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Carrero L, Antequera D, Municio C, Carro E. Circadian rhythm disruption and retinal dysfunction: a bidirectional link in Alzheimer's disease? Neural Regen Res 2024; 19:1967-1972. [PMID: 38227523 DOI: 10.4103/1673-5374.390962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/07/2023] [Indexed: 01/17/2024] Open
Abstract
Dysfunction in circadian rhythms is a common occurrence in patients with Alzheimer's disease. A predominant function of the retina is circadian synchronization, carrying information to the brain through the retinohypothalamic tract, which projects to the suprachiasmatic nucleus. Notably, Alzheimer's disease hallmarks, including amyloid-β, are present in the retinas of Alzheimer's disease patients, followed/associated by structural and functional disturbances. However, the mechanistic link between circadian dysfunction and the pathological changes affecting the retina in Alzheimer's disease is not fully understood, although some studies point to the possibility that retinal dysfunction could be considered an early pathological process that directly modulates the circadian rhythm.
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Affiliation(s)
- Laura Carrero
- Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), Madrid, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), ISCIII, Madrid, Spain
- PhD Program in Neuroscience, Autonoma de Madrid University, Madrid, Spain
| | - Desireé Antequera
- Neurobiology of Alzheimer's Disease Unit, Functional Unit for Research into Chronic Diseases, Instituto de Salud Carlos III, Madrid, Spain; Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), ISCIII, Madrid, Spain
| | - Cristina Municio
- Group of Neurodegenerative Diseases, Hospital Universitario 12 de Octubre Research Institute (imas12), Madrid, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), ISCIII, Madrid, Spain
| | - Eva Carro
- Neurobiology of Alzheimer's Disease Unit, Functional Unit for Research into Chronic Diseases, Instituto de Salud Carlos III, Madrid, Spain; Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), ISCIII, Madrid, Spain
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2
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Yang Q, Li S, Yang Y, Lin X, Yang M, Tian C, Mao J. Prolonged sleep duration as a predictor of cognitive decline: A meta-analysis encompassing 49 cohort studies. Neurosci Biobehav Rev 2024; 164:105817. [PMID: 39032844 DOI: 10.1016/j.neubiorev.2024.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/05/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
Despite numerous studies have explored the association between sleep duration and cognition, the link between sleep duration trajectories and cognition remains underexplored. This systematic review aims to elucidate this correlation. We analyzed 55 studies from 14 countries, comprising 36 studies focusing on sleep duration, 20 on insomnia, and 13 on hypersomnia. A total of 10,767,085 participants were included in 49 cohort studies with a mean follow-up duration of 9.1 years. A non-linear association between sleep duration and cognitive decline was identified. Both long (risk ratio (RR):1.35, 95 % confidence intervals (CIs):1.23-1.48) and short sleep durations (RR: 1.12, 95 % CIs:1.03-1.22) were associated with an elevated risk of cognitive decline compared to moderate sleep duration. Additionally, hypersomnia (RR:1.26, 95 % CIs: 1.15-1.39) and insomnia (RR: 1.16, 95 % CIs: 1.002-1.34) were also linked to an increased risk. Moreover, prolonged sleep duration posed a higher risk of cognitive decline than stable sleep duration (RR:1.42, 95 % CIs:1.27-1.59). Importantly, transitioning from short or moderate to long sleep duration, as well as persistent long sleep duration, exhibited higher RRs for cognitive decline (RRs: 1.94, 1.40, and 1.28, respectively) compared to persistent moderate sleep duration. Our findings underscore the significance of prolonged sleep duration, alongside short and long sleep durations, with an elevated risk of cognitive decline. The association is tied to the degree of sleep duration changes. Our study highlights the importance of considering changes in sleep patterns over time, not just static sleep durations.
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Affiliation(s)
- Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Suya Li
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yang Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuechun Lin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mengshu Yang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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3
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Raglio A, Figini C, Bencivenni A, Grossi F, Boschetti F, Manera MR. Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review. Brain Sci 2024; 14:842. [PMID: 39199533 PMCID: PMC11352551 DOI: 10.3390/brainsci14080842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/17/2024] [Accepted: 08/21/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND The use of music in cognitive interventions represents a possibility with potential worthy of further investigation in the field of aging, both in terms of prevention from dementia, in the phase of mild cognitive impairment, and in the treatment of overt dementia. OBJECTIVES Currently, the types of music-based interventions proposed in the literature are characterized by wide heterogeneity, which is why it is necessary to clarify which interventions present more evidence of effectiveness in stimulating different cognitive domains. METHOD The study was conducted in accordance with PRISMA guidelines for scoping reviews. By searching two different databases, PubMed and the Web of Science, all studies evaluating the cognitive effects of music-based interventions on people at early stages of cognitive decline (MCI or mild-to-moderate dementia) were selected. RESULTS The study selection included a total of 28 studies involving n = 1612 participants (mean age ranged from 69.45 to 85.3 years old). Most of the studies analyzed agree with the observation of an improvement, or at least maintenance, of global cognitive conditions (mainly represented by the results of the MMSE test) following music-based interventions, together with a series of other positive effects on verbal fluency, memory, and executive processes. CONCLUSIONS The results of this review suggest the introduction of music-based interventions as complementary approaches to usual cognitive treatments. Also, the use of standardized and well-defined protocols, in addition to strong methodological research approaches, is suggested. Music-based interventions are recommended in the early stages of dementia, in MCI, and in a preventive sense in healthy older adults.
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Affiliation(s)
- Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri, 27100 Pavia, Italy
| | | | | | - Federica Grossi
- Psychology Unit Pavia-Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.G.); (F.B.); (M.R.M.)
| | - Federica Boschetti
- Psychology Unit Pavia-Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.G.); (F.B.); (M.R.M.)
| | - Marina Rita Manera
- Psychology Unit Pavia-Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy; (F.G.); (F.B.); (M.R.M.)
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Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404:572-628. [PMID: 39096926 DOI: 10.1016/s0140-6736(24)01296-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/08/2024] [Accepted: 06/16/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - David Ames
- National Ageing Research Institute, Melbourne, VIC, Australia; University of Melbourne Academic Unit for Psychiatry of Old Age, Melbourne, VIC, Australia
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Nick C Fox
- The Dementia Research Centre, Department of Neurodegenerative Disease, University College London, London, UK
| | - Cleusa P Ferri
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Laura N Gitlin
- College of Nursing and Health Professions, AgeWell Collaboratory, Drexel University, Philadelphia, PA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University College of Health Sciences, Makerere University, Kampala City, Uganda
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Kokoro Shirai
- Graduate School of Social and Environmental Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK; Université Paris Cité, Inserm U1153, Paris, France
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Sebastian Walsh
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Yao Yao
- China Center for Health Development Studies, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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5
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Faucher C, Borne L, Behler A, Paton B, Giorgio J, Fripp J, Thienel R, Lupton MK, Breakspear M. A central role of sulcal width in the associations of sleep duration and depression with cognition in mid to late life. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae058. [PMID: 39221446 PMCID: PMC11362672 DOI: 10.1093/sleepadvances/zpae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/02/2024] [Indexed: 09/04/2024]
Abstract
Study Objectives Evidence suggests that poor sleep impacts cognition, brain health, and dementia risk but the nature of the association is poorly understood. This study examined how self-reported sleep duration, napping, and subjective depression symptoms are associated with the brain-cognition relationship in older adults, using sulcal width as a measure of relative brain health. Methods A canonical partial least squares analysis was used to obtain two composite variables that relate cognition and sulcal width in a cross-sectional study of 137 adults aged 46-72. We used a combination of ANCOVA and path analyses to test the associations of self-reported sleep duration, napping, and subjective depression symptoms with the brain-cognition relationship. Results We observed a significant main effect of sleep duration on sulcal width, with participants reporting 7 hours showing narrower sulci than other durations. This effect remained significant after including subjective depression as a covariate, which also had a significant main effect on sulcal width in the model. There was no significant effect of napping on sulcal width. In path analyses where the effects of age, self-reported sleep duration and depression symptoms were investigated together, sulcal width mediated the relationship between age and cognition. We also observed a significant indirect effect of sulci width in the subjective depression-cognition relationship. Conclusions Findings suggest that self-reported sleep duration and subjective depression may each be independently associated with brain morphology, which is related to cognitive functions. Results could help inform clinical trials and related intervention studies that aim at delaying cognitive decline in adults at risk of developing dementia.
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Affiliation(s)
- Caroline Faucher
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | - Léonie Borne
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Anna Behler
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Bryan Paton
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
| | - Joseph Giorgio
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA
| | - Jurgen Fripp
- Australian eHealth Research Centre, CSIRO, Brisbane, Australia
| | - Renate Thienel
- School of Public Health and Medicine, College of Health Medicine and Wellbeing, University of Newcastle, Australia
| | - Michelle K Lupton
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Michael Breakspear
- School of Psychological Science, College of Science, Engineering and the Environment, University of Newcastle, Australia
- School of Public Health and Medicine, College of Health Medicine and Wellbeing, University of Newcastle, Australia
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Baril AA, Picard C, Labonté A, Sanchez E, Duclos C, Mohammediyan B, Breitner JCS, Villeneuve S, Poirier J. Longer sleep duration and neuroinflammation in at-risk elderly with a parental history of Alzheimer's disease. Sleep 2024; 47:zsae081. [PMID: 38526098 PMCID: PMC11168764 DOI: 10.1093/sleep/zsae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
STUDY OBJECTIVES Although short sleep could promote neurodegeneration, long sleep may be a marker of ongoing neurodegeneration, potentially as a result of neuroinflammation. The objective was to evaluate sleep patterns with age of expected Alzheimer's disease (AD) onset and neuroinflammation. METHODS We tested 203 dementia-free participants (68.5 ± 5.4 years old, 78M). The PREVENT-AD cohort includes older persons with a parental history of AD whose age was nearing their expected AD onset. We estimated expected years to AD onset by subtracting the participants' age from their parent's at AD dementia onset. We extracted actigraphy sleep variables of interest (times of sleep onset and morning awakening, time in bed, sleep efficiency, and sleep duration) and general profiles (sleep fragmentation, phase delay, and hypersomnia). Cerebrospinal fluid (CSF) inflammatory biomarkers were assessed with OLINK multiplex technology. RESULTS Proximity to, or exceeding, expected age of onset was associated with a sleep profile suggestive of hypersomnia (longer sleep and later morning awakening time). This hypersomnia sleep profile was associated with higher CSF neuroinflammatory biomarkers (IL-6, MCP-1, and global score). Interaction analyses revealed that some of these sleep-neuroinflammation associations were present mostly in those closer/exceeding the age of expected AD onset, APOE4 carriers, and those with better memory performance. CONCLUSIONS Proximity to, or exceeding, parental AD dementia onset was associated with a longer sleep pattern, which was related to elevated proinflammatory CSF biomarkers. We speculate that longer sleep may serve a compensatory purpose potentially triggered by neuroinflammation as individuals are approaching AD onset. Further studies should investigate whether neuroinflammatory-triggered long sleep duration could mitigate cognitive deficits.
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Affiliation(s)
- Andrée-Ann Baril
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, QC, Canada
- Department of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Cynthia Picard
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Anne Labonté
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Erlan Sanchez
- Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Catherine Duclos
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, QC, Canada
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, QC, Canada
| | - Béry Mohammediyan
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - John C S Breitner
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Sylvia Villeneuve
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Judes Poirier
- Center for Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
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7
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Lee S, Quinn L, Fritschi C, Fink AM, Park C, Reutrakul S, Collins EG. Effects of daily sleep on physical activity after cardiac surgery. Heart Lung 2024; 65:47-53. [PMID: 38401358 DOI: 10.1016/j.hrtlng.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Maintaining physical activity is challenging after cardiac surgery. Postsurgical cardiac patients often experience sleep problems showing a reciprocal interaction with physical activity. As sleep and physical activity show day-to-day variations, their daily relationships need to be assessed. However, no studies have examined daily sleep-physical activity relationships in postsurgical cardiac patients. OBJECTIVES This study aimed to examine the effects of daily sleep factors on daily physical activity after cardiac surgery. METHODS Among 33 patients who underwent cardiac surgery at least 10 weeks earlier, 5 sleep and 4 physical activity variables were measured using a wrist-worn ActiGraph for 7 days. Mixed-effects models were applied for data analyses. RESULTS Most participants were male (57.6 %), non-Hispanic whites (63.6 %) who had coronary artery bypass graft surgery (54.6 %). Participants averaged 60.8 ± 10.1 years of age and 85.7 ± 91.2 months since surgery. They slept for an average of 385.6 ± 74.6 min (6.4 ± 1.2 h). Among sleep factors, greater number of awakenings (NOA) predicted lower next-day sedentary time. Higher sleep efficiency (SE) was associated with lower next-day sedentary time when not controlling for covariates. Among the psychosocial, demographic, and clinical covariates, higher comorbidity index was associated with fewer kcals expended, less daily moderate-to-vigorous physical activity, and more daily sedentary time. CONCLUSIONS Daily SE and NOA and individual health status, including comorbidity, should be assessed over time to support improvement of daily physical activity after cardiac surgery. Researchers should examine the relationship between NOA and next-day sedentary time with larger samples. Such research should address multiple psychosocial, demographic, and clinical factors and the potential mediating role of sleep.
