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      Association between sleep parameters and longitudinal shortening of telomere length

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          Abstract

          Background: The relationship between sleep parameters and longitudinal shortening of telomere length is unclear. This study aimed to investigate the relationship between sleep parameters and the shortening of leukocyte telomere length (LTL) over a year.

          Methods: Among the participants in the validation cohort of the Korea Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease, participants who measured both baseline and follow-up (two years later) of LTL were analyzed. They were dichotomized according to the degree of LTL attrition over two years. Clinical characteristics were compared between the faster and slower LTL shortening groups (cut-off points: −0.710 kbp, n = 119 each). Multivariable logistic regression analyses were performed to determine independent relationships between faster shortening of LTL length and sleep parameters.

          Results: A total of 238 participants, aged 55–88 years, were included. Participants with faster LTL shortening had a shorter duration of sleep ( P = 0.013) and longer sleep latency ( P = 0.007). Among the components of the PSQI, subjective measures of sleep quality, sleep latency, sleep duration, and sleep efficiency were significantly worse in participants with faster LTL shortening. Multivariate logistic regression analysis showed that sleep duration (per hour, OR = 0.831, 95% CI = 0.698–0.989), sleep latency (per minute, OR = 1.013, 95% CI = 1.002–1.024), global PSQI score (OR = 1.134, 95% CI = 1.040–1.236), shortest sleep duration (OR = 5.173, 95% CI = 1.563–17.126), and lowest sleep efficiency (OR = 7.351, 95% CI = 1.943–27.946) were independently associated with faster LTL shortening.

          Conclusions: Poor sleep quality, specifically short sleep duration, long sleep latency, and low sleep efficiency were associated with faster longitudinal shortening of LTL.

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          Most cited references46

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          A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

          Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis.
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            The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

            Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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              NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease

              In 2011, the National Institute on Aging and Alzheimer’s Association created separate diagnostic recommendations for the preclinical, mild cognitive impairment, and dementia stages of Alzheimer’s disease. Scientific progress in the interim led to an initiative by the National Institute on Aging and Alzheimer’s Association to update and unify the 2011 guidelines. This unifying update is labeled a “research framework” because its intended use is for observational and interventional research, not routine clinical care. In the National Institute on Aging and Alzheimer’s Association Research Framework, Alzheimer’s disease (AD) is defined by its underlying pathologic processes that can be documented by postmortem examination or in vivo by biomarkers. The diagnosis is not based on the clinical consequences of the disease (i.e., symptoms/signs) in this research framework, which shifts the definition of AD in living people from a syndromal to a biological construct. The research framework focuses on the diagnosis of AD with biomarkers in living persons. Biomarkers are grouped into those of β amyloid deposition, pathologic tau, and neurodegeneration [AT(N)]. This ATN classification system groups different biomarkers (imaging and biofluids) by the pathologic process each measures. The AT(N) system is flexible in that new biomarkers can be added to the three existing AT(N) groups, and new biomarker groups beyond AT(N) can be added when they become available. We focus on AD as a continuum, and cognitive staging may be accomplished using continuous measures. However, we also outline two different categorical cognitive schemes for staging the severity of cognitive impairment: a scheme using three traditional syndromal categories and a six-stage numeric scheme. It is important to stress that this framework seeks to create a common language with which investigators can generate and test hypotheses about the interactions among different pathologic processes (denoted by biomarkers) and cognitive symptoms. We appreciate the concern that this biomarker-based research framework has the potential to be misused. Therefore, we emphasize, first, it is premature and inappropriate to use this research framework in general medical practice. Second, this research framework should not be used to restrict alternative approaches to hypothesis testing that do not use biomarkers. There will be situations where biomarkers are not available or requiring them would be counterproductive to the specific research goals (discussed in more detail later in the document). Thus, biomarker-based research should not be considered a template for all research into age-related cognitive impairment and dementia; rather, it should be applied when it is fit for the purpose of the specific research goals of a study. Importantly, this framework should be examined in diverse populations. Although it is possible that β-amyloid plaques and neurofibrillary tau deposits are not causal in AD pathogenesis, it is these abnormal protein deposits that define AD as a unique neurodegenerative disease among different disorders that can lead to dementia. We envision that defining AD as a biological construct will enable a more accurate characterization and understanding of the sequence of events that lead to cognitive impairment that is associated with AD, as well as the multifactorial etiology of dementia. This approach also will enable a more precise approach to interventional trials where specific pathways can be targeted in the disease process and in the appropriate people.
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                Author and article information

                Journal
                Aging (Albany NY)
                Aging
                Aging (Albany NY)
                Impact Journals
                1945-4589
                15 April 2022
                02 April 2022
                : 14
                : 7
                : 2930-2944
                Affiliations
                [1 ]Department of Neurology, Hanyang University College of Medicine, Guri, Republic of Korea
                [2 ]Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea
                [3 ]Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
                [4 ]Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
                [5 ]Department of Neurology, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Republic of Korea
                [6 ]Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
                [7 ]Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
                [8 ]Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
                [9 ]Department of Neurology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea
                [10 ]Department of Neurology, Konyang University College of Medicine, Daejeon, Republic of Korea
                [11 ]GemVax & Kael Co. Ltd., Seongnam, Republic of Korea
                [12 ]Department of Laboratory Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
                [13 ]Department of Neurosurgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
                Author notes
                [*]

                Equal contribution

                Correspondence to: Seong Hye Choi; email: seonghye@inha.ac.kr
                Correspondence to: Seong-Ho Koh; email: ksh213@hanyang.ac.kr
                Article
                203993 203993
                10.18632/aging.203993
                9037260
                35366243
                43ad97f2-b600-45e8-9eff-e7dfe117bddd
                Copyright: © 2022 Jin et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 August 2021
                : 24 March 2022
                Categories
                Research Paper

                Cell biology
                sleep quality,telomere length,amyloid pathology,aging,sleep duration
                Cell biology
                sleep quality, telomere length, amyloid pathology, aging, sleep duration

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