Sleep onset/maintenance difficulties and cognitive function in nondemented older adults: The role of cognitive reserve

Molly E. Zimmerman, Marcelo E. Bigal, Mindy J. Katz, Adam M. Brickman, Richard B. Lipton

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


This study examined the relationship between cognitive function and sleep onset/maintenance difficulties (SO/MD) in nondemented older adults. We hypothesized that SO/MD negatively impacts cognition and that older adults with lower education would be especially vulnerable to its effects. The sample comprised 549 older adults from the Einstein Aging Study (EAS), a community-based cohort. Participants completed neuropsychological assessment and a sleep questionnaire. Univariate ANCOVAs were performed with cognitive performance as a dependent variable, SO/MD (present or absent) and education (lower: ≤12 years; higher: >12 years) as between-subjects factors, and age, ethnicity, gender, depression, and cardiovascular comorbidies as covariates. Participants were an average age of 79.7 ± 5.0 years (range = 71-97 years). Fifty-seven percent (n = 314) of the sample met criteria for SO/MD. Among participants with SO/MD, those with lower education performed more poorly on a test of category fluency than participants with higher education (means: 35.2 vs. 41.0; p <.001); among older adults without SO/MD, educational attainment had no measurable effect on cognition (SO/MD × education interaction (F(1,536) = 14.5; p =.00)). Consistent with the cognitive reserve hypothesis, older adults with lower education appear selectively vulnerable to the negative effects of sleep onset/maintenance difficulties on tests of verbal fluency.

Original languageEnglish (US)
Pages (from-to)461-470
Number of pages10
JournalJournal of the International Neuropsychological Society
Issue number3
StatePublished - May 2012


  • Cognitive Reserve
  • Depression
  • Education
  • Elderly
  • Neuropsychology
  • Sleep

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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