Advanced Circadian Timing and Sleep Fragmentation Differentially Impact on Memory Complaint Subtype in Subjective Cognitive Decline

Background: Increased sleep fragmentation and advanced circadian timing are hallmark phenotypes associated with increased age-related cognitive decline. Subjective cognitive decline (SCD) is considered a prodromal stage of neurode-generation and dementia; however, little is known about how sleep and circadian timing impact on memory complaints in SCD. Objective: To determine how sleep and circadian timing impact on memory complaint subtypes in older adults with SCD. Methods: Twenty-five older adults with SCD (mean age = 69.97, SD = 5.33) completed the Memory Functioning Questionnaire to characterize their memory complaints. They also underwent neuropsychological assessment, and completed 1 week of at-home monitoring of sleep with actigraphy and sleep diaries. This was followed by a two-night laboratory visit with overnight polysomnography and a dim light melatonin onset assessment to measure circadian timing. Results: Advanced circadian timing was associated with greater memory complaints, specifically poorer memory of past events (r=-0.688, p = 0.002), greater perceived decline over time (r = -0.568, p = 0.022), and increased reliance on mnemonic tools (r = -0.657, p = 0.004). Increased sleep fragmentation was associated with reduced self-reported memory decline (r=0.529, p = 0.014), and reduced concern about everyday forgetfulness (r=0.435, p = 0.038). Conclusion: Advanced circadian timing was associated with a number of subjective memory complaints and symptoms. By contrast, sleep fragmentation was linked to lowered perceptions of cognitive decline, and less concern about memory failures. As circadian disruption is apparent in both MCI and Alzheimer's disease, and plays a key role in cognitive function, our findings further support a circadian intervention as a potential therapeutic tool for cognitive decline.