Objective: We aimed to determine the relationship between day-to-day sleep efficiency variability and cognitive function among older adults using accelerometer data and three cognitive tests. Methods: Older adults aged 65+ with 5 days of accelerometer data from the National Health and Nutrition Examination Survey (NHANES) who completed the Digit Symbol Substitution Test (DSST), the Consortium to Establish a Registry for Alzheimers Disease Word-Learning subtest (CERAD WL), and Animal Fluency Test (AFT) were included in this study. Associations between sleep efficiency variability and each cognitive test were examined adjusted for age, sex, education, household income, marital status, depressive symptoms, diabetes, smoking habits, alcohol consumption, arthritis, heart disease, prior heart attack, prior stroke, activities of daily living, and instrumental activities of daily living. Results: A total of 1074 older adults were included in this study. Greater sleep efficiency variability was univariably associated with worse cognitive function based on the DSST (per 10% increase, Beta -3.34, 95% CI -5.33 to -1.34), CERAD-WL (per 10% increase, Beta -1.00, 95% CI -1.79 to -0.21), and AFT (per 10% increase, Beta -1.02, 95% CI -1.68 to -0.36). In adjusted models, greater sleep efficiency variability remained associated with lower DSST (per 10% increase, Beta -2.01, 95% CI -3.62 to -0.40) and AFT (per 10% increase, Beta -0.84, 95% CI -1.47 to -0.21) scores but not CERAD WL scores. Conclusions: Targeting consistency regarding sleep quality may be useful for interventions seeking to preserve cognitive function among older adults.

翻译：目的：本研究旨在利用加速计数据和三项认知测试，探讨老年人日间睡眠效率变异性与认知功能之间的关系。方法：研究对象选自美国国家健康与营养调查（NHANES）中年龄≥65岁、具有5天加速计数据，并完成数字符号替换测试（DSST）、阿尔茨海默病注册联盟词语学习子测试（CERAD WL）和动物流畅性测试（AFT）的老年人。在调整年龄、性别、教育程度、家庭收入、婚姻状况、抑郁症状、糖尿病、吸烟习惯、饮酒量、关节炎、心脏病、既往心脏病发作、既往中风、日常生活活动能力及工具性日常生活活动能力等协变量后，分析了睡眠效率变异性与各项认知测试的关联。结果：共纳入1074名老年人。单因素分析显示，睡眠效率变异性越大，DSST（每增加10%，Beta=-3.34，95% CI -5.33至-1.34）、CERAD-WL（每增加10%，Beta=-1.00，95% CI -1.79至-0.21）和AFT（每增加10%，Beta=-1.02，95% CI -1.68至-0.36）评分越低。在调整模型中，较大的睡眠效率变异性仍与较低的DSST（每增加10%，Beta=-2.01，95% CI -3.62至-0.40）和AFT（每增加10%，Beta=-0.84，95% CI -1.47至-0.21）评分显著相关，但与CERAD WL评分无显著关联。结论：关注睡眠质量的稳定性可能有助于制定针对老年人认知功能保护的干预措施。