Importance Disrupted sleep is common in aging and is associated with cognition. Age-related changes to sleep are associated with multiple causes, including early Alzheimer disease pathology (amyloid β [Aβ]), depression, and cardiovascular disease. Objective To investigate the associations between self-reported sleep duration and brain Aβ burden as well as the demographic, cognitive, and lifestyle variables in adults with normal cognition. Design, Setting, and Participants This cross-sectional study obtained data from participants in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study, which is being conducted in 67 sites in the United States, Canada, Australia, and Japan. The sample for this analysis consisted of individuals aged 65 to 85 years who underwent an Aβ positron emission tomography (PET) scan, had complete apolipoprotein E (APOE) genotype data, and were identified as clinically normal (per a Clinical Dementia Rating score of 0) and cognitively unimpaired (per a Mini-Mental State Examination score of 25 to 30 and Logical Memory Delayed Recall test score of 6 to 18). Data were analyzed from April 3, 2020, to June 20, 2021. Main Outcomes and Measures The outcome was self-reported nightly sleep duration (grouped by short sleep duration: ≤6 hours, normal sleep duration: 7-8 hours, and long sleep duration: ≥9 hours) compared with demographic characteristics, Aβ burden (as measured with a fluorine 18-labeled-florbetapir PET scan), objective and subjective cognitive function measures, and lifestyle variables. Results The 4417 participants in the study included 2618 women (59%) and had a mean (SD) age of 71.3 (4.7) years. Self-reported shorter sleep duration was linearly associated with higher Aβ burden (β [SE] = -0.01 [0.00]; P = .005), and short sleep duration was associated with reduced cognition that was mostly in memory domains. No difference in Aβ was found between long and normal sleep duration groups (β [SE] = 0.00 [0.01]; P = .99). However, compared with normal sleep duration, both short and long sleep durations were associated with higher body mass index (short vs normal sleep duration: β [SE] = 0.48 [0.17], P = .01; long vs normal sleep duration: β [SE] = 0.97 [0.31], P = .002), depressive symptoms (short vs normal sleep duration: β [SE] = 0.31 [0.05], P < .001; long vs normal sleep duration: β [SE] = 0.39 [0.09], P < .001), and daytime napping (short vs normal sleep duration: β [SE] = 2.66 [0.77], P = .001; long vs normal sleep duration: β [SE] = 3.62 [1.38], P = .01). Long sleep duration was associated with worse performance across multiple cognitive domains. Conclusions and Relevance In this cross-sectional study, both short and long sleep durations were associated with worse outcomes for older adults, such as greater Aβ burden, greater depressive symptoms, higher body mass index, and cognitive decline, emphasizing the importance of maintaining adequate sleep.

中文翻译：

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短期和长期睡眠时间与 Amyloid-β 负荷和衰老认知的关联。

重要性 睡眠中断在衰老中很常见，并且与认知有关。与年龄相关的睡眠变化与多种原因有关，包括早期阿尔茨海默病病理学（淀粉样蛋白 β [Aβ]）、抑郁症和心血管疾病。目的 探讨认知正常的成年人自我报告的睡眠时间与脑 Aβ 负荷以及人口统计学、认知和生活方式变量之间的关联。设计、设置和参与者 这项横断面研究从无症状阿尔茨海默病 (A4) 研究的参与者那里获得数据，该研究在美国、加拿大、澳大利亚和日本的 67 个地点进行。该分析的样本包括接受 Aβ 正电子发射断层扫描 (PET) 扫描的 65 至 85 岁的个体，具有完整的载脂蛋白 E (APOE) 基因型数据，被确定为临床正常（临床痴呆评分为 0）和认知未受损（根据简易精神状态检查评分为 25 至 30 分和逻辑记忆延迟回忆测试评分为6 至 18)。数据分析时间为 2020 年 4 月 3 日至 2021 年 6 月 20 日。 主要结果和措施 结果为自我报告的夜间睡眠时间（按睡眠时间短：≤6 小时、正常睡眠时间：7-8 小时和长睡眠时间：≥9 小时）与人口统计学特征、Aβ 负荷（用氟 18 标记的 florbetapir PET 扫描测量）、客观和主观认知功能测量以及生活方式变量进行比较。结果 该研究的 4417 名参与者包括 2618 名女性 (59%)，平均 (SD) 年龄为 71.3 (4.7) 岁。自我报告的较短睡眠时间与较高的 Aβ 负荷呈线性相关（β [SE] = -0.01 [0.00]；P = .005），睡眠时间短与主要在记忆域中的认知能力下降相关。长睡眠时间组和正常睡眠时间组之间的 Aβ 没有差异（β [SE] = 0.00 [0.01]；P = .99）。然而，与正常睡眠时间相比，短睡眠时间和长睡眠时间都与较高的体重指数相关（短睡眠时间与正常睡眠时间：β [SE] = 0.48 [0.17]，P = .01；长睡眠时间与正常睡眠时间：β [SE] = 0.97 [0.31], P = .002)，抑郁症状（短与正常睡眠持续时间：β [SE] = 0.31 [0.05]，P < .001；长与正常睡眠持续时间：β [SE] = 0.39 [0.09]，P < .001）和白天小睡（短与正常睡眠时间：β [SE] = 2.66 [0.77]，P = .001；长与正常睡眠时间：β [SE] = 3.62 [1.38]，P = .01）。较长的睡眠时间与多个认知领域的较差表现相关。结睡觉。