Cognitive Status Moderates Long-term Benefits of Non-pharmacological Insomnia Therapy in Older Adults

INTRODUCTION: This secondary analysis examined whether mild cognitive impairment (MCI)moderates the effectiveness of non-pharmacological insomnia therapy, and whether insomniatherapy is associated with clinically meaningful symptom reduction.METHODS: Cognitively intact (CI; n=87) and MCI (n=38) older adults with insomniacompleted insomnia therapy. The primary outcome was the Insomnia Severity Index (ISI),assessed at baseline, post-treatment, and six-month follow-up (6FU). Linear mixed effectsmodels evaluated ISI changes across time and group. Logistic regression examined clinicallymeaningful reductions (ISI decrease≥6).RESULTS: Both groups showed significant ISI reductions at post-treatment and 6FU (pvalues<.0001). There were no between-group differences at post-treatment (p=.869). Yet, at6FU, CI participants, compared to MCI, showed significantly greater symptom reduction(p=.036), and a higher proportion achieved clinically meaningful reduction in ISI (78.7% vs45.8%).DISCUSSION: Older adults with MCI benefit from insomnia therapy; however, their continuedsymptom reduction six-months later may be dampened compared to CI older adults.