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- Creators: School of Life Sciences
Sleep is imperative for health and wellness with direct impacts on brain function, physiology, emotional well-being, performance and safety when compromised. Adolescents and young adults are increasingly affected by factors affecting the maintenance of regular sleep schedules. College and university students are a potentially vulnerable population to sleep deprivation and sleep insufficiency. Possible factors that could contribute to poor sleep hygiene include, but are not limited to, academic pressures, social activities, and increased screen time. Arguably, students are still experiencing bone mineralization, until the age of 30 or even 40 years old, which makes it more important to understand the effects that altered sleep patterns could have on continued development of bone health. It is our understanding that to date, studies assessing the risk of sleep insufficiency on bone mineral density in college students have not been conducted. We hypothesized that college-aged students, between the ages of 18-25 years, with shorter sleep durations, greater sleep schedule variability, and poorer sleep environments will have significantly lower bone mineral density. ActiGraph monitoring, via a wrist ActiWatch was used to quantitatively measure sleep habits for up to 7 consecutive days. During the week-long study participants also captured their self-reported sleep data through the use of a sleep diary. Participants were measured one time within the study for bone mineral density of the lumbar spine and total hip through a dual energy x-ray absorptiometry. This was a preliminary analysis of a larger cross-sectional analysis looked at 17 participants, of which there were 14 females and 3 males, (n=5, 1 and 11 Hispanic, Black and White, respectively). The mean age of participants was 20.8±1.7 y with an average BMI of 22.9±3.2 kg/m2. ActiWatch measurement data showed a mean daily sleep duration of participants to be 437.5 ± 43.1 (372.5 – 509.4) minutes. Mean sleep efficiency (minutes of sleep divided by minutes of time in bed) and mean number of awakenings were 87.4±4.3 (75.4-93.4) minutes and 32.1±6.4 (22.3-42.7) awakenings, respectively. The median time for wake after sleep onset (WASO) was 34.5±10.5 (18.3-67.4) minutes. The mean bone mineral density (BMD) for the hips was 1.06±0.14 (0.81-1.28) g/cm2 with a mean BMD of the lumbar spine being 1.24±0.12 (0.92-1.43) g/cm2. Age-matched Z-scores of the hips was 0.31±0.96 (-1.6-2.1) and lumbar spine was 0.53 (IQR: 0.13, 0.98; -2.25-1.55). Neither sleep duration nor sleep efficiency was significantly correlated to BMD of either locations. While WASO was positively associated with hip and spine BMD, this value was not statistically significant in this population. Overall, associations between sleep and BMD of the femur and spine were not seen in this cohort. Further work utilizing a larger cohort will allow for control of covariates while looking for potential associations between bone health, sleep duration and efficiency.
Survivors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) often experience chronic symptoms that include fatigue, shortness of breath, and brain fog. The collection of ongoing post-COVID-19 symptoms have been classified as Post-Acute Sequela of SARS-CoV-2 (PASC). Older adult patients are especially susceptible to experiencing PASC related complications and have a high risk for long-term cognitive impairment symptoms. Definitions for categorizing PASC- associated cognitive impairment and neuropsychological assessments used to evaluate cognitive impairment are inconsistent between studies examining older adults. This systematic review aims to identify which neuropsychological tests best identify cognitive impairments associated with PASC and suggest a guide to standardize the measurement of PASC-related cognitive impairments. Through a literature search using PubMed, we included within this review 14 studies that fulfilled our inclusion and exclusion criteria evaluating middle-aged and older adult populations affected by PASC-associated cognitive impairments. The majority of the studies used tests designed to screen for general cognitive function to test for the prevalence of cognitive impairment, with the most common one being Montreal Cognitive Assessment (MoCA), followed by MMSE and TICS. MoCA reported the highest prevalence of the general cognitive screeners which suggests higher sensitivity and specificity. Telephone Interview for Cognitive Status (TICS) demonstrated similar scores as MoCA despite administration being remote while MMSE identified the lowest prevalence. Four studies also used domain-specific cognitive evaluations and reported instances of cognitive impairment in individuals who had previously tested healthy. Furthermore, the results gathered in this review were stratified based on disease symptom severity. This review identifies MoCA to be better suited for evaluating general cognitive impairment in older adults. TICS has the added utility in being able to access a wider range of older adults through remote screening. Disease severity must be clearly defined to allow better comparisons between studies and allow for standardization. Early identification of PASC-associated cognitive impairment in middle-aged and older adults can be performed using general cognitive function evaluations and administering a baseline cognitive evaluation one month after infection is suggested.