Sleep EEG Signal Criticality as a Non-Invasive Predictor of Cognitive Decline in Dementia

Early detection of neurodegeneration remains a critical clinical challenge. This study investigates whether sleep EEG signal criticality, quantified via Multifractal Detrended Fluctuation Analysis (MFDFA), serves as a non-invasive biomarker for future cognitive decline. We analyzed longitudinal data from the National Sleep Research Resource (NSRR) Study of Osteoporotic Fractures (SOF) cohort, comparing baseline sleep EEG dynamics between women who remained cognitively normal and those who later progressed to dementia-related impairment (3MS < 78).Our results reveal significant group-level differences in Hurst exponent H(q) distributions, particularly during non-REM stages N2 and N3. Cognitively healthy individuals exhibited signal dynamics significantly closer to an optimally critical state across all electrode locations (p leqslant 0.001), supporting the Brain Criticality Hypothesis. Supervised UMAP projections confirmed clear spatial separation between groups throughout the overnight sleep architecture.The dementia group demonstrated a shift in DFA exponents toward 1.0, suggesting that a reconfiguration of scale-free neural dynamics during sleep precedes clinical symptoms. These findings highlight the potential for MFDFA-derived measures to be integrated into automated, sleep-based screening tools, enabling earlier preventative interventions during the prodromal window of dementia.