Abstract Introduction Sleep disturbances are common among older adults and have been linked to adverse health outcomes, including cognitive impairment. However, sleep is rarely assessed before major surgery in older patients, and it remains unclear whether preoperative sleep quality is associated with postoperative cognitive decline. Methods We analyzed data from an ongoing prospective cohort of older adults (≥ 70y) undergoing surgery, including knee, hip, spine, general, and vascular procedures (n= 34). Preoperative sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at one week before surgery (baseline). Cognitive function was measured using a modified version of the Montreal Cognitive Assessment (MoCA) at baseline and 1 month postoperatively, with scores ranging from 0 to 22. Linear regression models were used to examine associations between preoperative sleep quality and ΔMoCA (difference between 1-month and baseline). Model adjusted for baseline MoCA score, age, sex, and surgical type. Results Mean MoCA score at baseline was 19.38 (SD 2.06), and mean MoCA score at 1 month after surgery was 20.50 (SD 1.26), resulting in a mean ΔMoCA of 1.12 (SD 1.68), suggesting a trend towards postoperative cognitive recovery. Poorer preoperative sleep quality predicted smaller postoperative cognitive gains. In the adjusted model, each 1-SD increase in PSQI score was associated with a 0.48-point smaller ΔMoCA score (β = -0.48, p 0.001). Age, sex, and surgical type were not significantly associated with cognition change (all p 0.05), whereas a higher baseline MoCA score was associated with smaller improvement (β = -0.74, p 0.001). Conclusion Poor preoperative sleep quality is associated with worse short-term postoperative cognitive recovery in older adults. These preliminary findings highlight perioperative sleep health as a potential modifiable factor in cognitive recovery. Future analyses with the completed target cohort of 150 patients, longer follow-up, and objective sleep measures will provide a more comprehensive understanding of the relationship between sleep and cognitive trajectories. Support (if any) Alzheimer's Association Clinician Scientist Fellowship (AACSF-23-1148490, LG)
Cai et al. (Fri,) studied this question.