0083 You Don’t Snooze, You Lose (Awareness): Sleep’s Role on Awareness of Cognition in Mild Cognitive Impairment

Abstract Introduction In adults with Mild Cognitive Impairment (prodromal phase of Alzheimer’s disease; MCI), the level of awareness of cognitive functioning varies significantly. A lack of awareness of cognitive functioning may interfere with monitoring of disease progression and opportunities for intervention. Therefore, understanding mechanisms associated with this relationship is critical. Given age-related changes in sleep and known relationships between sleep health and cognition, this pilot tested whether sleep moderates associations between subjective and objective cognition in older adults with MCI. Methods Older adults with MCI (N=46, Mage=68.2 years, SD=6.1 years, 33 women) completed one week of sleep diaries averages of sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE), Cognitive Failures Questionnaire (sub-scores CFQ-memory, CFQ-distractibility, CFQ-blunders), and cognitive tasks Cambridge Brain Sciences; Polygons (processing speed), Feature Match (attention), Double Trouble (attention/inhibition), Digit Span (working memory). Multiple regressions tested if sleep parameters moderated associations between subjective and objective cognition, covarying for depressive symptoms and number of medical conditions. Results SE moderated associations between Polygons and CFQ-blunders (R2-change=.08, p=.03). Specifically, at highest SE, slower processing speed was associated with more blunder complaints (B=-.10, p=.04). Additionally, SE moderated associations between Digit Span and CFQ-distractibility (R2-change=.06, p=.03) and CFQ-blunders (R2-change=.12, p=.004). Specifically, at lowest SE, worse working memory was associated with less distractibility (B=3.01, p=.002) and blunders (B=2.45, p.001) complaints, while at highest SE worse working memory was associated with more blunder complaints (B=-2.48, p=.04). Conclusion Preliminary findings suggest in older adults with MCI, lower sleep efficiency may exacerbate discrepancies between objective and subjective cognition, while higher sleep efficiency may converge this relationship. Sleep efficiency should be considered to fully understand the level of awareness of cognitive functioning in older adults with MCI. Critically, these findings may help identify those at risk of further cognitive decline. While future prospective studies are warranted, present findings suggest a potential next step is to examine whether behavioral treatments for insomnia (e.g., Cognitive Behavioral Therapy for Insomnia, cognitive training) may also change the relationship between objective/subjective cognition. Support (if any) This research was supported in part by the University of Missouri School of Medicine TRIUMPH award (PI: Curtis).