Cognitive functions in elderly patients with insomnia: a case-control study
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Background
Insomnia is a disorder commonly associated with the elderly population that may affect cognitive function and mood, Buysse (JAMA 309:70, 2013). Insomnia diminishes attention, memory, visuospatial capacities, and executive functioning. The association between insomnia and age-related cognitive deterioration has been previously established (Sci Rep 15:30284, 2025).
Aim
The primary aim of this study was to assess the effect of chronic insomnia on cognitive functioning in older persons. We hypothesized that elderly individuals with insomnia would demonstrate significantly lower performance on objective cognitive measures compared to age- and education-matched healthy controls.
Method
This case-control study recruited 110 participants (55 cases, 55 controls) aged 60 and above. Cases were recruited from a sleep outpatient clinic, while controls were recruited from a geriatric social center and meticulously screened to ensure the absence of psychiatric disorders (MINI), current insomnia (ISI ≤ 7), or poor sleep quality (PSQI < 6). All participants were evaluated using the Mini Neuropsychiatric Interview (MINI), the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and the Montreal Cognitive Assessment Basic Version (MOCA-B).
Results
The patients and controls showed notable variations in terms of executive functioning, calculation, visuoperception, naming, attention, and the overall score of the MOCA-B test. Furthermore, comparison between patients with early insomnia and other types of insomnia revealed a statistically significant impairment in the total MOCA-B test, delayed recall, and attention subtests.
Conclusion
Elderly people with chronic insomnia demonstrate poorer cognitive performance when compared to screened, matched controls, affecting critical domains like executive skills, attention, calculation, visuoperception, and naming. The findings support the hypothesis and emphasize the clinical importance of screening for insomnia in geriatric cognitive health.
