. (1998). Equivalence of two screens of cognitive functioning: the short portable mental status questionnaire and the orientation-memory-concentration test. Journal of the American Geriatrics Society, 46, 1512–1518. doi: 10.1111/j.1532-5415.1998.tb01535.x.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Gu, D., Dupre, M. E., Sautter, J., Zhu, H., Liu, Y. and Yi, Z. (2009). Frailty and mortality among Chinese at advanced ages. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 64, 279–289. doi: 10.1093/geronb/gbn009.Google Scholar
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: Guilford Press.Google Scholar
Hirshkowitz, M. et al. (2015). National sleep foundation's sleep time duration recommendations: methodology and results summary. Sleep Health, 1, 40–43. doi: 10.1016/j.sleh.2014.12.010.CrossRefGoogle ScholarPubMed
Hunter, J. E. and Schmidt, F. L. (2004). Methods of Meta-Analysis: Correcting Error and Bias in Research Findings. Thousand Oaks, CA: Sage.Google Scholar
Kohout, F. J., Berkman, L. F., Evans, D. A. and Cornoni-Huntley, J. (1993). Two shorter forms of the CES-D depression symptoms index. Journal of Aging and Health, 5, 179–193. doi: 10.1177/089826439300500202.Google Scholar
Kronholm, E., Sallinen, M., Suutama, T., Sulkava, R., Era, P. and Partonen, T. (2009). Self-reported sleep duration and cognitive functioning in the general population. Journal of Sleep Research, 18, 436–446. doi: 10.1111/J.1365-2869.2009.00765.X.Google Scholar
Lo, J. C., Groeger, J. A., Cheng, G. H.-L., Dijk, D. J. and Chee, M. W. (2016). Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Medicine, 17, 87–98. doi: 10.1016/j.sleep.2015.08.021.Google Scholar
Lo, J. C., Loh, K. K., Zheng, H., Sim, S. K. Y. and Chee, M. W. L. (2014). Sleep duration and age-related changes in brain structure and cognitive performance. Sleep, 37, 1171–1178. doi:10.5665/sleep.3832.Google Scholar
Loerbroks, A., Debling, D., Amelang, M. and Stürmer, T. (2010). Nocturnal sleep duration and cognitive impairment in a population-based study of older adults. International Journal of Geriatric Psychiatry, 25, 100–109. doi: 10.1002/gps.2305.Google Scholar
Lubben, J. and Gironda, M. (2003). Centrality of social ties to the health and well-being of older adults. In Berkman, B. and Harootyan, L. (eds.), Social Work and Health Care in an Aging Society (pp. 319–345). New York, NY: Springer.Google Scholar
Malhotra, C., Chan, A., Matchar, D., Seow, D., Chuo, A. and Do, Y. K. (2013a). Diagnostic performance of short portable mental status questionnaire for screening dementia among patients attending cognitive assessment clinics in Singapore. Annals of the Academy of Medicine, Singapore, 42, 315–319.CrossRefGoogle ScholarPubMed
Malhotra, R., Chan, A. and Ostbye, T. (2010b). Prevalence and correlates of clinically significant depressive symptoms among elderly people in Sri Lanka: findings from a national survey. International Psychogeriatrics, 22, 227–236. doi: 10.1017/S1041610209990871.Google Scholar
Malhotra, R., Chan, A., Malhotra, C. and Ostbye, T. (2010a). Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore. Hypertension Research, 33, 1223–1231. doi: 10.1038/hr.2010.177.Google Scholar
Malhotra, R., Haaland, B. A., Chei, C. L., Chan, A., Malhotra, C. and Matchar, D. B. (2015). Presence of and correction for interviewer error on an instrument assessing cognitive function of older adults. Geriatrics & Gerontology International, 15, 372–380. doi: 10.1111/ggi.12331.Google Scholar
Malhotra, R., Malhotra, C., Chan, A. and Ostbye, T. (2013b). Life-course socioeconomic status and obesity among older Singaporean Chinese men and women. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 68, P117–P127. doi: 10.1093/geronb/gbs102.Google Scholar
