Longitudinal sleep duration patterns and their association with cognitive decline in older Chinese adults

INTRODUCTION Associations between sleep duration and cognitive decline are inconsistent, and the value of longitudinal changes versus static measurements remains unclear. METHODS We identified longitudinal sleep patterns in 4780 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) using K‐means clustering. Linear mixed‐effects models and Cox models assessed cognitive decline and incident dementia risk over 10 years. RESULTS The “Consistently Long” pattern showed the fastest cognitive decline ( β = −0.027 standard deviation/year; p < 0.001) and highest cumulative dementia incidence. Conversely, patterns trending toward healthy duration slowed decline. However, adjusted Cox models found no significant association between sleep patterns and incident dementia risk. DISCUSSION The trajectory of sleep duration, particularly the direction of change, is a powerful correlate of cognitive decline. Monitoring long‐term dynamics outperforms static assessments for identifying high‐risk older adults.