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Affiliation(s)
- Sueyeon Lee
- Loyola University Chicago, Marcella Niehoff School of Nursing, 2160 S. 1st Ave., Maywood, IL 60153, USA.
| | - Lauretta Quinn
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Cynthia Fritschi
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Anne M Fink
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Chang Park
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
| | - Sirimon Reutrakul
- University of Illinois Chicago, Department of Medicine, 835 S. Wolcott, Chicago, IL 60612, USA
| | - Eileen G Collins
- University of Illinois Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA
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Tang S, Liu R, Ren J, Song L, Dong L, Qin Y, Zhao M, Wang Y, Dong Y, Zhao T, Liu C, Hou T, Cong L, Sindi S, Winblad B, Du Y, Qiu C. Association of objective sleep duration with cognition and brain aging biomarkers in older adults. Brain Commun 2024; 6:fcae144. [PMID: 38756537 PMCID: PMC11098043 DOI: 10.1093/braincomms/fcae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/21/2024] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
The neuropathological mechanisms underlying the association between sleep duration and mild cognitive impairment remain poorly understood. This population-based study included 2032 dementia-free people (age ≥ 60 years; 55.1% women) derived from participants in the Multimodal Interventions to Delay Dementia and Disability in Rural China; of these, data were available in 841 participants for Alzheimer's plasma biomarkers (e.g. amyloid-β, total tau and neurofilament light chain), 1044 for serum microvascular biomarkers (e.g. soluble adhesion molecules) and 834 for brain MRI biomarkers (e.g. whiter matter, grey matter, hippocampus, lacunes, enlarged perivascular spaces and white matter hyperintensity WMH). We used electrocardiogram-based cardiopulmonary coupling analysis to measure sleep duration, a neuropsychological test battery to assess cognitive function and the Petersen's criteria to define mild cognitive impairment. Data were analysed with multivariable logistic and general linear models. In the total sample (n = 2032), 510 participants were defined with mild cognitive impairment, including 438 with amnestic mild cognitive impairment and 72 with non-amnestic mild cognitive impairment. Long sleep duration (>8 versus 6-8 h) was significantly associated with increased likelihoods of mild cognitive impairment and non-amnestic mild cognitive impairment and lower scores in global cognition, verbal fluency, attention and executive function (Bonferroni-corrected P < 0.05). In the subsamples, long sleep duration was associated with higher plasma amyloid-β40 and total tau, a lower amyloid-β42/amyloid-β40 ratio and smaller grey matter volume (Bonferroni-corrected P < 0.05). Sleep duration was not significantly associated with serum-soluble adhesion molecules, white matter hyperintensity volume, global enlarged perivascular spaces and lacunes (P > 0.05). Alzheimer's and neurodegenerative pathologies may represent common pathways linking long sleep duration with mild cognitive impairment and low cognition in older adults.
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Affiliation(s)
- Shi Tang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Rui Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Juan Ren
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lingling Dong
- Department of Neurology, Dongying People’s Hospital, Dongying 257091, China
| | - Yu Qin
- Department of Neurology, Liaocheng People’s Hospital, Liaocheng 252000, China
| | - Mingqing Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tong Zhao
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
| | - Cuicui Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Shireen Sindi
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Neuroepidemiology and Ageing Research Unit (AGE), School of Public Health, Imperial College London, London SW7 2AZ, United Kingdom
| | - Bengt Winblad
- Division of Neurogeriatrics and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan 250021, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
- Institute of Brain Science and Brain-Inspired Research, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, 171 65 Solna, Sweden
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Sun K, Jin S, Yang Z, Li X, Li C, Zhang J, Yang G, Yang C, Abdelrahman Z, Liu Z. Transition to healthier lifestyle associated with reduced risk of incident dementia and decreased hippocampal atrophy. J Affect Disord 2024; 349:552-558. [PMID: 38195008 DOI: 10.1016/j.jad.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/23/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Research has estimated the associations of lifestyle at one-time point with the risk of dementia and hippocampal volume, but the impact of lifestyle transition on dementia and hippocampal volume remains unclear. This study aims to examine the associations of lifestyle transition with the risk of dementia and hippocampal volume. METHODS Based on data from the UK Biobank, a weighted lifestyle score was constructed by incorporating six lifestyle factors. Within each baseline lifestyle group (i.e., healthy, intermediate, and unhealthy), lifestyle transition was classified into decline, maintenance, and improvement. Cox proportional hazard regression was used to estimate the association of lifestyle transition and incident dementia (N = 16,305). A multiple linear regression model was used to estimate the association between lifestyle transition and hippocampal volume (N = 5849). RESULTS During a median follow-up period of 8.6 years, 120 (0.7 %) dementia events were documented. Among participants with healthy baseline lifestyles, the improvement group had a lower risk of incident dementia (HR: 0.18, 95 % CI: 0.04-0.81) and a larger hippocampal volume (β = 111.69, P = 0.026) than the decline group. Similar results were observed among participants with intermediate baseline lifestyles regarding dementia risk but not hippocampal volume. No benefits were observed in the improvement group among those with unhealthy baseline lifestyles. LIMITATIONS A lower incidence of dementia than other cohort study and this may have resulted in an underestimation of the risk of dementia. CONCLUSIONS Earlier transitions to healthier lifestyle were associated with reduced risk of incident dementia and decreased hippocampal atrophy.
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Affiliation(s)
- Kaili Sun
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Shuyi Jin
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Zhenqing Yang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Xueqin Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Chenxi Li
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Gan Yang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China
| | - Chongming Yang
- Research Support Center, Brigham Young University, Provo, UT 84602, USA
| | - Zeinab Abdelrahman
- Centre for Public Health, Queen's University of Belfast, Belfast BT12 6BA, UK
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China.
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Rosenau C, Köhler S, Soons LM, Anstey KJ, Brayne C, Brodaty H, Engedal K, Farina FR, Ganguli M, Livingston G, Lyketsos CG, Mangialasche F, Middleton LE, Rikkert MGMO, Peters R, Sachdev PS, Scarmeas N, Salbæk G, van Boxtel MPJ, Deckers K. Umbrella review and Delphi study on modifiable factors for dementia risk reduction. Alzheimers Dement 2024; 20:2223-2239. [PMID: 38159267 PMCID: PMC10984497 DOI: 10.1002/alz.13577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta-analyses with a two-round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts. HIGHLIGHTS: An umbrella review was combined with opinions of 18 dementia experts. Various candidate targets for dementia risk reduction were identified. Experts prioritized hearing impairment, social contact, and sleep. Re-assessment of dementia risk scores is encouraged. Future work should evaluate the predictive validity of updated risk scores.
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Affiliation(s)
- Colin Rosenau
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Lion M. Soons
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Kaarin J. Anstey
- School of PsychologyUniversity of New South WalesKensingtonNew South WalesAustralia
- Neuroscience Research Australia (NeuRA)SydneyNew South WalesAustralia
- UNSW Ageing Futures InstituteKensingtonNew South WalesAustralia
| | - Carol Brayne
- Cambridge Public HealthUniversity of CambridgeCambridgeUK
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Knut Engedal
- Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
| | - Francesca R. Farina
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Mary Ganguli
- Departments of PsychiatryNeurologyand EpidemiologySchool of Medicine and School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Constantine G. Lyketsos
- Richman Family Precision Medicine Center of Excellence in Alzheimer's DiseaseJohns Hopkins BayviewJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Francesca Mangialasche
- Division of Clinical GeriatricsDepartment of NeurobiologyCare Sciences and SocietyCenter for Alzheimer ResearchKarolinska InstitutetStockholmSweden
- Theme Inflammation and AgingMedical Unit AgingKarolinska University HospitalStockholmSweden
| | - Laura E. Middleton
- Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
- Schlegel‐UW Research Institute for AgingWaterlooOntarioCanada
| | - Marcel G. M. Olde Rikkert
- Department of Geriatric MedicineRadboud University Medical CenterNijmegenthe Netherlands
- Radboudumc Alzheimer CenterDonders Center of Medical NeurosciencesNijmegenthe Netherlands
| | - Ruth Peters
- UNSW Ageing Futures InstituteKensingtonNew South WalesAustralia
- The George Institute for Global HealthNewtownNew South WalesAustralia
- School of Biomedical SciencesUniversity of New South WalesKensingtonNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition HospitalNational and Kapodistrian University of Athens Medical SchoolAthensGreece
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - Geir Salbæk
- Norwegian National Centre for Ageing and HealthVestfold Hospital TrustTønsbergNorway
- Department of Geriatric MedicineOslo University HospitalOsloNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtthe Netherlands
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11
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Baril AA, Kojis DJ, Himali JJ, Decarli CS, Sanchez E, Johnson KA, El Fakhri G, Thibault E, Yiallourou SR, Himali D, Cavuoto MG, Pase MP, Beiser AS, Seshadri S. Association of Sleep Duration and Change Over Time With Imaging Biomarkers of Cerebrovascular, Amyloid, Tau, and Neurodegenerative Pathology. Neurology 2024; 102:e207807. [PMID: 38165370 PMCID: PMC10834132 DOI: 10.1212/wnl.0000000000207807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Both short and long sleep duration were previously associated with incident dementia, but underlying mechanisms remain unclear. We evaluated how self-reported sleep duration and its change over time associate with (A)myloid, (T)au, (N)eurodegeneration, and (V)ascular neuroimaging markers of Alzheimer disease. METHODS Two Framingham Heart Study overlapping samples were studied: participants who underwent 11C-Pittsburg Compound B amyloid and 18F-flortaucipir tau PET imaging and participants who underwent an MRI. MRI metrics estimated neurodegeneration (total brain volume) and cerebrovascular injuries (white matter hyperintensities [WMHs] volume, covert brain infarcts, free-water [FW] fraction). Self-reported sleep duration was assessed and split into categories both at the time of neuroimaging testing and approximately 13 years before: short ≤6 hours. average 7-8 hours, and long ≥9 hours. Logistic and linear regression models were used to examine sleep duration and neuroimaging metrics. RESULTS The tested cohort was composed of 271 participants (age 53.6 ± 8.0 years; 51% male) in the PET imaging sample and 2,165 participants (age 61.3 ± 11.1 years; 45% male) in the MRI sample. No fully adjusted association was observed between cross-sectional sleep duration and neuroimaging metrics. In fully adjusted models compared with consistently sleeping 7-8 hours, groups transitioning to a longer sleep duration category over time had higher FW fraction (short to average β [SE] 0.0062 [0.0024], p = 0.009; short to long β [SE] 0.0164 [0.0076], p = 0.031; average to long β [SE] 0.0083 [0.0022], p = 0.002), and those specifically going from average to long sleep duration also had higher WMH burden (β [SE] 0.29 [0.11], p = 0.007). The opposite associations (lower WMH and FW) were observed in participants consistently sleeping ≥9 hours as compared with people consistently sleeping 7-8 hours in fully adjusted models (β [SE] -0.43 [0.20], p = 0.028; β [SE] -0.019 [0.004], p = 0.020). Each hour of increasing sleep (continuous, β [SE] 0.12 [0.04], p = 0.003; β [SE] 0.002 [0.001], p = 0.021) and extensive increase in sleep duration (≥2 hours vs 0 ± 1 hour change; β [SE] 0.24 [0.10], p = 0.019; β [SE] 0.0081 [0.0025], p = 0.001) over time was associated with higher WMH burden and FW fraction in fully adjusted models. Sleep duration change was not associated with PET amyloid or tau outcomes. DISCUSSION Longer self-reported sleep duration over time was associated with neuroimaging biomarkers of cerebrovascular pathology as evidenced by higher WMH burden and FW fraction. A longer sleep duration extending over time may be an early change in the neurodegenerative trajectory.
