SLEEP DISTURBANCES AND MILD COGNITIVE IMPAIRMENT IN THE ENGLISH LONGITUDINAL STUDY OF AGEING

Recent scientific developments clearly indicate that sleep has an important effect on brain behaviour and function. In particular, it has very important effects on memory, co-ordination and executive functions. Furthermore, it is now known that there is a relationship between the severity of sleep disturbance and these functions of the brain in a number of different clinical conditions and it has been suggested that sleep disturbance may be an important early marker of progressive brain disorders such as Alzheimer's disease. As sleep disorders determine the severity and type of cognitive (brain) impairment in various brain-related disorders their diagnosis and treatment may slow disease progression. It is possible that sleep disorders may, therefore, be present and treatable in individuals with mild brain impairment. This is important as treatment may delay further progression from mild brain impairment to dementia, for example. It is therefore essential to develop tools to easily and accurately detect these individuals who are at greater risk. Our proposed study will assess the evidence for links between two types of mild brain impairments using data which has already been collected on a large group (N~10,000) of men and women over the age of 50 years from the English Longitudinal Study of Ageing (ELSA) who self-report any sleep disturbances.

The specific aims of our project are to explore the links between the quantity (i.e. duration) and quality of sleep in relation to the different types of mild brain impairment in individuals from the ELSA study. We will also explore which different social, behavioural and biochemical factors have an effect on these links. This will establish the baseline for future analyses of the causes of further decline in cognitive (brain) function that may occur in subsequent years and as individuals get older.

The Sleep Health & Society Research Programme is focused on establishing the evidence of the role sleep and in particular, sleep disturbances play in underpinning short and long-term poor functioning and ill health. The Programme uses epidemiological tools to gather data that would be generalizable to the population at large. We use a variety of approaches: evidence synthesis of cross-sectional and prospective studies, direct cross-sectional and prospective analyses of population samples, controlled clinical trials. We maximise the impact of our research findings in several ways. The process by which we have done this has been to use both pre-existing networks and research relationships as well as developing new ones. Our research proposal is timely due to recent proposed increase in Government funding of dementia research. The Prime Minister's ambition is for Britain to be a world leader in dementia research and care. The content of our proposed study fits this context.

We use several types of impact activities: (i) professional events - we have a track record of invited lectures on sleep worlwide; (ii) public engagement - we have held successful meetings open to the public (ThinkTank Science Museum in Birmingham, University of Warwick Ideas Café initiative; (iii) press and communication activities with the aid of traditional (TV, radio, printed media) and innovative (web-pages, podcasts, i-casts, webinars) means - cf. appearances on BBC and ITV, a three-days sleep series on Korean TV, radio interviews worldwide (cf. BBC, ITN, Sky, CNN, CBC, CBS, RAI), web-productions, podcasts, i-casts; (iv) collaborations and networks (local, national and international) -partnerships with Harvard Medical School, Boston University and Monash; (v) training and transfer of skills - research-led Sleep Medicine teaching module and student research projects leading to publications; (vi) involvement in policy making - cf. EWTD for Junior doctors, American Federal Policy on shift-work of truck drivers. One main vehicle of academic dissemination remains through high-impact peer-reviewed publications and presentations at conferences. Since 2005 we have published more than 35 papers and book chapters and the first Textbook of Sleep Epidemiology and Public Health. Milestones and measures of success of our impact activities will be reviewed every 6 months (Web & media hits, citations of papers, Website statistics, exit questionnaires at public engagement events).

Local presentations will be made at the departmental seminar series to disseminate findings and to invite critique from our peers. Publications will be supported by a press release by our Media team (in consultation with the ESRC), with summaries on our website. In addition, as part of the locally funded Boston-Warwick partnership the applicants will visit Boston University to present the results. Findings will be included in the Study Module on Sleep Medicine.

The project has the support of our Media Relations department. They will liaise with the ESRC so that findings can be disseminated to the general public through our website and by press releases. We will organise show case events to publicise our findings. These events will be open to the wider university community and to members of the public.

Both applicants have experience in the development and implementation of public health policy (cf WHO collaborating centre for Nutrition). Their research in the cardiovascular field has had a direct impact on both policy formulation and implementation and has been instrumental in changing public health guidelines. Findings will be targeted to public health departments and policy makers. The applicants have experience in disseminating information to general practitioners to assist in the implementation of the BHS/NICE guidelines on the management of hypertension. Moreover, their textbook was designed to reach prevention specialists, policy makers, sleep researchers, clinicians.