The Impact of Sleep on Cognitive and Mental Health Outcomes in Older Adults: A Longitudinal Study of Circadian Rhythms and Early Cognitive and Emotional Change

De Tauzia, Romane (2026) The Impact of Sleep on Cognitive and Mental Health Outcomes in Older Adults: A Longitudinal Study of Circadian Rhythms and Early Cognitive and Emotional Change. Doctoral thesis, University of East Anglia.

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Abstract

Sleep disturbances are common in later life and have been linked to poor psychological health and cognition. However, findings remain unclear regarding which sleep characteristics and cognitive domains are most affected, and how these relationships change over time. Genetic vulnerability from apolipoprotein E ε4 (APOE ε4) carrier status, a well-established genetic risk factor for Alzheimer’s disease, may further influence these associations.

A systematic review explored associations between sleep characteristics and visuospatial memory and spatial navigation in adults over 50 years. An empirical longitudinal study then examined associations between subjective and objective actigraphy-derived sleep measures, cognitive outcomes, and psychological wellbeing over time, and whether relationships differed according to APOE ε4 status.

The systematic review revealed predominantly null findings, with substantial heterogeneity across measures and study designs. However, some evidence suggests that sleep continuity and aspects of sleep architecture are related to visuospatial and navigational performance. The empirical study found no consistent longitudinal associations between changes in sleep parameters and cognitive performance, and no evidence that APOE ε4 status moderated sleep-cognition relationships. In contrast, poorer subjective sleep quality was significantly associated with increased depressive symptoms, and poorer objective sleep efficiency was associated with increased depressive and anxiety symptoms over time.

Overall, findings suggest that sleep characteristics may be more closely related to psychological wellbeing than cognitive changes in cognitively healthy older adults, highlighting sleep as a potentially modifiable factor for supporting mental health in aging populations. Findings should be interpreted in the context of measures and methodological limitations discussed in this thesis.

Keywords: sleep, psychological wellbeing, cognition, ageing, APOE ε4, longitudinal

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	12 Nov 2026 08:23
Last Modified:	12 Nov 2026 08:23
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105095
DOI:

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