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Affiliation(s)
- Andrée-Ann Baril
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Daniel J Kojis
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Jayandra J Himali
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Charles S Decarli
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Erlan Sanchez
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Keith A Johnson
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Georges El Fakhri
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Emma Thibault
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Stephanie R Yiallourou
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Dibya Himali
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Marina G Cavuoto
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Matthew P Pase
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Alexa S Beiser
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
| | - Sudha Seshadri
- From the Douglas Mental Health University Institute (A.-A.B.), McGill University, Montreal, Quebec, Canada; The Framingham Heart Study (A.-A.B., D.J.K., J.J.H., D.H., M.P.P., A.S.B., S.S.); Boston University School of Public Health (D.J.K., J.J.H.), MA; Boston University School of Medicine (J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., S.S.), UT Health San Antonio, TX; UC Davis Center for Neuroscience (C.S.D.), CA; Sunnybrook Research Institute (E.S.), University of Toronto, Ontario, Canada; Harvard Aging Brain Institute (K.A.J.), Harvard Medical School, Boston, MA; Gordon Center for Medical Imaging (G.E.F., E.T.), Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston; Turner Institute for Brain and Mental Health (S.R.Y., M.G.C., M.P.P.), Monash University, Clayton, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Harvard University, Boston, MA
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Liu X, Xu P, Wei R, Cheng B, Sun L, Yang L, Chen G. Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China. Front Public Health 2024; 11:1047025. [PMID: 38249381 PMCID: PMC10796606 DOI: 10.3389/fpubh.2023.1047025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Objective To examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations. Methods This community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored. Results The age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p < 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7-7.9 h regarded as the reference group) for individuals with a sleep duration of <6, 6-6.9, 8-8.9, and ≥ 9 h were 1.280 (1.053-1.557), 1.425 (1.175-1.728), 1.294 (1.068-1.566), and 1.360 (1.109-1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60-80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108-1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055-1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080-1.534) and those aged 81-97 years (OR: 2.128, 95%CI: 1.152-3.934). For cognitive impairment, the group aged 81-97 years with daytime dysfunction was associated with a higher odds ratio than other age groups. Conclusion The present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81-97 years exhibiting the strongest association.
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Affiliation(s)
- Xuechun Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, China
| | - Peiru Xu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Rong Wei
- Outpatient Department of the Second Hospital of Anhui Medical University, Hefei, China
| | - Beijing Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Fuyang Center of Disease Control and Prevention, Fuyang, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Guihai Chen
- Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China
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Bulycheva I, Watanabe Y, Kitamura K, Kabasawa K, Saito T, Takahashi A, Kobayashi R, Oshiki R, Takachi R, Tsugane S, Yamazaki O, Watanabe K, Nakamura K. Self-Reported Sleep Duration and Bedtime Are Associated with Dementia Risk in Community-Dwelling People Aged 40-74 Years: The Murakami Cohort Study. J Alzheimers Dis 2024; 99:535-547. [PMID: 38669530 DOI: 10.3233/jad-231104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Sleep is a potentially modifiable factor associated with dementia, including Alzheimer's disease, but current evidence supporting this is insufficient. Objective This study aimed to determine whether sleep duration and bedtime patterns are associated with the risk of dementia among middle-aged and older people. Methods This cohort study had an eight-year follow-up period. Participants were 13,601 community-dwelling people aged 40-74 years living in Murakami (Niigata, Japan). Data were collected using a self-administered questionnaire. Predictors were self-reported sleep duration and bedtime, and the outcome was newly-diagnosed dementia determined using the long-term care insurance database. Covariates were demographic characteristics, body mass index, smoking, alcohol consumption, total physical activity, insomnia symptoms, disease history, and either bedtime or sleep duration. Cox proportional hazard models were used to calculate hazard ratios (HRs). Results The mean age of participants at baseline was 59.2 years. Over a mean follow-up period of 8.0 years, 319 cases of dementia were observed. A long self-reported sleep duration relative to the reference sleep duration (7 hours) was associated with increased dementia risk, with the "8 hours" group (adjusted HR = 1.30, 95% CI:0.99-1.73) and "≥9 hours" group (adjusted HR = 1.46, 95% CI:1.00-2.15) having an increased risk (marginally significant) relative to the reference group. Early bedtime was associated with increased dementia risk (adjusted p for trend = 0.0010), with the "21 : 00 or earlier" group (adjusted HR = 1.61, 95% CI:1.14-2.28) having an increased risk relative to the reference ("23 : 00"). Conclusions A long self-reported sleep duration and early bedtime are both associated with increased dementia risk in middle-aged and older people.
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Affiliation(s)
- Irina Bulycheva
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshiko Saito
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | | | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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14
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Bettencourt C, Skene N, Bandres-Ciga S, Anderson E, Winchester LM, Foote IF, Schwartzentruber J, Botia JA, Nalls M, Singleton A, Schilder BM, Humphrey J, Marzi SJ, Toomey CE, Kleifat AA, Harshfield EL, Garfield V, Sandor C, Keat S, Tamburin S, Frigerio CS, Lourida I, Ranson JM, Llewellyn DJ. Artificial intelligence for dementia genetics and omics. Alzheimers Dement 2023; 19:5905-5921. [PMID: 37606627 PMCID: PMC10841325 DOI: 10.1002/alz.13427] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
Genetics and omics studies of Alzheimer's disease and other dementia subtypes enhance our understanding of underlying mechanisms and pathways that can be targeted. We identified key remaining challenges: First, can we enhance genetic studies to address missing heritability? Can we identify reproducible omics signatures that differentiate between dementia subtypes? Can high-dimensional omics data identify improved biomarkers? How can genetics inform our understanding of causal status of dementia risk factors? And which biological processes are altered by dementia-related genetic variation? Artificial intelligence (AI) and machine learning approaches give us powerful new tools in helping us to tackle these challenges, and we review possible solutions and examples of best practice. However, their limitations also need to be considered, as well as the need for coordinated multidisciplinary research and diverse deeply phenotyped cohorts. Ultimately AI approaches improve our ability to interrogate genetics and omics data for precision dementia medicine. HIGHLIGHTS: We have identified five key challenges in dementia genetics and omics studies. AI can enable detection of undiscovered patterns in dementia genetics and omics data. Enhanced and more diverse genetics and omics datasets are still needed. Multidisciplinary collaborative efforts using AI can boost dementia research.
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Affiliation(s)
- Conceicao Bettencourt
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - Nathan Skene
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Sara Bandres-Ciga
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Emma Anderson
- Department of Mental Health of Older People, Division of Psychiatry, University College London, London, UK
| | | | - Isabelle F Foote
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Jeremy Schwartzentruber
- Open Targets, Cambridge, UK
- Wellcome Sanger Institute, Cambridge, UK
- Illumina Artificial Intelligence Laboratory, Illumina Inc, Foster City, California, USA
| | - Juan A Botia
- Departamento de Ingeniería de la Información y las Comunicaciones, Universidad de Murcia, Murcia, Spain
| | - Mike Nalls
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
- Data Tecnica International LLC, Washington, DC, USA
| | - Andrew Singleton
- Center for Alzheimer's and Related Dementias (CARD), National Institute on Aging and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Brian M Schilder
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Jack Humphrey
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sarah J Marzi
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Christina E Toomey
- Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
- The Francis Crick Institute, London, UK
| | - Ahmad Al Kleifat
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eric L Harshfield
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - Cynthia Sandor
- UK Dementia Research Institute. School of Medicine, Cardiff University, Cardiff, UK
| | - Samuel Keat
- UK Dementia Research Institute. School of Medicine, Cardiff University, Cardiff, UK
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, Neurology Section, University of Verona, Verona, Italy
| | - Carlo Sala Frigerio
- UK Dementia Research Institute, Queen Square Institute of Neurology, University College London, London, UK
| | | | | | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK
- The Alan Turing Institute, London, UK
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15
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Sen A, Tai XY. Sleep Duration and Executive Function in Adults. Curr Neurol Neurosci Rep 2023; 23:801-813. [PMID: 37957525 PMCID: PMC10673787 DOI: 10.1007/s11910-023-01309-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW To review the literature examining the relationship between sleep and cognition, specifically examining the sub-domain of executive function. We explore the impact of sleep deprivation and the important question of how much sleep is required for optimal cognitive performance. We consider how other sleep metrics, such as sleep quality, may be a more meaningful measure of sleep. We then discuss the putative mechanisms between sleep and cognition followed by their contribution to developing dementia. RECENT FINDINGS Sleep duration and executive function display a quadratic relationship. This suggests an optimal amount of sleep is required for daily cognitive processes. Poor sleep efficiency and sleep fragmentation are linked with poorer executive function and increased risk of dementia during follow-up. Sleep quality may therefore be more important than absolute duration. Biological mechanisms which may underpin the relationship between sleep and cognition include brain structural and functional changes as well as disruption of the glymphatic system. Sleep is an important modifiable lifestyle factor to improve daily cognition and, possibly, reduce the risk of developing dementia. The impact of optimal sleep duration and sleep quality may have important implications for every ageing individual.
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Affiliation(s)
- Aayushi Sen
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Level 6 West Wing, Oxford, UK.
| | - Xin You Tai
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Level 6 West Wing, Oxford, UK
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16
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Fang W, Le S, Han W, Peng-Jiao X, Shuai Y, Rui-Ling Z, Lin L, Ya-Hui X. Association between napping and cognitive impairment: A systematic review and meta-analysis. Sleep Med 2023; 111:146-159. [PMID: 37776585 DOI: 10.1016/j.sleep.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/12/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023]
Abstract
STUDY OBJECTIVES Increasing evidence suggests that napping is associated with cognitive impairment and dementia, but the conclusions are inconsistent. Moreover, the extent of the risk is uncertain. We therefore conducted a systematic review and meta-analysis to quantify the connection between napping and cognitive impairment. METHODS We performed a systematic search of PubMed, EMBASE, Web of Science, and Cochrane Library for studies that were published up to June 2023, and assessed associations between napping and cognitive impairment. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed. RESULTS A total of 4535 papers were retrieved, with 20 reports assessing the relationships between napping and cognitive impairment. Pooled analysis indicated that napping was associated with dementia (OR = 1.14; 95% CI: 1.07-1.21). Importantly, we found that those napping longer than 30, 45, and 60 min/day were 35%, 41%, and 40%, respectively, more likely to have an increased risk of cognitive impairment (30 min: OR = 1.35; 95% CI: 1.24-1.48; 45 min: OR = 1.41; 95% CI: 1.27-1.58; 60 min: OR = 1.40; 95% CI: 1.26-1.56). North America and Europe showed that associations existed between napping and cognitive impairment (North America: OR = 1.15; 95% CI: 1.04-1.27; Europe: OR = 1.13; 95% CI: 1.08-1.18). CONCLUSIONS This meta-analysis indicated associations between long napping durations and cognitive impairment or dementia, suggesting that longer napping might be a potential risk factor of adverse cognitive outcomes.
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Affiliation(s)
- Wu Fang
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Shi Le
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing, China
| | - Wang Han
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xu Peng-Jiao
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yu Shuai
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhang Rui-Ling
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Lu Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing, China.
| | - Xu Ya-Hui
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
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17
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Kinoshita K, Otsuka R, Takada M, Nishita Y, Tange C, Jinzu H, Suzuki K, Shimokata H, Imaizumi A, Arai H. Dietary amino acid intake and sleep duration are additively involved in future cognitive decline in Japanese adults aged 60 years or over: a community-based longitudinal study. BMC Geriatr 2023; 23:653. [PMID: 37821805 PMCID: PMC10568860 DOI: 10.1186/s12877-023-04359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Sleep duration and amino acid intake are independently associated with cognitive decline. This study aimed to determine the longitudinal association between sleep duration and cognitive impairment incidence and to examine the involvement of diet, particularly amino acid intake, in these associations in community dwellers. METHODS In this longitudinal study in a community-based setting, we analyzed data from 623 adults aged 60-83 years without cognitive impairment at baseline. Sleep duration was assessed using a self-report questionnaire. Amino acid intake was assessed using 3-day dietary records. Cognitive impairment was defined as a Mini-Mental State Examination score ≤ 27. Participants were classified into short-, moderate-, and long-sleep groups according to baseline sleep duration (≤ 6, 7-8, and > 8 h, respectively). Using moderate sleep as a reference, odds ratios (ORs) and 95% confidence intervals (CIs) of short- and long-sleep for cognitive-impairment incidence were estimated using the generalized estimating equation. Participants were classified according to sex-stratified quartiles (Q) of 19 amino acid intake: Q1 and Q2-Q4 were low- and middle to high-intake groups, respectively. Using middle- to high-intake as a reference, ORs and 95% CIs of low intake for cognitive impairment incidence were estimated using the generalized estimating equation in each sleep-duration group. Follow-up period, sex, age, body mass index, depressive symptoms, education, smoking status, employment status, sleep aids use, physical activity, medical history, and Mini-Mental State Examination score at baseline were covariates. RESULTS Mean follow-up period was 6.9 ± 2.1 years. Adjusted ORs (95% CIs) for cognitive impairment in short- and long-sleep groups were 0.81 (0.49-1.35, P = 0.423) and 1.41 (1.05-1.87, P = 0.020), respectively. Particularly in long sleepers (i.e., > 8 h), cognitive impairment was significantly associated with low cystine, proline, and serine intake [adjusted ORs (95% CIs) for cognitive impairment were 2.17 (1.15-4.11, P = 0.017), 1.86 (1.07-3.23, P = 0.027), and 2.21 (1.14-4.29, P = 0.019), respectively]. CONCLUSIONS Community-dwelling adults aged ≥ 60 years who sleep longer are more likely to have cognitive decline, and attention should be paid to the low cystine, proline, and serine intake.
