Semester Award Granted

Summer 2025

Submission Date

August 2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Thesis/Dissertation Advisor [Chair]

Monica Rosselli

Abstract

Objective: Our aims were to examine differences in sleep quality sub scores and total scores across diagnostic groups cross-sectionally and longitudinally, correlate executive function scores and volumetric biomarkers of AD (prefrontal cortical and hippocampal volumes) with sleep quality scores, and explore how demographic variables may serve to moderate how sleep quality effects diagnosis. Method: 381 participants were classified into 3 diagnostic groups (Cognitively normal (CN), mild cognitive impairment (MCI), and dementia) based on the CDR global score. Prefrontal cortical volume, hippocampal volume, and PSQI total and sub scores were used as predictors of progression status. Daytime dysfunction, sleep duration, and adjusted PSQI global scores were significantly different across diagnostic groups cross sectionally. Within subject effects of subjective sleep quality from baseline to follow-up were found with varied scores across diagnostic groups. Subjective sleep quality, sleep duration, and sleep disturbance scores significantly predicted progressor status, with poorer subjective sleep quality, longer sleep duration, and increased sleep disturbances indicating greater likelihood of cognitive diagnosis progression. Conclusion: we identified cognitive markers for progression in specific sleep quality components. These findings provide further evidence of the benefit of measuring sleep quality in abnormal aging populations and may indicate PSQI sub scores as potential markers of progression to MCI or dementia. It may be recommended for future research to adapt the traditional PSQI to abnormal aging populations, in which longer sleep durations may not be indicative of better sleep quality.

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