A-50: When the Mind Won’t Rest: Cognitive Concern and Sleep Struggles in Former Athletes
Abstract
Objective: Subjective cognitive concerns are common among older adults and aging former athletes, even without objective impairment, and may reflect underlying emotional or behavioral factors. Sleep disturbance is closely linked to mood and cognitive functioning but remains underexplored. This study examined whether subjective cognitive concern is associated with sleep difficulties and related symptoms in former collegiate athletes without objective cognitive impairment. Method/Data Selection: Participants included 680 former collegiate athletes age 50+ from the College Level Aging Athlete Study (M age = 61; 348 men, 332 women) with Telephone Interview for Cognitive Status–modified (TICSm) scores ≥ 32. Participants were classified into higher versus lower cognitive concern groups using a prespecified Cognitive Functioning Index (CFI) median split (cutoff = 2). Adjusted regression models examined associations between cognitive concern group and sleep and emotional outcomes (Neuro-QoL sleep disturbance, Neuro-QoL positive affect, PHQ-8, and GAD-7), controlling for age, sex, and concussion history. Results were consistent across models treating outcomes as continuous and ordinal. Results/Data Synthesis: Higher cognitive concern was associated with greater overall sleep disturbance and difficulties across sleep domains, including sleep initiation, daytime sleepiness, and sleep-related functional impairment (ps < .001). Higher concern was also associated with greater depression, more anxiety symptoms, and lower positive affect (ps < .001). Age, sex, and concussion history were also associated with select sleep and symptom outcomes. Conclusions: Subjective cognitive concern was associated with greater sleep disturbance and emotional symptoms in older former collegiate athletes. These findings suggest sleep may be a modifiable factor associated with perceived cognitive decline and a potential intervention target to improve well-being.