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Affiliation(s)
- Kaori Kinoshita
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan.
| | - Rei Otsuka
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Michihiro Takada
- Research Institute for Bioscience Products & Fine Chemicals, AJINOMOTO CO., Inc., Kanagawa, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Hiroko Jinzu
- Institute of Food Sciences and Technologies, AJINOMOTO CO., Inc., Kanagawa, Japan
| | - Katsuya Suzuki
- Institute of Food Sciences and Technologies, AJINOMOTO CO., Inc., Kanagawa, Japan
| | - Hiroshi Shimokata
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Akira Imaizumi
- Research Institute for Bioscience Products & Fine Chemicals, AJINOMOTO CO., Inc., Kanagawa, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
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18
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Arévalo SP, Nguyen-Rodriguez ST, Scott TM, Gao X, Falcón LM, Tucker KL. Longitudinal Associations Between Sleep and Cognitive Function in a Cohort of Older Puerto Rican Adults: Sex and Age Interactions. J Gerontol A Biol Sci Med Sci 2023; 78:1816-1825. [PMID: 37306295 PMCID: PMC10562885 DOI: 10.1093/gerona/glad144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Evidence on sleep duration or quality and cognitive function in diverse older adults is limited. We examined prospective associations between subjective sleep measures and cognitive function, with modifying effects of sex and age (<65 vs ≥65 years). METHODS Data are from the longitudinal Boston Puerto Rican Health Study, Waves 2 (n = 943) and 4 (n = 444), with mean follow-up of 10.5 years (range 7.2-12.8). Subjective measures of sleep duration (short <7, ref. 7, or long ≥8 hours) and insomnia symptoms (sum of difficulty falling asleep, waking up at night, and early morning awakening), were assessed at Wave 2. Linear regression models were used to assess changes in global cognition, executive function, memory, and Mini-Mental State Examination, and tested for modifying roles of sex and age. RESULTS Significant 3-way interaction (sex × age × cognition) in fully adjusted models showed greater decline in global cognitive function in older men with short (β [95% confidence interval]: -0.67 [-1.24, -0.10]) or long sleep duration (-0.92 [-1.55, -0.30]), compared to women, younger men, and older men with 7 hours of sleep. Insomnia symptoms were associated with a greater decline in memory (-0.54, [-0.85, -0.22]) among older men, compared to women and younger men. CONCLUSION Sleep duration showed a U-shaped association with cognitive decline, and insomnia symptoms were associated with memory decline in fully adjusted models. Older men, versus women and younger men, were at relatively greater risk for cognitive decline associated with sleep factors. These findings are important for personalizing sleep interventions to support cognitive health.
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Affiliation(s)
- Sandra P Arévalo
- Department of Human Development, California State University, Long Beach, California, USA
| | | | - Tammy M Scott
- Neuroscience and Aging Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Boston, Massachusetts, USA
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Luis M Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, Massachusetts, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of MassachusettsLowell, Massachusetts, USA
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19
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Moysés-Oliveira M, Adami LNG, Guerreiro P, Mosini AC, Kloster A, Cunha L, Paschalidis M, Marquezini BP, Pires GN, Tempaku PF, Andersen ML, Tufik S. Endocrine and Epigenetic Regulation as Common Pathways Underlying the Genetic Basis of Sleep Traits and Longevity. Rejuvenation Res 2023; 26:206-213. [PMID: 37694591 DOI: 10.1089/rej.2023.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
The amount of sleep needed over one's lifespan is age dependent and not sleeping enough or sleeping in excess is associated with increased morbidity and mortality. Yet, the convergent molecular mechanisms that link longevity and sleep are largely unknown. We performed a gene enrichment study that (1) identified genes associated with both longevity and sleep traits and (2) determined molecular pathways enriched among these shared genes. We manually curated two sets of genes, one associated with longevity and aging and the other with sleep traits (e.g., insomnia, narcolepsy, sleep duration, chronotype, among others), with both gene lists heavily driven by hits from recent large-scale Genome-Wide Association Studies. There were 47 overlapping genes between the gene list associated with sleep traits (1064 genes total) and the genes associated with longevity (367 genes total), indicating significantly more overlap than expected by chance. An overrepresentation analysis identified enriched pathways that suggest endocrine and epigenetic regulation as potential shared mechanisms between sleep traits and longevity. Concordantly, functional network analysis retrieved two clusters, being one associated with proteins of nuclear functions and the other, with extracellular proteins. This overlapping gene set, and the highlighted biological pathways may serve as preliminary findings for new functional investigations of sleep and longevity shared genetic mechanisms.
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Affiliation(s)
| | - Luana N G Adami
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Pedro Guerreiro
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | | | - Anna Kloster
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Lais Cunha
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Mayara Paschalidis
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | | | - Gabriel N Pires
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Priscila F Tempaku
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
| | - Monica L Andersen
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Sleep Institute, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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20
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Harse JD, Marriott RJ, Zhu K, Murray K, Bucks RS. Vitamin D status and cognitive performance in community-dwelling adults: A dose-response meta-analysis of observational studies. Front Neuroendocrinol 2023:101080. [PMID: 37268277 DOI: 10.1016/j.yfrne.2023.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/27/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
Low vitamin D status is linked with poorer cognition in adults while findings in relation to high levels are mixed.We performed a systematic review and meta-analyses to examine dose-response associations between 25-hydroxyvitamin D (25OHD) levelsand cognitive performance in community-dwelling adults. Thirty-eight observational studies were included in dose-response meta-analyses. Positive, nonlinear associations were identified between baseline25OHD levels and global cognition incross-sectional and longitudinal analyses, and for performance in memory and executive function in longitudinal analyses. When restricted to studies involving older adults, thepattern emerged forspecific domains in cross-sectional analyses. Poorer performance was associated with low 25OHD levels, while a sharp improvement was associated withlevels up to 60-70 nM/L. Further improvement was observed only for longitudinal global cognition. Our findings support the association between low vitamin D and poorer cognition and suggest levels of at least 60 nM/L are associated with better cognition during ageing.
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Affiliation(s)
- Janis D Harse
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia.
| | - Ross J Marriott
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Medical School, University of Western Australia, Crawley, Western Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
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Kong J, Zhou L, Li X, Ren Q. Sleep disorders affect cognitive function in adults: an overview of systematic reviews and meta-analyses. Sleep Biol Rhythms 2023; 21:133-142. [PMID: 38469285 PMCID: PMC10900040 DOI: 10.1007/s41105-022-00439-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023]
Abstract
Sleep disorders frequently result in poor memory, attention deficits, as well as a worse prognosis for neurodegenerative changes, such as Alzheimer's disease. The purpose of this study is to investigate the impact of sleep disorders on cognition. We screened four databases for all meta-analyses and systematic reviews from the establishment through March 2022. We have carried out quality evaluation and review the eligible systematic reviews. Evidence grading and quality assessment were performed on 22 eligible articles. Sleep deprivation primarily affects simple attention, complex attention, and working memory in cognition and alertness. The moderate-to-high-quality evidence proves optimal sleep time as 7-8 h. Sleep time outside this range increases the risk of impaired executive function, non-verbal memory, and working memory. Sleep-related breathing disorders is more likely to cause mild cognitive impairment and affects several cognitive domains. In older adults, insomnia primarily affects working memory, episodic memory, inhibitory control, cognitive flexibility, problem-solving, operational ability, perceptual function, alertness, and complex attention, and maintaining sensitivity. Sleep disturbances significantly impair cognitive function, and early detection and intervention may be critical steps in reducing poor prognosis. A simple neuropsychological memory test could be used to screen people with sleep disorders for cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00439-9.
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Affiliation(s)
- Jingting Kong
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
| | - Lv Zhou
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
| | - Xiaoli Li
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 China
| | - Qingguo Ren
- School of Medicine, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 Jiangsu China
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009 China
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Zhou L, Kong J, Li X, Ren Q. Sex differences in the effects of sleep disorders on cognitive dysfunction. Neurosci Biobehav Rev 2023; 146:105067. [PMID: 36716906 DOI: 10.1016/j.neubiorev.2023.105067] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Sleep is an essential physiological function that sustains human life. Sleep disorders involve problems with the quality, duration, and abnormal behaviour of sleep. Insomnia is the most common sleep disorder, followed by sleep-disordered breathing (SDB). Sleep disorders often occur along with medical conditions or other mental health conditions. Of particular interest to researchers is the role of sleep disorders in cognitive dysfunction. Sleep disorder is a risk factor for cognitive dysfunction, yet the exact pathogenesis is still far from agreement. Little is known about how sex differences influence the changes in cognitive functions caused by sleep disorders. This narrative review examines how sleep disorders might affect cognitive impairment, and then explores the sex-specific consequences of sleep disorders as a risk factor for dementia and the potential underlying mechanisms. Some insights on the direction of further research are also presented.
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Affiliation(s)
- Lv Zhou
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Jingting Kong
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Xiaoli Li
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Qingguo Ren
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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Acupuncture is associated with reduced dementia risk in patients with insomnia: A propensity-score-matched cohort study of real-world data. J Tradit Complement Med 2023; 13:297-305. [PMID: 37128194 PMCID: PMC10148128 DOI: 10.1016/j.jtcme.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
Background and aim Insomnia is a subjective illness that has been identified as a risk factor for dementia. In this study, we investigated the association of acupuncture treatment for insomnia with the risk of dementia. We collected data from the National Health Insurance Research Database (NHIRD) of Taiwan to analyze the incidence of dementia in patients with insomnia who received acupuncture treatment. Experimental procedure This retrospective matched-cohort study included 152,585 patients, selected from the NHIRD, who were newly diagnosed with insomnia between 2000 and 2010. The follow-up period ranged from the index date to the date of dementia diagnosis, date of withdrawal from the insurance program, or December 31, 2013. A 1:1 propensity score method was used to match an equal number of patients (N = 18,782) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazards models to evaluate the risk of dementia. The cumulative incidence of dementia in both cohorts was estimated using the Kaplan-Meier method, and the difference between them was assessed through a log-rank test. Results and conclusion Patients with insomnia who received acupuncture treatment were observed to have a lower risk of dementia (adjusted hazard ratio = 0.54, 95% confidence interval = 0.50-0.60) than those who did not undergo acupuncture treatment. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The results suggest that acupuncture treatment significantly reduced or slowed the development of dementia in patients with insomnia.
