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Wang S, Zheng X, Huang J, Liu J, Li C, Shang H. Sleep characteristics and risk of Alzheimer's disease: a systematic review and meta-analysis of longitudinal studies. J Neurol 2024; 271:3782-3793. [PMID: 38656621 DOI: 10.1007/s00415-024-12380-7] [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: 01/09/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is on the rise in our aging society, making it crucial to identify additional risk factors to mitigate its increasing incidence. This systematic review and meta-analysis aimed to provide updated evidence regarding the association between sleep and AD. METHODS We conducted a comprehensive search of MEDLINE, EMBASE, and Web of Science databases from inception to July 2023 to identify longitudinal studies. Adjusted relative risks were pooled for each sleep characteristic, and a dose-response analysis was performed specifically for sleep duration. RESULTS A total of 15,278 records were initially retrieved, and after screening, 35 records were ultimately included in the final analysis. The results showed that insomnia (RR, 1.43; 95%CI, 1.17-1.74), sleep-disordered breathing (RR, 1.22; 95%CI, 1.07-1.39), as well as other sleep problems, including sleep fragmentation and sleep-related movement disorders, were associated with a higher risk of developing AD, while daytime napping or excessive daytime sleepiness (RR, 1.18; 95%CI, 1.00-1.40) only exhibited a trend toward a higher risk of AD development. Furthermore, our analysis revealed a significant association between self-reported sleep problems (RR, 1.34; 95%CI, 1.26-1.42) and the incidence of AD, whereas this association was not observed with sleep problems detected by objective measurements (RR, 1.14; 95%CI, 0.99-1.31). Moreover, both quite short sleep duration (< 4 h) and long duration (> 8 h) were identified as potential risk factors for AD. CONCLUSIONS Our study found the association between various types of sleep problems and an increased risk of AD development. However, these findings should be further validated through additional objective device-based assessments. Additional investigation is required to establish a definitive causal connection between sleep problems and AD.
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Affiliation(s)
- Shichan Wang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China
| | - Xiaoting Zheng
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China
| | - Jingxuan Huang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China
| | - Jiyong Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China
| | - Chunyu Li
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China.
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37, Guoxue Lane, Chengdu, 610041, China.
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2
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Long JJ, Chen Y, Kim B, Bae S, Li Y, Orandi BJ, Chu NM, Mathur A, Segev DL, McAdams-DeMarco MA. Sleep Disorders and Dementia Risk in Older Patients with Kidney Failure: A Retrospective Cohort Study. Clin J Am Soc Nephrol 2024:01277230-990000000-00412. [PMID: 38913442 DOI: 10.2215/cjn.0000000000000504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024]
Abstract
Key Points
Older patients with kidney failure who are newly diagnosed with sleep disorders are at higher risk of developing any type of dementia, vascular dementia, and other/mixed types of dementia.For older patients with kidney failure who are diagnosed with obstructive sleep apnea, positive airway pressure therapy is an intervention that is associated with lower dementia risk.
Background
Community-dwelling older adults with sleep disorders are at higher risk of developing dementia. Greater than 50% of older patients with kidney failure experience sleep disorders, which may explain their high burden of dementia.
Methods
Among 216,158 patients (aged 66 years and older) with kidney failure (United States Renal Data System; 2008–2019), we estimated the risk of dementia (including subtypes) associated with sleep disorders using Cox proportional hazards models with propensity score weighting. We tested whether positive airway pressure (PAP) therapy was associated with reduced dementia risk among patients with obstructive sleep apnea (OSA).
Results
26.3% of patients were diagnosed with sleep disorders; these patients had a higher 5-year unadjusted cumulative incidence for any type of dementia (36.2% versus 32.3%; P < 0.001), vascular dementia (4.4% versus 3.7%; P < 0.001), and other/mixed dementia (29.3% versus 25.8%; P < 0.001). Higher risk of any type of dementia was identified in patients with insomnia (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 1.34 to 1.51), sleep-related breathing disorders (SRBDs) (aHR, 1.20, 95% CI, 1.17 to 1.23), and other sleep disorders (aHR, 1.24; 95% CI, 1.11 to 1.39). Higher vascular dementia risk was observed in patients with insomnia (aHR, 1.43; 95% CI, 1.19 to 1.73) and SRBDs (aHR, 1.15; 95% CI, 1.07 to 1.24). Patients with SRBDs (aHR, 1.07; 95% CI, 1.00 to 1.15) were at higher risk of Alzheimer disease. Among patients with OSA, PAP therapy was associated with lower risk of any type of dementia (aHR, 0.82; 95% CI, 0.76 to 0.90) and vascular dementia (aHR, 0.65; 95% CI, 0.50 to 0.85).
Conclusions
Older patients with kidney failure and sleep disorders are at a higher risk of dementia. Sleep is an important modifiable factor that should be considered for targeted interventions to mitigate dementia risk in patients with kidney failure. For patients with OSA, PAP therapy is associated with lower dementia risk.
