Associations Between Sleep Quality Plasma Neurofilament Light And Cognition In Older Adults Without Dementia Haihua Guo Dongxin Liang Qun Zhang Yan Fu Liangyu Huang Zehu Sheng Lan Tan Zuoteng Wang by Hai-hua Guo & Dong-xin Liang & Qun Zhang & Yan Fu & Liang-yu Huang & Ze-hu Sheng & Lan Tan & Zuo-teng Wang instant download after payment.

The relationship between sleep quality, neurofilament light chain (NFL), and cognitive impairment, including the potential effect ofplasma NFL in this association, remains unclear. Using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort, we excludedindividuals with dementia or a history of sleep-related medication use at baseline, including 640 participants with complete sleepassessments and covariates. Sleep quality was assessed using the Neuropsychiatric Inventory sleep subscale, which includes ratingsof frequency, severity, and their product, with higher scores indicating poorer sleep quality. Baseline and follow-up demographics,sleep indices, plasma NFL levels, and cognition scores (including Mini-Mental State Examination [MMSE], Montreal CognitiveAssessment [MoCA], Alzheimer’s Disease Assessment Scale-Cognitive Subscale [ADAS13], Clinical Dementia Rating Scale-Sum of1234567890();,:Boxes [CDRSB], Executive Function [EF], Language [LAN], and Memory [MEM]) were also collected. Multivariable linear regressionexamined the associations between baseline sleep quality, plasma NFL, and cognition, as well as the relationship between sleepquality and longitudinal cognitive decline, calculated using linear mixed-effects models. Mediation analysis evaluated the role ofplasma NFL in the sleep-cognition association. Multiple testing significance was corrected using false discovery rate, with resultspresented as Q-values. Poor sleep quality scores were associated with elevated plasma NFL levels (β: 0.055 to 2.645, P < 0.05),poorer cognition (ADAS13, CDRSB, EF, LAN, MEM; β: −0.188 to 1.279, Q < 0.05), and accelerated longitudinal cognitive decline(MoCA; β: −0.005, Q < 0.05) in both models, with sensitivity analyses supporting these findings. Furthermore, plasma NFL levelspartially mediated the relationship between sleep quality and both baseline cognition (ADAS13, CDRSB, LAN, MEM; P < 0.05) andlongitudinal cognitive decline (MoCA; P < 0.05), with mediation proportions ranging from 9.2% to 26.7%. Poorer sleep quality wasassociated with cognitive impairment and accelerated cognitive decline, suggesting its potential role in Alzheimer’s disease. Theseassociations may be partially mediated by neuroaxonal injury.Translational Psychiatry (2025) 15:169 ;