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Zhang H, Zhang L, Chen C, Zhong X. Association between daytime napping and cognitive impairment among Chinese older population: a cross-sectional study. Environ Health Prev Med 2023; 28:72. [PMID: 37989282 PMCID: PMC10685077 DOI: 10.1265/ehpm.23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/30/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Both napping and nighttime sleep duration have been reported to be associated with cognitive function in older adults, whereas little is known about the association between daytime napping and cognitive impairment in different nighttime sleep duration subgroups. This study aimed to explore the correlation between daytime napping and cognitive impairment across nighttime sleep duration subgroups. METHODS A cross-sectional study was conducted by using the fourth survey of China Health and Retirement Longitudinal Study (CHARLS). We utilized the Mini-Mental State Examination (MMSE) scale to define cognitive impairment, and the daytime napping and nighttime sleep duration was self-reported by individuals. We applied the Restricted Cubic Spline (RCS) to analysis the dose-response relationships between daytime napping and cognitive impairment. And the multivariate Logistic Regression Model (LRM) was performed to evaluate the association of daytime napping and cognitive impairment. RESULTS A total of 3,052 individuals were included, of which 769 were cognitive impairment. The RCS showed there were non-linear association between daytime napping and cognitive impairment in all participants group and longer nighttime sleep duration subgroup (PNon-linear < 0.05, PDaytime napping < 0.05). The LRM revealed no napping (OR = 1.62, 95%CI 1.14-2.30) and excessive napping (1.64 95%CI 1.09-2.48) were related to cognitive impairment in longer nighttime sleep duration subgroup. CONCLUSIONS Daytime napping had nonlinear association with cognitive impairment in Chinese elderly population. No napping and excessive daytime napping (>90 minutes) were related to cognitive impairment in participants with 7 and more hours nighttime sleep duration.
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Affiliation(s)
- Hong Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Lijuan Zhang
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Chen Chen
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
| | - Xiaoni Zhong
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing 400016, PR China
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Lyu Q, Guan CX, Kong LN, Zhu JL. Prevalence and risk factors of cognitive frailty in community-dwelling older adults with diabetes: A systematic review and meta-analysis. Diabet Med 2023; 40:e14935. [PMID: 35962598 DOI: 10.1111/dme.14935] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/19/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
AIMS Cognitive frailty can increase the risk of adverse health outcomes in older adults. Estimates of the prevalence of cognitive frailty among older adults with diabetes varied widely in literature. This study aimed to conduct a systematic review and meta-analysis to assess the pooled prevalence of cognitive frailty and risk factors in community-dwelling older adults with diabetes, providing evidence for healthcare professionals to better understand the status of cognitive frailty and help develop effective interventions. METHODS Databases of PubMed, Web of Science, Cochrane Library, Embase, Cumulative Index of Nursing and Allied Health, Proquest, China National Knowledge Infrastructure and China Biology Medicine were searched from inception to February 10th, 2022. The reviewers independently selected studies, extracted data and assessed the quality of studies. Pooled prevalence of cognitive frailty and risk factors were estimated. Subgroup analysis, meta-regression analysis, sensitivity analysis and publication bias were also conducted. RESULTS A total of 15 studies with 6391 participants were included in this review. The pooled prevalence of cognitive frailty was 11% (95%CI = 7.9-14%) in community-dwelling older adults with diabetes. Pooled estimates showed that increasing age, higher level of HbA1c, shorter night sleep duration and depression were risk factors, and regular exercise was the protective factor of cognitive frailty in community-dwelling older adults with diabetes. CONCLUSION Cognitive frailty was common in community-dwelling older adults with diabetes. Routine screening of cognitive frailty and effective interventions should be implemented for this population in community settings. REGISTRATION PROSPERO ID CRD42021276973.
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Affiliation(s)
- Qiong Lyu
- Department of General Practice, The first Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chi-Xun Guan
- School of Nursing, Dalian University, Dalian, China
| | - Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Jia-Lu Zhu
- School of Nursing, Chongqing Medical University, Chongqing, China
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26
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Xiong Y, Zhang Y, Zhang F, Wu C, Qin F, Yuan J. Reduced sleep duration increases the risk of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in middle-aged and elderly males: a national cross-sectional study. Aging Male 2022; 25:159-166. [PMID: 35635060 DOI: 10.1080/13685538.2022.2079627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The prevalence of lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) remains high in men. However, whether reduced sleep duration enhances the risk of LUTS/BPH remains unknown. MATERIALS AND METHODS The 2015 China Health and Retirement Longitudinal Study was used in this study. Binary logistic regression was adopted to test the relationship between sleep duration and LUTS/BPH. Restricted cubic spline (RCS) regression was used to examine the non-linear association. In sensitivity analyses, propensity scores matching was performed to verify the robustness of the results. RESULTS In this study, 8,920 males aged 40 years above were enrolled. In the fully adjusted logistic model, across the quartiles of sleep duration, the odds ratios of LUTS/BPH were 1.00 (reference), 0.94 (95% CI 0.77-1.15), 0.74 (95% CI 0.58-0.94), 0.54 (0.37-0.75), respectively. The results of RCS indicated a non-linear inverted U-shaped association between sleep duration and LUTS/BPH (p for non-linearity <0.05). In the subgroup analyses, no significant effects of settlements, alcohol and cigarette consumption, depression, and hypertension on the association between sleep duration and prevalent LUTS/BPH were observed (p for interaction >0.05). CONCLUSION Reduced sleep duration is significantly associated with the increases of the LUTS/BPH risk in Chinese middle-aged and elderly males.
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Affiliation(s)
- Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yangchang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Changjing Wu
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, China
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
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27
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Naismith SL, Leng Y, Palmer JR, Lucey BP. Age differences in the association between sleep and Alzheimer's disease biomarkers in the EPAD cohort. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12380. [PMID: 36447477 PMCID: PMC9695753 DOI: 10.1002/dad2.12380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/26/2022]
Abstract
Introduction We aimed to determine the independent association between sleep quality and Alzheimer's disease (AD) biomarkers, and whether the associations differ with age. Methods We included 1240 individuals aged ≥50, without dementia from the European Prevention of Alzheimer's Disease v1500.0 dataset. Linear regression was used to examine Pittsburgh Sleep Quality Index (PSQI) scores against cerebrospinal fluid (CSF) phosphorylated tau/β-amyloid ratio (p-tau/Aβ42) for the entire sample and via age tertiles. Models controlled for demographic, clinical, genetic, vascular, and neuroimaging variables. Results For the youngest age tertile, shorter sleep duration and higher sleep efficiency were associated with greater p-tau/Aβ42 ratio. For the oldest tertile, longer sleep latency was associated with greater p-tau/Aβ42. Discussion Differential relationships between sleep and AD pathology depend on age. Short sleep duration and sleep efficiency are relevant in middle age whereas time taken to fall asleep is more closely linked to AD biomarkers in later life. Highlights This study shows age differences in the link between sleep and AD biomarkers.Shorter sleep was associated with greater p-tau/Aβ42 ratio in middle age.The association was independent of genetic, vascular, and neuroimaging markers of AD.
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Affiliation(s)
- Sharon L. Naismith
- School of PsychologyFaculty of ScienceThe University of SydneySydneyNew South WalesAustralia
- CogSleep NHMRC Centre of Research ExcellenceThe University of SydneySydneyNew South WalesAustralia
- Brain and Mind Centre and Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Yue Leng
- Department of Psychiatry and Behavioural SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Jake R. Palmer
- School of PsychologyFaculty of ScienceThe University of SydneySydneyNew South WalesAustralia
- CogSleep NHMRC Centre of Research ExcellenceThe University of SydneySydneyNew South WalesAustralia
- Brain and Mind Centre and Charles Perkins CentreThe University of SydneySydneyNew South WalesAustralia
| | - Brendan P. Lucey
- Department of NeurologyWashington University School of MedicineSt LouisMissouriUSA
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Huang SY, Li YZ, Zhang YR, Huang YY, Wu BS, Zhang W, Deng YT, Chen SD, He XY, Chen SF, Dong Q, Zhang C, Chen RJ, Suckling J, Rolls ET, Feng JF, Cheng W, Yu JT. Sleep, physical activity, sedentary behavior, and risk of incident dementia: a prospective cohort study of 431,924 UK Biobank participants. Mol Psychiatry 2022; 27:4343-4354. [PMID: 35701596 DOI: 10.1038/s41380-022-01655-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/17/2022] [Accepted: 05/31/2022] [Indexed: 02/07/2023]
Abstract
Although sleep, physical activity and sedentary behavior have been found to be associated with dementia risk, findings are inconsistent and their joint relationship remains unclear. This study aimed to investigate independent and joint associations of these three modifiable behaviors with dementia risks. A total of 431,924 participants (median follow-up 9.0 years) without dementia from UK Biobank were included. Multiple Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Models fitted with restricted cubic spline were conducted to test for linear and nonlinear shapes of each association. Sleep duration, leisure-time physical activity (LTPA), and screen-based sedentary behavior individually associated with dementia risks in different non-linear patterns. Sleep duration associated with dementia in a U-shape with a nadir at 7 h/day. LTPA revealed a curvilinear relationship with dementia in diminishing tendency, while sedentary behavior revealed a J-shaped relationship. The dementia risk was 17% lower in the high LTPA group (HR[95%CI]: 0.83[0.76-0.91]) and 22% higher in the high sedentary behavior group (1.22[1.10-1.35]) compared to the corresponding low-level group, respectively. A combination of seven-hour/day sleep, moderate-to-high LTPA, and low-to-moderate sedentary behavior showed the lowest dementia risk (0.59[0.50-0.69]) compared to the referent group (longer or shorter sleep/low LTPA/high sedentary behavior). Notably, each behavior was non-linearly associated with brain structures in a pattern similar to its association with dementia, suggesting they may affect dementia risk by affecting brain structures. Our findings highlight the potential to change these three daily behaviors individually and simultaneously to reduce the risk of dementia.
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Affiliation(s)
- Shu-Yi Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Zhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Yuan Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Yue-Ting Deng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao-Yu He
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Fen Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, Mass General Institute for Neurodegenerative Diseases (MIND), Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Ren-Jie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Oxford Centre for Computational Neuroscience, Oxford, UK
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
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Gan J, Liu S, Wang F, Shi Z, Lü Y, Niu J, Meng X, Cai P, Wang XD, Chen Z, Gang B, Ji Y. Association between prevalence rate of dementia with Lewy bodies and sleep characteristics in Chinese old adults. Front Hum Neurosci 2022; 16:976753. [PMID: 36188174 PMCID: PMC9518672 DOI: 10.3389/fnhum.2022.976753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction: Few studies are available on the prevalence and sleep-related factors of dementia with Lewy bodies (DLB) in Chinese older adults, aiming to explore the associations between sleep characteristics and DLB. Methods: A cross-sectional study with 7,528 individuals aged ≥65 years in 106 communities in Northern China was conducted from April 2019 to January 2020. Questionaries (including demographic characteristics, comorbidities, lifestyles, and sleep characteristics) were administered, and neuropsychological assessments and physical examination were conducted in phase I; screening for probable DLB was done in phase II. Logistic regressions were used to assess associations. Results: A total of 919 (12.2%, 919/7,528) participants had dementia, and 101 (1.3%, 101/7,528) participants were diagnosed with DLB. The prevalence of dementia and DLB were slightly higher or equal in women, increased with age, and roughly decreased with nighttime sleep duration. Of the 101 participants, all of them (100.0%) had cognitive impairment, 46 (44.54%) displayed fluctuating cognition, 72 (71.29%) of them showed visual hallucination, 22 (21.78%) individuals reported RBD, and 27.71% showed Parkinsonism. Sleeping for <5 h (adjusted OR = 1.795, 95%CI: 1.055–3.054, p < 0.05) or having hypersomnolence (adjusted OR = 31.213, 95% CI: 17.618–55.301, p < 0.001) were significantly associated with the occurrence of DLB. Sleep duration of <5 h or >8 h had combined diagnostic value for DLB (AUC = 0.783, 95%CI: 0.734–0.831, p < 0.001). Conclusions: The current prevalence of DLB is 1.3% in Northern China. Short or long nighttime sleep duration is independently associated with the occurrence of dementia and DLB.
