Summary: Gender and age are well‐established determinants of health and sleep health that influence overall health, which also often varies by gender and age. Sleep architecture is an important component of sleep health. The goal of this analysis was to examine whether associations between age and sleep stages differ by gender in the absence of moderate–severe obstructive sleep apnea (OSA) in a rural setting in Brazil. This study conducted polysomnography recordings in the Baependi Heart Study, a cohort of Brazilian adults. Our sample included 584 women and 309 men whose apnea–hypopnea index was ≤15 events/h. We used splines to distinguish non‐linear associations between age, total sleep time, wake after sleep onset (WASO), N2, N3, and rapid‐eye‐movement sleep. The mean (standard deviation; range) age was 47 (14; 18–89) years. All sleep outcomes were associated with age. Compared to men, women had more N3 sleep and less WASO after adjusting for age. Model‐based comparisons between genders at specific ages showed statistically higher mean WASO for men at ages 60 (+13.6 min) and 70 years (+19.5 min) and less N3 for men at ages 50 (−13.2 min), 60 (−19.0 min), and 70 years (−19.5 min) but no differences at 20, 30, 40 or 80 years. The other sleep measures did not differ by gender at any age. Thus, even in the absence of moderate–severe OSA, sleep architecture was associated with age across adulthood, and there were gender differences in WASO and N3 at older ages in this rural community.

Chronotype or diurnal preference is a questionnaire-based measure influenced both by circadian period and by the sleep homeostat. In order to further characterize the biological determinants of these measures, we used a hypothesis-free approach to investigate the association between the score of the morningness-eveningness questionnaire (MEQ) and the Munich chronotype questionnaire (MCTQ), as continuous variables, and volumetric measures of brain regions acquired by magnetic resonance imaging (MRI). Data were collected from the Baependi Heart Study cohort, based in a rural town in South-Eastern Brazil. MEQ and anatomical 1.5-T MRI scan data were available from 410 individuals, and MCTQ scores were available from a subset of 198 of them. The average MEQ (62.2 ± 10.6) and MCTQ (average MSFsc 201 ± 85 min) scores were suggestive of a previously reported strong general tendency toward morningness in this community. Setting the significance threshold at P > .002 to account for multiple comparisons, we observed a significant association between lower MEQ score (eveningness) and greater volume of the left anterior occipital sulcus (β = −0.163, p = .001) of the occipital lobe. No significant associations were observed for MCTQ. This may reflect the smaller dataset for MCTQ, and/or the fact that MEQ, which asks questions about preferred timings, is more trait-like than the MCTQ, which asks questions about actual timings. The association between MEQ and a brain region dedicated to visual information processing is suggestive of the increasingly recognized fluidity in the interaction between visual and nonvisual photoreception and the circadian system, and the possibility that chronotype includes an element of masking.

Objective: People with diabetes are more likely to have obstructive sleep apnea, but there are few studies examining sleep architecture in people with diabetes, especially in the absence of moderate-severe sleep apnea. Therefore, we compared sleep architecture among people with diabetes, prediabetes or neither condition, whilst excluding people with moderate-severe sleep apnea. Research design and methods: This sample is from the Baependi Heart Study, a prospective, family-based cohort of adults in Brazil. 1,074 participants underwent at-home polysomnography (PSG). Diabetes was defined as 1) FBG>125 OR 2) HbA1c>6.4 OR 3) taking diabetic medication, and prediabetes was defined as 1) [(5.7≤HbA1c≤6.4) OR (100≤FBG≤125)] AND 2) not taking diabetic medication. We excluded participants that had an apnea-hypopnea index (AHI)>30 from these analyses to reduce confounding due to severe sleep apnea. We compared sleep stages among the 3 groups. Results: Compared to those without diabetes, we found shorter REM duration for participants with diabetes (−6.7min, 95%CI -13.2, -0.1) or prediabetes (−5.9min, 95%CI -10.5, -1.3), even after adjusting for age, gender, BMI, and AHI. Diabetes was also associated with lower total sleep time (−13.7min, 95%CI -26.8, -0.6), longer slow-wave sleep (N3) duration (+7.6min, 95%CI 0.6, 14.6) and higher N3 percentage (+2.4%, 95%CI 0.6, 4.2), compared to those without diabetes. Conclusions: People with diabetes and prediabetes had less REM sleep after taking into account potential confounders, including AHI. People with diabetes also had more N3 sleep. These results suggest that diabetes is associated with different sleep architecture, even in the absence of moderate-severe sleep apnea.