Nagi, S. Z. (1976). An epidemiology of disability among adults in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 54, 439–467. doi: 10.2307/3349677.Google Scholar
Ng, T. P., Feng, L., Nyunt, M. S. Z., Larbi, A. and Yap, K. B. (2014). Frailty in older persons: multisystem risk factors and the Frailty Risk Index (FRI). Journal of the American Medical Directors Association, 15, 635–642. doi: 10.1016/j.jamda.2014.03.008.Google Scholar
Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433–441. doi: 10.1037/t04145-000.Google Scholar
Qiu, L., Sautter, J., Liu, Y. and Gu, D. (2011). Age and gender differences in linkages of sleep with subsequent mortality and health among very old Chinese. Sleep Medicine, 12, 1008–1017. doi: 10.1016/j.sleep.2011.04.014.Google Scholar
Rockwood, K., Mitnitski, A., Song, X., Steen, B. and Skoog, I. (2006). Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. Journal of the American Geriatrics Society, 54, 975–979. doi: 10.1111/j.1532-5415.2006.00738.x.Google Scholar
Seeman, T. E. and McEwen, B. S. (1996). Impact of social environment characteristics on neuroendocrine regulation. Psychosomatic Medicine, 58, 459–471. doi: 10.1097/00006842-199609000-00008.Google Scholar
Sims, R. C., Hosey, M., Levy, S. A., Whitfield, K. E., Katzel, L. I. and Waldstein, S. R. (2014). Distinct functions of social support and cognitive function among older adults. Experimental Aging Research, 40, 40–59. doi: 10.1080/0361073x.2014.857551.CrossRefGoogle ScholarPubMed
Sims, R. C., Levy, S. A., Mwendwa, D. T., Callender, C. O. and Campbell, A. L. Jr. (2011). The influence of functional social support on executive functioning in middle-aged African Americans. Aging, Neuropsychology and Cognition, 18, 414–431. doi: 10.1080/13825585.2011.567325.Google Scholar
Singapore Department of Statistics (2015). Population trends 2015. http://www.singstat.gov.sg/publications/publications-and-papers/population-and-population-structure/population-trends; last accessed 3 April 2016.Google Scholar
Singapore Housing and Development Board (2016). Priority schemes. http://www.hdb.gov.sg/cs/infoweb/residential/buying-a-flat/new/priority-schemes&rendermode=preview; last accessed 3 April 2016.Google Scholar
Singapore National Population and Talent Division (2013). A sustainable population for a dynamic Singapore: population white paper. http://population.sg/whitepaper/resource-files/population-white-paper.pdf; last accessed 23 October, 2015.Google Scholar
Starkman, M. N., Giordani, B., Berent, S., Schork, M. A. and Schteingart, D. E. (2001). Elevated cortisol levels in Cushing's disease are associated with cognitive decrements. Psychosomatic Medicine, 63, 985–993. doi: 10.1097/00006842-200111000-00018.Google Scholar
van Gelder, B. M., Tijhuis, M., Kalmijn, S., Giampaoli, S., Nissinen, A. and Kromhout, D. (2006). Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: the FINE Study. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 61, P213–P219. doi: 10.1093/geronb/61.4.p213.Google Scholar
Xu, L. et al. (2011). Short or long sleep duration is associated with memory impairment in older Chinese: the Guangzhou Biobank Cohort Study. Sleep, 34, 575–580.Google Scholar
Yang, Y. C., Schorpp, K. and Harris, K. M. (2014). Social support, social strain and inflammation: evidence from a national longitudinal study of U.S. adults. Social Science & Medicine, 107, 124–135. doi: 10.1016/j.socscimed.2014.02.013.Google Scholar
Yeh, S.-C. J. and Liu, Y.-Y. (2003). Influence of social support on cognitive function in the elderly. BMC Health Services Research, 3, 9. doi: 10.1186/1472-6963-3-9.Google Scholar