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Affiliation(s)
- Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Liu
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Fei Wang
- Department of Neurology, Yuncheng Central Hospital of Shanxi Province, Shanxi, China
| | - Zhihong Shi
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianping Niu
- Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Xinling Meng
- Department of Neurology, Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, China
| | - Pan Cai
- Dementia Clinic, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiao-Dan Wang
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhichao Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baozhi Gang
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
- *Correspondence: Baozhi Gang Yong Ji
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Tianjin Dementia Institute, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
- *Correspondence: Baozhi Gang Yong Ji
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Liu W, Wu Q, Wang M, Wang P, Shen N. Prospective association between sleep duration and cognitive impairment: Findings from the China Health and Retirement Longitudinal Study (CHARLS). Front Med (Lausanne) 2022; 9:971510. [PMID: 36148464 PMCID: PMC9485441 DOI: 10.3389/fmed.2022.971510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The association between sleep duration and cognition are inconclusive. Our study aimed to comprehensively investigate the effects of sleep duration on the risk of cognitive impairment in the middle-aged and older Chinese population. Methods We used the longitudinal cohort data from waves 1-4 (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS). Self-reported exposures included total sleep duration, nocturnal sleep duration, post-lunch napping, and changes in sleep duration over time according to face-to-face interviews. Cognitive function was assessed by a Chinese version of the Modified Mini-Mental State Examination (MMSE). Results A total of 7,342 eligible participants were included. The mean age was 61.5 ± 6.5 years, and 48.9% (3,588/7,342) were male. We identified a U-shaped association of total sleep duration as well as nocturnal sleep duration with the risk of cognitive impairment. People with 7-8 h of total sleep duration and 6-7 h of nocturnal sleep had the lowest risk of cognitive impairment. Further results showed that post-lunch napping within 2 h was beneficial to cognition and 60 min was optimal. Moreover, analyses of changes in sleep duration further supported that sleeping less or more was harmful to cognition. Notably, those "excessive-change" sleepers (from ≤6 to ≥9 h, or from ≥9 to ≤6 h) had more risks. Conclusions Keeping 7-8 h per day was related to the lowest risk of cognitive impairment in midlife and late life, and an optimal post-lunch napping was 60 min for these stable sleepers. Especially, excessive changes in sleep duration over time led to poorer cognition. Our work highlights the importance of optimal sleep habits to cognitive function. The self-reported sleep measures limited our findings, and further studies are needed for verification.
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Affiliation(s)
- Wenhua Liu
- Clinical Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingsong Wu
- Department of Scientific Research Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minghuan Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Wang
- Institute and Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Na Shen
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Midorikawa H, Tachikawa H, Aiba M, Watanabe T, Tamiya N, Arai T. Factors associated with short and long sleep duration in older adults: Analysis of a national survey in Japan. Geriatr Gerontol Int 2022; 22:660-666. [PMID: 35844191 DOI: 10.1111/ggi.14438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to clarify the association between sleep duration and various physical and psychosocial factors among older Japanese adults. METHODS Data from 295 367 households were obtained from the 2013 Comprehensive Survey of Living Conditions in Japan, a self-administered questionnaire survey. We restricted our analyses to 115 205 participants who responded to all the items required for this study. Multinomial logistic regression models examined the association between sleep duration and various factors. RESULTS Overall, 26.0% of the participants slept for <6 h, 56.0% slept for 6-8 h, and 18.0% slept for ≥8 h. Poor subjective health and mental health increased the risk of both short (poor subjective health: odds ratio [OR] 1.22, 95% confidence interval [CI] 1.17-1.27; severe mental distress: OR 2.21, 95% CI 2.04-2.40) and long (poor subjective health: OR 1.19, 95% CI 1.13-1.24; severe mental distress: OR 1.25, 95% CI 1.13-1.38) sleep duration. Many subjective symptoms, including chest, respiratory, musculoskeletal and urogenital symptoms, were associated with short sleep duration. However, only memory loss was associated with long sleep duration (OR 1.23, 95% CI 1.16-1.31). CONCLUSIONS We need to be aware that older people with short sleep duration may have various physical symptoms. Moreover, as physical and mental problems, cognitive decline and unhealthy lifestyles are associated with long sleep duration, we also need to pay attention to the living conditions of those who complain of long sleep duration. The limitations of this study were that the variables were self-reported and sleep duration was not evaluated objectively. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.,Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan
| | - Miyuki Aiba
- Faculty of Human Sciences, Toyo Gakuen University, Tokyo, Japan
| | - Taeko Watanabe
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Research and Development Center for Health Services, University of Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Sleep habits are associated with cognition decline in physically robust, but not in frail participants: a longitudinal observational study. Sci Rep 2022; 12:11595. [PMID: 35804185 PMCID: PMC9270465 DOI: 10.1038/s41598-022-15915-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
Frail older adults are vulnerable to stressors; thus, sleep related cognition impairment might more greatly affect frail than healthy older adults. In the present study, we investigated whether the association between sleep problems and cognition varies with physical frailty status (modified from Fried et al.). Participants 55 years and older who completed a baseline and follow-up questionnaire (median follow-up: 5.5 years), were included in the analysis. Sleep parameters were evaluated in an interview at the baseline. Cognitive decline was defined as a loss of 3 or more points on the Mini-Mental State Examination (MMSE) at follow-up. Associations between sleep problems and cognitive decline were examined using logistic regression and were stratified by baseline physical frailty status, adjusted for potential confounders. A short total sleep duration (< 5 vs. 7-9 h, odds ratio (OR) = 1.88, 95% confidence interval (CI) 1.18-3.00), excessive daytime sleepiness (OR = 1.49, 95% CI 1.04-2.13), low sleep efficiency (< 65% vs. ≥ 85%, OR = 1.62, 95% CI 1.07-2.46), and insomnia complaints (OR = 2.34, 95% CI 1.23-4.43) were associated with MMSE decline in physically robust. The association was stronger for the sleep summary score, which summarized abnormal sleep duration, excessive daytime sleepiness, and insomnia complaints ([Formula: see text] 2 vs. 0, OR = 3.79, 95% CI 2.10-6.85, p < 0.0001). Due to the low prevalence of frailty in this community-dwelling population, the statistical power to detect an association was low. More evidence is needed to clarify the role of sleep in the progression of cognitive decline in frail individuals.
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Li Y, Sahakian BJ, Kang J, Langley C, Zhang W, Xie C, Xiang S, Yu J, Cheng W, Feng J. The brain structure and genetic mechanisms underlying the nonlinear association between sleep duration, cognition and mental health. NATURE AGING 2022; 2:425-437. [PMID: 37118065 DOI: 10.1038/s43587-022-00210-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/17/2022] [Indexed: 04/30/2023]
Abstract
Sleep duration, psychiatric disorders and dementias are closely interconnected in older adults. However, the underlying genetic mechanisms and brain structural changes are unknown. Using data from the UK Biobank for participants primarily of European ancestry aged 38-73 years, including 94% white people, we identified a nonlinear association between sleep, with approximately 7 h as the optimal sleep duration, and genetic and cognitive factors, brain structure, and mental health as key measures. The brain regions most significantly underlying this interconnection included the precentral cortex, the lateral orbitofrontal cortex and the hippocampus. Longitudinal analysis revealed that both insufficient and excessive sleep duration were significantly associated with a decline in cognition on follow up. Furthermore, mediation analysis and structural equation modeling identified a unified model incorporating polygenic risk score (PRS), sleep, brain structure, cognition and mental health. This indicates that possible genetic mechanisms and brain structural changes may underlie the nonlinear relationship between sleep duration and cognition and mental health.
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Affiliation(s)
- Yuzhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Barbara J Sahakian
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Christelle Langley
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Jintai Yu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- Shanghai Medical College and Zhongshan Hosptital Immunotherapy Technology Transfer Center, Shanghai, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
- School of Data Science, Fudan University, Shanghai, China.
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Umar A, Khan MS, Sehgal SA, Jafar K, Ahmad S, Waheed A, Aslam MW, Wajid M, Rehman TU, Khan T, Ditta A, Akmal H, Ashfaq M, Javed T, Tahir R. Epidemiological studies of sleep disorder in educational community of Pakistani population, its major risk factors and associated diseases. PLoS One 2022; 17:e0266739. [PMID: 35446890 PMCID: PMC9022811 DOI: 10.1371/journal.pone.0266739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/25/2022] [Indexed: 11/18/2022] Open
Abstract
Sleep is one of the most important functions of the life. The disturbance in sleep or quality of sleep leads to several dysfunctions of the human body. This study aimed to investigate the prevalence of sleep disorders, their possible risk factors and their association with other health problems. The data was collected from the educational community of the Pakistani population. The Insomnia Severity Index (ISI) was used to evaluate the insomnia and the sleep apnea was evaluated through a simple questionnaire method. The blood samples were collected to perform significant blood tests for clinical investigations. Current research revealed that the individuals in the educational community had poor sleep quality. A total of 1998 individuals from the educational community were surveyed, 1584 (79.28%) of whom had a sleep disorders, including insomnia (45.20%) and sleep apnea (34.08%). The measured onset of age for males and females was 30.35 years and 31.07 years respectively. The Clinical investigations showed that the sleep had significant impact on the hematology of the patients. Higher levels of serum uric acid and blood sugar were recorded with a sleep disorder. The individuals of the educational community were using the sleeping pills. The other associated diseases were mild tension, headaches, migraines, depression, diabetes, obesity, and myopia. The use of beverage, bad mood, medical condition, mental stress, disturbed circadian rhythms, workload and extra use of smartphone were major risk factors of sleep disorders. It was concluded that the insomnia was more prevalent than the sleep apnea. Furthermore, life changes events were directly linked with disturbance of sleep. Tension, depression, headaches, and migraine were more associated with sleep disorders than all other health issues.
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Affiliation(s)
- Ali Umar
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Saleem Khan
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
- * E-mail: (MSK); (SAS)
| | - Sheikh Arslan Sehgal
- Department of Bioinformatics, Faculty of Life Sciences, University of Okara, Okara, Pakistan
- * E-mail: (MSK); (SAS)
| | - Kamran Jafar
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Shabbir Ahmad
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Ahmad Waheed
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Waseem Aslam
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Wajid
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tanzil Ur Rehman
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tehmina Khan
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Allah Ditta
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Hasnain Akmal
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Muhammad Ashfaq
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Tariq Javed
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
| | - Rida Tahir
- Department of Zoology, Faculty of Life Sciences, University of Okara, Okara, Pakistan
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35
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Sidani S, Fox MT, Butler JI, Maimets IK. Development of a multi-component intervention to promote sleep in older persons with dementia transitioning from hospital to home. Int J Older People Nurs 2022; 17:e12463. [PMID: 35362239 DOI: 10.1111/opn.12463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 10/18/2021] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hospitalised older persons with dementia are commonly discharged with intensified sleep disturbances. These disturbances can impede the recovery process. Nurses are well-positioned to assist persons with dementia and their family caregivers in managing sleep disturbances during the transition from hospital to home. OBJECTIVES To describe the development of a multi-component intervention to promote sleep. METHODS We applied three stages of the intervention mapping method to develop a non-pharmacological, multi-component sleep intervention. The first stage involved a review of the literature to generate an understanding of the determinants of sleep disturbances experienced by persons with dementia in hospital and home settings. The second stage consisted of a literature review to identify therapies for managing commonly reported determinants of sleep disturbances. The third stage entailed delineation of the intervention components. RESULTS The most common determinants of sleep disturbances experienced by persons with dementia in hospital and home settings were: physiological changes associated with ageing, sleep environments non-conducive to sleep, limited exposure to light and engagement in physical activity, stress and sleep-related beliefs and behaviours. Therapies found effective included: light therapy, physical activity therapy, sleep hygiene, and stimulus control therapy. These therapies were integrated into a multi-component sleep intervention to be provided using the teach-back technique, during and following hospitalisation. DISCUSSION Consistent with the principles of patient engagement, the multi-component sleep intervention will be evaluated for its acceptability and feasibility. IMPLICATIONS FOR PRACTICE The intervention has potentials to improve sleep during the transition from hospital to home.