Background: Metabolic syndrome (MetS) is linked to brain degeneration and Alzheimer’s disease (AD). Women, especially during menopausal transition, show increased susceptibility to AD-related brain changes. This study investigated the sex-specific neurostructural impact of MetS on brain regions vulnerable to AD. Methods: This cross-sectional study analyzed data from 500 participants (303 women, 197 men) from the Baependi Heart Study cohort, Brazil. High-resolution T1-weighted MRI scans were used for volumetric analysis of AD-related regions of interest (ROIs). Non-parametric quantile regression models compared ROI volumes between MetS and Non-MetS groups, stratified by sex and age (median split), adjusting for age and education. Results: No significant differences in ROI volume were observed between the MetS and Non-MetS groups in men. In women, findings were age-dependent. The younger cohort (≤48 years) with MetS exhibited significantly smaller left hippocampal volume (p = 0.02) and a trend toward smaller left middle temporal gyrus volume (p = 0.05) compared to Non-MetS. The older cohort (>48 years) with MetS showed a significantly larger right amygdala volume (p < 0.001). Furthermore, age-related volume decline in the hippocampus and middle temporal gyrus was significant in Non-MetS women but not in women with MetS, suggesting that MetS may be a confounding factor in age-related neurodegeneration. Conclusions: MetS is associated with sex-specific alterations in AD-vulnerable brain structures. In women, MetS may influence medial temporal lobe atrophy pre-menopause, and is linked to amygdala enlargement post-menopause. These exploratory results generate the hypothesis that MetS may uniquely predispose women to AD-related neurodegeneration, which requires critical longitudinal confirmation.

Introduction: Early in the COVID-19 pandemic, Brazil adopted measures to minimize the spread of the virus, including quarantine orders where people only left home for essential business. This practice could negatively impact sleep by reducing exposure to daylight and physical activity. We examined subjective sleep quality in Baependi, a small rural town in Brazil during the COVID-19 quarantine order. Methods: This sample is from the Baependi Heart Study, a family-based cohort of adults. Participants (n=800, 71% women, mean age 51.6±15.6 years) completed the Pittsburgh Sleep Quality Index (PSQI) early in the COVID pandemic (April-May, 2020). They were also asked about their compliance to the quarantine order (yes/no). We compared sleep between quarantined (QT) and not-quarantined individuals (NQT). Longitudinal data was obtained from a subsample of 417 individuals who also completed a pre-COVID PSQI between January, 2010 and September, 2014. Results: Individuals compliant with the quarantine had worse sleep quality than non-quarantined individuals [QT PSQI= 6.1 (±3.9), NQT PSQI= 5.0 (±3.5), p<0.01]. Stratified analysis showed that differences in PSQI scores between QT and NQT was greater for women [QT = 6.4 (±4), NQT = 5.2 (±3.7), p<0.01] and older people [QT = 6.6 (±0.1), NQT = 5.5 (±3.3), p=0.02]. Associations were attenuated after adjusting for age and gender. PSQI components demonstrated a higher sleep latency for the QT group in the full sample (p=0.02), women (p<0.01) and young (<50 years, p=0.03). Sleep duration was shorter in the QT young subsample (p=0.03). QT women also reported lower sleep efficiency (p=0.01) and greater use of sleep medication than NQT women (p<0.01). In the longitudinal subsample, PSQI scores were significantly higher during COVID than pre-pandemic [COVID= 5.7 (±3.8), pre-COVID= 5 (±3.3), p<0.01]. The significant change in PSQI was only observed in the QT participants [COVID= 5.9 (±3.7), pre-COVID= 5.2 (±3.4), p<0.01] and not NQT [COVID= 5 (±3.7), pre-COVID= 4.5 (±3), p=0.12. Conclusion: Individuals who quarantined during COVID-19 had worse sleep quality than individuals who did not quarantine. Longitudinal comparison demonstrated that participants who quarantined had worse sleep quality during COVID compared to before to the pandemic. Support (if any): NIH 1R01HL141881

Executive functions (EFs) are a set of cognitive abilities associated with many social and clinical outcomes that are believed to be sensitive to culture, age, and educational attainment. Yet, this was determined using EF theoretical models and tests developed for highly educated young adults, so it may not apply to more diverse samples. A community sample from Brazil (Baependi Heart Study cohort: N = 1,253; 753 females), in which age (18-88 years) and schooling (0-23 years) varied widely, was assessed based on a popular theoretical model of EF (the unity and diversity EF framework), which describes the pattern of interassociations of three specific types of EFs (inhibition, shifting, and updating). To this end, we employed a short, nonautomated, open-access EF test battery adapted for use in samples with varying ages and educational attainment that included EF indicators obtained from three tasks (Plus-Minus, Trail Making, and Random Number Generation tasks). Using confirmatory factor analyses, we found a good-fitting three-correlated factor solution confirming the fractionation and interassociation of the three EF domains, which was invariant (except for one of eight indicators) to age, schooling, and sex. More years of schooling were related to higher latent traits in all domains and older age to worse shifting, and women scored lower in latent shifting and inhibition. The unity-diversity EF framework can be determined across adulthood in diverse samples with tasks adapted for these populations. Building upon our findings may expand a theory-oriented investigation of sociocultural, demographic, and clinical factors that influence EFs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).