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Affiliation(s)
- Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Mary T Fox
- School of Nursing, York University, Toronto, Ontario, Canada.,York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Jeffrey I Butler
- School of Nursing, York University, Toronto, Ontario, Canada.,York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Ilo-Katryn Maimets
- Steacie Science and Engineering Library, York University, Toronto, Ontario, Canada
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36
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Gao C, Guo J, Gong TT, Lv JL, Li XY, Liu FH, Zhang M, Shan YT, Zhao YH, Wu QJ. Sleep Duration/Quality With Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies. Front Med (Lausanne) 2022; 8:813943. [PMID: 35127769 PMCID: PMC8811149 DOI: 10.3389/fmed.2021.813943] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background To quantitatively evaluate the evidence of duration and quality of sleep as measured by multiple health outcomes. Methods This review is registered with PROSPERO, number CRD42021235587. We systematically searched three databases from inception until November 15, 2020. For each meta-analysis, the summary effect size using fixed and random effects models, the 95% confidence interval, and the 95% prediction interval were assessed; heterogeneity, evidence of small-study effects, and excess significance bias were also estimated. According to the above metrics, we evaluated the credibility of each association. Results A total of 85 meta-analyses with 36 health outcomes were included in the study. We observed highly suggestive evidence for an association between long sleep and an increased risk of all-cause mortality. Moreover, suggestive evidence supported the associations between long sleep and 5 increased risk of health outcomes (stroke, dyslipidaemia, mortality of coronary heart disease, stroke mortality, and the development or death of stroke); short sleep and increased risk of overweight and/or obesity; poor sleep quality and increased risk of diabetes mellitus and gestational diabetes mellitus. Conclusions Only the evidence of the association of long sleep with an increased risk of all-cause mortality was graded as highly suggestive. Additional studies are needed to be conducted. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021235587
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Affiliation(s)
- Chang Gao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiao Guo
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Ting-Ting Gong
| | - Jia-Le Lv
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin-Yu Li
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang-Hua Liu
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Tong Shan
- Department of Statistics, University of Washington, Seattle, WA, United States
| | - Yu-Hong Zhao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qi-Jun Wu
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37
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Reyes S, Rimkus CDM, Lozoff B, Algarin C, Peirano P. Nighttime Sleep Characteristics and White Matter Integrity in Young Adults. Nat Sci Sleep 2022; 14:1363-1373. [PMID: 35965887 PMCID: PMC9364986 DOI: 10.2147/nss.s360311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep is essential for life and plays a key role for optimal physiology, brain functioning, and health. Evidence suggests a relation between sleep and cerebral white matter integrity. Human studies report that sleep duration shows a U-shaped association with brain functioning. We hypothesized that participants with longer or shorter sleep time in the nighttime period show altered microstructural white matter integrity. PARTICIPANTS AND METHODS Seventy-three young adult participants were evaluated. Sleep-wake cycle parameters were assessed objectively using actigraphy. Diffusion tensor imaging studies were performed to assess white matter integrity using fractional anisotropy and mean, axial, and radial diffusivities. Relations between white matter microstructure indexes and sleep parameters were investigated through tract-based spatial statistics. Participants were grouped according to their nocturnal total sleep time: 27 in the Reference sleep group (6.5-8.0 h), 23 in the Short sleep group (<6.5 h) and 23 in the Long sleep group (>8.0 h). RESULTS Compared with the Reference sleep group, participants in the Long sleep group showed lower fractional anisotropy (p < 0.05) and higher radial diffusivity (p < 0.05) values in white matter tracts linked to sleep regulation (corona radiata, body of the corpus callosum, superior longitudinal fasciculus, and anterior thalamic radiation). CONCLUSION This pattern of reduced fractional anisotropy and increased radial diffusivity in the Long sleep group indicates an association between sleep duration and lower integrity of myelin sheaths. Because myelin is continuously remodeled in the brain, nighttime sleep characteristics appear to be a key player for its quality and maintenance.
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Affiliation(s)
- Sussanne Reyes
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Carolina de Medeiros Rimkus
- Laboratory of Medical Investigation (LIM-44), Department of Radiology and Oncology, Faculty of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Betsy Lozoff
- Department of Pediatrics and Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Cecilia Algarin
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Patricio Peirano
- Laboratory of Sleep and Functional Neurobiology, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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38
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Kim REY, Abbott RD, Kim S, Thomas RJ, Yun CH, Kim H, Johnson H, Shin C. Sleep Duration, Sleep Apnea, and Gray Matter Volume. J Geriatr Psychiatry Neurol 2022; 35:47-56. [PMID: 33511901 DOI: 10.1177/0891988720988918] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study aimed to evaluate the effect of sleep duration on brain structures in the presence versus absence of sleep apnea in middle-aged and older individuals. The study investigated a population-based sample of 2,560 individuals, aged 49-80 years. The presence of sleep apnea and self-reported sleep duration were examined in relation to gray matter volume (GMV) in total and lobar brain regions. We identified ranges of sleep duration associated with maximal GMV using quadratic regression and bootstrap sampling. A significant quadratic association between sleep duration and GMV was observed in total and lobar brain regions of men with sleep apnea. In the fully adjusted model, optimal sleep durations associated with peak GMV between brain regions ranged from 6.7 to 7.0 hours. Shorter and longer sleep durations were associated with lower GMV in total and 4 sub-regions of the brain in men with sleep apnea.
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Affiliation(s)
- Regina Eun Young Kim
- Institute of Human Genomic Study, Korea University College of Medicine, Ansan City, South Korea.,Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Robert Douglas Abbott
- Institute of Human Genomic Study, Korea University College of Medicine, Ansan City, South Korea
| | - Soriul Kim
- Institute of Human Genomic Study, Korea University College of Medicine, Ansan City, South Korea
| | - Robert Joseph Thomas
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam-si Gyeonggi-do, South Korea
| | - Chang-Ho Yun
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and the Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Hyun Kim
- Department of Clinical Psychology, Boston University, Boston, MA, USA
| | - Hans Johnson
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA
| | - Chol Shin
- Institute of Human Genomic Study, Korea University College of Medicine, Ansan City, South Korea
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39
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Wen C, Hu H, Ou YN, Bi YL, Ma YH, Tan L, Yu JT. Risk factors for subjective cognitive decline: the CABLE study. Transl Psychiatry 2021; 11:576. [PMID: 34753917 PMCID: PMC8578345 DOI: 10.1038/s41398-021-01711-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022] Open
Abstract
Increasing evidences supported that subjective cognitive decline (SCD) might be a potential first symptomatic manifestation of Alzheimer's disease (AD). The rapidly growing number of SCD individuals who seek medical help and advice also makes it urgent to develop more precise strategy for SCD. Therefore, this study aimed to explore the risk factors for SCD. Logistics and linear regression models were performed to investigate 41 factors for SCD in 1165 participants without objective cognitive impairment. Cochran-Armitage trend test was used to confirm the constant trend toward higher prevalence of SCD with an increasing number of risk factors. A high overall prevalence of SCD was found in total participants (42%). Eight factors were eventually identified as risk factors for SCD, including four stable factors associated with both SCD statues and severity (older age, thyroid diseases, minimal anxiety symptoms, and day time dysfunction; odds ratio (OR) ranging from 1.74 to 2.29) as well as four suggestive factors associated with either SCD statues or severity (female sex, anemia, lack of physical exercises, and living alone; OR ranging from 1.30 to 2.29). The prevalence of SCD gradually increased with the number of risk factors clustering increased in individuals (p for trend <0.001). Five of these eight factors were further proved among individuals with SCD-plus features. These findings revealed several risk factors for SCD, providing some new clues for formulating priority strategies for early prevention of SCD.
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Affiliation(s)
- Chen Wen
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Hao Hu
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan-Lin Bi
- grid.410645.20000 0001 0455 0905Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- grid.410645.20000 0001 0455 0905Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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Zhu Q, You Y, Fan L, Fan H. Associations between sleep duration patterns and cognitive decline trajectories in older Chinese adults. Aging Clin Exp Res 2021; 33:3057-3063. [PMID: 33837933 DOI: 10.1007/s40520-021-01851-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Abnormal sleep duration has been identified as a risk factor for cognitive decline. However, most studies have measured sleep duration and cognitive function at a single time point, while both tend to decrease with age. AIMS This study aimed to investigate the association between changes in sleep duration patterns and cognitive trajectories in older adults. METHODS Using longitudinal data (2005-2014) from the Chinese Longitudinal Healthy Longevity Survey, a total of 4347 subjects were included in this study. Cognitive function was measured with the Chinese version of the Mini-Mental State Examination. Group-based trajectory models were used to identify the trajectories of sleep duration and cognitive decline within the study sample as the participants aged. Furthermore, the association between sleep duration patterns and cognitive trajectories was examined by multinomial logistic regression analysis. RESULTS Using the medium-stable sleep duration pattern as a reference, the trajectory with a long and increased sleep duration pattern was more likely to be associated with the slight cognitive decline trajectory (OR = 1.80; 95% CI 1.31-2.44). Persistent short sleep was associated with a decreased likelihood of having a rapid cognitive decline trajectory (OR = 0.32; 95% CI 0.12-0.75). DISCUSSION Changes in sleep duration over time were independently associated with cognitive decline and may be a marker of cognitive decline. CONCLUSIONS Tracking of sleep duration over time in older adults may provide a useful insight for prevention of cognitive decline, and the increased sleep duration should be noticed with greater vigilance.
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Affiliation(s)
- Qi Zhu
- Department of Preventive Medicine, North Sichuan Medical College, Fujiang Road, Shunqing, Nanchong, 234, Sichuan, China.
| | - Yueyue You
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Lin Fan
- Department of Indoor Environment and Health Monitoring, China CDC Key Laboratory of Environment and Population Health, Chinese Center for Disease Control and Prevention, National Institute of Environmental Health, Beijing, China
| | - Hui Fan
- Department of Preventive Medicine, North Sichuan Medical College, Fujiang Road, Shunqing, Nanchong, 234, Sichuan, China.
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Li W, Sun N, Kondracki A, Sun W. Sex, Sleep Duration, and the Association of Cognition: Findings from the China Health and Retirement Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910140. [PMID: 34639442 PMCID: PMC8508459 DOI: 10.3390/ijerph181910140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/17/2021] [Accepted: 09/24/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to examine the association between sleep duration and cognitive impairment among elderly Chinese people. METHODS generalized linear modeling was used to analyze the baseline data for adults aged 65 years and over (n = 4785) selected from the 2011 China Health and Retirement Longitudinal Study (CHARLS). The two aspects of cognitive impairment assessed in the study were mental status and memory. Sex-stratified logistic regression models were conducted to identify the effect of sleep duration in the different gender groups. RESULTS of all the participants, 49.8% were females and 32.5% aged 75 years and over. Of the participants, 59.7% had short sleep duration (<7 h/day), and 9.0% of them had long sleep duration (>8 h/day). Compared to normal sleep duration, long sleep duration was associated with lower mental status scores (β = -0.43, p = 0.001) and lower memory scores (β = -0.26, p = 0.006). Long sleep duration was associated with lower mental status in both men (β = -0.37, p = 0.033) and women (β = -0.46, p = 0.025), however, only in men was long sleep duration found to be associated with low memory scores (β = -0.26, p = 0.047). CONCLUSIONS Our study showed that long sleep duration was significantly associated with poorer mental status and memory scores in elderly Chinese people. Paying greater attention to the effects of sleep patterns on the risk of cognitive decline may yield practical implications for dementia prevention and health promotion, especially among older women with lower educational attainment, living in rural areas, and those who have long sleep duration.
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Affiliation(s)
- Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA; (W.L.); (N.S.)
| | - Ning Sun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA; (W.L.); (N.S.)
| | - Anthony Kondracki
- Department of Community Medicine, School of Medicine, Mercer University, Savannah, GA 31404, USA;
| | - Wenjie Sun
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
- Correspondence: ; Tel.: +50-498-842-23
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Palpatzis E, Bass N, Jones R, Mukadam N. Longitudinal association of apolipoprotein E and sleep with incident dementia. Alzheimers Dement 2021; 18:888-898. [PMID: 34477303 DOI: 10.1002/alz.12439] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Few longitudinal studies have explored the association between apolipoprotein E gene (APOE) status, sleep disturbances, and incident dementia among middle-aged participants. METHODS Cox regression analyses explored the association of sleep duration, insomnia, and daytime napping with incident all-cause dementia and their interaction with APOE genetic risk among 397,777 middle-aged adults. RESULTS During a median of 10.8 years follow-up, sleeping more or fewer than 7 hours was associated with a higher dementia risk (hazard ratio [HR] for 5 vs 7 hours: 1.35, 95% confidence interval [CI] 1.11-1.64; HR for 9 vs 7 hours: 1.59; 95% CI 1.37-1.85) as was daytime napping (HR for often/all of the time vs never/rarely: 1.67; 95% CI 1.37-2.03). Stratified analyses revealed that the effects of sleep disturbances were similar across all APOE genetic risk groups. DISCUSSION Short and long sleep duration and daytime napping in middle-aged individuals are associated with the development of dementia in later life. Sleep duration and quality are important for everyone regardless of their genetic risk by APOE genotype.
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Affiliation(s)
- Eleni Palpatzis
- Division of Psychiatry, University College London, London, UK
| | - Nick Bass
- Division of Psychiatry, University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation trust, London, UK
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Kitamura K, Watanabe Y, Nakamura K, Takano C, Hayashi N, Sato H, Someya T. Short daytime napping reduces the risk of cognitive decline in community-dwelling older adults: a 5-year longitudinal study. BMC Geriatr 2021; 21:474. [PMID: 34454431 PMCID: PMC8401113 DOI: 10.1186/s12877-021-02418-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults. METHODS Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011-2013 and 2016-2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa's dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ - 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis. RESULTS Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1-29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23-0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480). CONCLUSION Short daytime napping (< 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.
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Affiliation(s)
- Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan.
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
| | | | - Naomi Hayashi
- Ojiya City Government, Ojiya, Niigata, 947-0028, Japan
| | - Hisami Sato
- Ojiya City Government, Ojiya, Niigata, 947-0028, Japan
| | - Toshiyuki Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
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Li J, Cao D, Huang Y, Chen Z, Wang R, Dong Q, Wei Q, Liu L. Sleep duration and health outcomes: an umbrella review. Sleep Breath 2021; 26:1479-1501. [PMID: 34435311 DOI: 10.1007/s11325-021-02458-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To collect existing evidence on the relationship between sleep duration and health outcomes. METHODS A thorough search was conducted in PubMed, Web of Science, Embase, and the Cochrane Database of Systematic Reviews from inception to January, 2021. Meta-analyses of observational and interventional studies were eligible if they examined the associations between sleep duration and human health. RESULTS In total, this umbrella review identified 69 meta-analyses with 11 outcomes for cancers and 30 outcomes for non-cancer conditions. Inappropriate sleep durations may significantly elevate the risk for cardiovascular disease (CVD), cognitive decline, coronary heart disease (CHD), depression, falls, frailty, lung cancer, metabolic syndrome (MS), and stroke. Dose-response analysis revealed that a 1-h reduction per 24 hours is associated with an increased risk by 3-11% of all-cause mortality, CHD, osteoporosis, stroke, and T2DM among short sleepers. Conversely, a 1-h increment in long sleepers is associated with a 7-17% higher risk of stroke mortality, CHD, stroke, and T2DM in adults. CONCLUSION Inappropriate sleep duration is a risk factor for developing non-cancer conditions. Decreasing and increasing sleep hours towards extreme sleep durations are associated with poor health outcomes.
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Affiliation(s)
- Jin Li
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Dehong Cao
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yin Huang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zeyu Chen
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ruyi Wang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Dong
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Wei
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| | - Liangren Liu
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Smith L, Shin JI, Jacob L, Carmichael C, López Sánchez GF, Oh H, Butler LT, Barnett Y, Pizzol D, Tully MA, Soysal P, Veronese N, Koyanagi A. Sleep problems and mild cognitive impairment among adults aged ≥50 years from low- and middle-income countries. Exp Gerontol 2021; 154:111513. [PMID: 34384889 DOI: 10.1016/j.exger.2021.111513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The limited available literature suggests that sleep problems are linked to an increased risk of mild cognitive impairment (MCI). However, this association has been little studied to date in low-income settings. OBJECTIVE To investigate the association between sleep problems and MCI in a large sample of adults from six low-and middle-income countries (LMICs). DESIGN Cross-sectional. SETTING Study on Global Ageing and Adult Health (SAGE). SUBJECTS 32,715 individuals aged ≥50 years with preservation in functional abilities [age range 50-114 years; 51.7% females]. METHODS MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Sleep problems were assessed by the question "Overall in the last 30 days, how much of a problem did you have with sleeping, such as falling asleep, waking up frequently during the night or waking up too early in the morning?" and categorized as "None", "Mild", "Moderate", "Severe/Extreme". Multivariable logistic regression analysis and meta-analysis were conducted. RESULTS Compared to no sleep problems, mild, moderate, and severe/extreme sleep problems were associated with significant 1.40, 1.83, and 2.69 times higher odds for MCI with similar associations being observed between age groups and sex. Severe/extreme sleep problems were positively associated with MCI (i.e., OR > 1) in the six countries studied with the overall estimate being OR = 1.80 (95% CI = 1.50-2.16), and a low level of between-country heterogeneity was observed (I2 = 28.2%). CONCLUSIONS Sleep problems were associated with higher odds for MCI. Interventions to improve sleep quality among middle-aged and older adults in LMICs may be an effective strategy in reducing risk of MCI and dementia.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Christina Carmichael
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Laurie T Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation - Khartoum, Sudan
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Northern Ireland, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), 34093 Fatih, İstanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain
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Wang L, Li J, Wang Z, Du Y, Sun T, Na L, Niu Y. Social capital and cognitive decline: Does sleep duration mediate the association? PLoS One 2021; 16:e0252208. [PMID: 34043692 PMCID: PMC8158899 DOI: 10.1371/journal.pone.0252208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Jiangping Li
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, China
| | - Zhizhong Wang
- Department of Epidemiology and Statistics at School of Public Health of Guangdong Medical University, Dongguan, China
| | - Yong Du
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China.,School of Clinical Medicine at Ningxia Medical University, Yinchuan, China
| | - Ting Sun
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Li Na
- Surgical Laboratory of General Hospital, Ningxia Medical University, Yinchuan, China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, China.,School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, China
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Sabia S, Fayosse A, Dumurgier J, van Hees VT, Paquet C, Sommerlad A, Kivimäki M, Dugravot A, Singh-Manoux A. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun 2021; 12:2289. [PMID: 33879784 PMCID: PMC8058039 DOI: 10.1038/s41467-021-22354-2] [Citation(s) in RCA: 250] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/09/2021] [Indexed: 01/10/2023] Open
Abstract
Sleep dysregulation is a feature of dementia but it remains unclear whether sleep duration prior to old age is associated with dementia incidence. Using data from 7959 participants of the Whitehall II study, we examined the association between sleep duration and incidence of dementia (521 diagnosed cases) using a 25-year follow-up. Here we report higher dementia risk associated with a sleep duration of six hours or less at age 50 and 60, compared with a normal (7 h) sleep duration, although this was imprecisely estimated for sleep duration at age 70 (hazard ratios (HR) 1.22 (95% confidence interval 1.01-1.48), 1.37 (1.10-1.72), and 1.24 (0.98-1.57), respectively). Persistent short sleep duration at age 50, 60, and 70 compared to persistent normal sleep duration was also associated with a 30% increased dementia risk independently of sociodemographic, behavioural, cardiometabolic, and mental health factors. These findings suggest that short sleep duration in midlife is associated with an increased risk of late-onset dementia.
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Affiliation(s)
- Séverine Sabia
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France.
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Julien Dumurgier
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
- Université de Paris, Inserm U1144, Cognitive Neurology Center, GHU APHP Nord Lariboisière - Fernand Widal Hospital, Paris, France
| | | | - Claire Paquet
- Université de Paris, Inserm U1144, Cognitive Neurology Center, GHU APHP Nord Lariboisière - Fernand Widal Hospital, Paris, France
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
- Clinicum, University of Helsinki, Helsinki, Finland
| | - Aline Dugravot
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
- Department of Epidemiology and Public Health, University College London, London, UK
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Wang KN, Page AT, Etherton-Beer CD. Mild cognitive impairment: To diagnose or not to diagnose. Australas J Ageing 2021; 40:111-115. [PMID: 33604998 DOI: 10.1111/ajag.12913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022]
Abstract
Older people living with mild cognitive impairment (MCI) have a slight but noticeable decline in their cognitive function, though do not meet the diagnostic criteria for dementia. MCI is controversial, with some saying it is a condition that does not require diagnosis, and others stating that it is a genuine clinical syndrome. Many people with MCI will improve, and most will not progress to dementia. Managing co-morbidities and exercising are likely to be the best treatment options. With limited evidence for effective interventions and uncertainty as to the prognostic value of the condition, the benefit of diagnosing MCI remains unclear.
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Affiliation(s)
- Kate N Wang
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.,Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
| | - Amy T Page
- Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher D Etherton-Beer
- Western Australian Centre for Health and Ageing, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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Wu J, Cheng GHL, Sheng LT, Feng L, Yuan JM, Chee M, Pan A, Koh WP. Prospective associations between change in sleep duration and cognitive impairment: Findings from the Singapore Chinese Health Study. J Affect Disord 2021; 281:125-130. [PMID: 33316717 DOI: 10.1016/j.jad.2020.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The relation of changes in sleep duration with risk of cognitive impairment are inconclusive. This study evaluated the prospective relationships of changes in sleep duration with risk of cognitive impairment in Singapore Chinese. METHODS We used data from 16,948 Chinese men and women who were aged 45-74 years at baseline (1993-1998) during recruitment into the Singapore Chinese Health Study cohort. Daily sleep duration was assessed at baseline, follow-up 2 (2006 to 2010) and follow-up 3 interviews (2014-2016). Cognitive function was evaluated with a Singapore-Modified Mini-Mental State Examination at follow-up 3 interviews when participants were 61-96 years old. Multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (95% CIs) for cognitive impairment. RESULTS Of the 16,948 participants, 14.4% were defined to have cognitive impairment. Compared with 7 h/day sleep at both baseline and follow-up 2, the OR (95% CI) for cognitive impairment was 1.50 (1.04-2.16) for those who maintained long sleep duration (≥9 h/day), 2.18 (1.37-3.45) for those who prolonged sleep from short duration (≤5 h/day) to long duration (≥9 h/day), and 1.55 (1.20-2.02) for those who prolonged sleep from recommended duration (7 h/day) to long duration. The highest risk was observed in those who shortened sleep from long to short duration (2.93, 1.35-6.34). LIMITATIONS Measures of sleep were self-reported. CONCLUSIONS Substantial changes in sleep duration over time were associated with higher risks of cognitive impairment. The findings underscore the importance of maintaining optimal sleep duration for the prevention of cognitive impairment.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Grand H-L Cheng
- School of Arts and Social Sciences, The Open University of Hong Kong, Hong Kong, China
| | - Li-Ting Sheng
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Chee
- Centre for Cognitive Neuroscience, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
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Baril AA, Beiser AS, Redline S, McGrath ER, Aparicio HJ, Gottlieb DJ, Seshadri S, Pase MP, Himali JJ. Systemic inflammation as a moderator between sleep and incident dementia. Sleep 2021; 44:zsaa164. [PMID: 32860698 PMCID: PMC7879417 DOI: 10.1093/sleep/zsaa164] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/17/2020] [Indexed: 01/17/2023] Open
Abstract
STUDY OBJECTIVES To determine whether C-reactive protein (CRP), a marker of systemic inflammation, moderates the association between sleep and incident dementia. METHODS We studied Framingham Heart Study participants who completed at baseline a serum CRP assessment and in-home polysomnography to measure sleep duration, sleep efficiency, sleep latency, wake after sleep onset (WASO), number of awakenings, arousal index, and apnea-hypopnea index. Participants were divided into groups according to their CRP level: low (<1 mg/L), average (1-3 mg/L), and high inflammation (>3 mg/L). Surveillance for outcomes (incident all-cause and Alzheimer's disease [AD] dementia) commenced at baseline and continued up to 22.5 years. RESULTS In 291 participants (mean age 67.5 ± 4.9 years, 51.6% men) followed for 13.4 ± 5.4 years, we observed 43 cases of all-cause dementia, 33 of which were clinically consistent with AD. Whereas no direct association between CRP or sleep exposures was observed with incident dementia, CRP levels interacted with nighttime wakefulness when predicting both incident all-cause and AD dementia. In the high CRP group, longer WASO (hazard ratio [HR], 2.89; 95% CI, 1.31-6.34) and more nighttime awakenings (HR, 4.55; 95% CI, 1.19-17.38) were associated with higher risk of incident dementia. In the low CRP group, fewer nighttime awakenings were associated with a higher risk of incident dementia (HR, 0.07; 95% CI, 0.01-0.68). CONCLUSIONS Our findings suggest that inflammation moderates the association between sleep, particularly nighttime wakefulness, and dementia risk. The presence of inflammation may be an important determinant in evaluating how sleep disturbances relate to neurodegeneration.
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Affiliation(s)
- Andrée-Ann Baril
- The Framingham Heart Study, Framingham, MA
- Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Alexa S Beiser
- The Framingham Heart Study, Framingham, MA
- Department of Neurology, Boston University School of Medicine, Boston, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Harvard Medical School, Boston, MA
| | - Emer R McGrath
- The Framingham Heart Study, Framingham, MA
- Harvard Medical School, Boston, MA
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA
| | - Hugo J Aparicio
- The Framingham Heart Study, Framingham, MA
- Department of Neurology, Boston University School of Medicine, Boston, MA
| | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- VA Boston Healthcare System, Boston, MA
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, MA
- Department of Neurology, Boston University School of Medicine, Boston, MA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX
- Department of Neurology, University of Texas Health Science Center, San Antonio, TX
| | - Matthew P Pase
- The Framingham Heart Study, Framingham, MA
- The Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jayandra J Himali
- The Framingham Heart Study, Framingham, MA
- Department of Neurology, Boston University School of Medicine, Boston, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX
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