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Affiliation(s)
- Jane J Long
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Yusi Chen
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Byoungjun Kim
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Sunjae Bae
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Yiting Li
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Babak J Orandi
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Medicine, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aarti Mathur
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dorry L Segev
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Mara A McAdams-DeMarco
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
- Department of Population Health, NYU Grossman School of Medicine and NYU Langone Health, New York, New York
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3
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Wong R, Lovier MA. Sleep Disturbances and Dementia Risk in Older Adults: Findings From 10 Years of National U.S. Prospective Data. Am J Prev Med 2023; 64:781-787. [PMID: 36707315 DOI: 10.1016/j.amepre.2023.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Previous research has identified a link between sleep disturbances and cognitive impairment; however, no study has examined this relationship using a national United States sample. This study examines how multiple longitudinal measures of sleep disturbances (sleep-initiation insomnia, sleep-maintenance insomnia, sleep-medication usage) are associated with dementia risk. METHODS Ten annual waves (2011-2020) of prospective cohort data from a nationally representative U.S. sample of adults aged ≥65 years were analyzed from the National Health and Aging Trends Study. Sleep disturbances were converted into a longitudinal score and measured as sleep-initiation insomnia (trouble falling asleep in 30 minutes), sleep-maintenance insomnia (trouble falling asleep after waking up early), and sleep-medication usage (taking medication to help sleep). Cox regression models analyzed time to dementia diagnosis for a sample of 6,284 respondents. RESULTS In the unadjusted model, sleep-initiation insomnia was significantly associated with a 51% increased dementia risk (hazard ratio=1.51, 95% CI=1.19, 1.90). Adjusted for sociodemographics, sleep-medication usage was significantly associated with a 30% increased dementia risk (adjusted hazard ratio=1.30, 95% CI=1.08-1.56). Adjusted for sociodemographics and health, sleep-maintenance insomnia was significantly associated with a 40% decreased dementia risk (adjusted hazard ratio=0.60, 95% CI=0.46, 0.77). CONCLUSIONS These findings suggest that sleep-initiation insomnia and sleep-medication usage may elevate dementia risk. On the basis of the current evidence, sleep disturbances should be considered when assessing the risk profile for dementia. Future research is needed to examine other sleep disturbance measures and to explore the mechanisms for decreased dementia risk among older adults with sleep-maintenance insomnia.
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Affiliation(s)
- Roger Wong
- Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York.
| | - Margaret Anne Lovier
- Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York
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4
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Mollayeva T, Tran A, Hurst M, Escobar M, Colantonio A. The effect of sleep disorders on dementia risk in patients with traumatic brain injury: A large-scale cohort study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12411. [PMID: 37234486 PMCID: PMC10207584 DOI: 10.1002/dad2.12411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 05/28/2023]
Abstract
Introduction We investigated the association between sleep disorders (SDs) and incident dementia in adults with traumatic brain injury (TBI). Methods Adults with a TBI between 2003 and 2013 were followed until incident dementia. Sleep disorders at TBI were predictors in Cox regression models, controlling for other dementia risks. Results Over 52 months, 4.6% of the 712,708 adults (59% male, median age 44, <1% with SD) developed dementia. An SD was associated with a 26% and a 23% of increased risk of dementia in male and female participants (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.11-1.42 and HR 1.23, 95% CI 1.09-1.40, respectively). In male participants, SD was associated with a 93% increased risk of early-onset dementia (HR 1.93, 95% CI 1.29-2.87); this did not hold in female participants (HR 1.38, 95% CI 0.78-2.44). Discussion In a province-wide cohort, SDs at TBI were independently associated with incident dementia. Clinical trials testing sex-specific SD care after TBI for dementia prevention are timely. Highlights TBI and sleep disorders are linked to each other, and to dementia.It is unclear if sleep disorders pose a sex-specific dementia risk in brain injury.In this study, presence of a sleep disorder increased dementia risk in both sexes.The risk differed by type of sleep disorder, which differed between the sexes.Sleep disorder awareness and care in persons with brain injury is vital for dementia prevention.
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Affiliation(s)
- Tatyana Mollayeva
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada
- Rehabilitation Sciences InstituteTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Andrew Tran
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Mackenzie Hurst
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Michael Escobar
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Angela Colantonio
- KITE‐Toronto Rehabilitation InstituteUniversity Health NetworkTorontoOntarioCanada
- Rehabilitation Sciences InstituteTemerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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5
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Circadian disruption and sleep disorders in neurodegeneration. Transl Neurodegener 2023; 12:8. [PMID: 36782262 PMCID: PMC9926748 DOI: 10.1186/s40035-023-00340-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/03/2023] [Indexed: 02/15/2023] Open
Abstract
Disruptions of circadian rhythms and sleep cycles are common among neurodegenerative diseases and can occur at multiple levels. Accumulating evidence reveals a bidirectional relationship between disruptions of circadian rhythms and sleep cycles and neurodegenerative diseases. Circadian disruption and sleep disorders aggravate neurodegeneration and neurodegenerative diseases can in turn disrupt circadian rhythms and sleep. Importantly, circadian disruption and various sleep disorders can increase the risk of neurodegenerative diseases. Thus, harnessing the circadian biology findings from preclinical and translational research in neurodegenerative diseases is of importance for reducing risk of neurodegeneration and improving symptoms and quality of life of individuals with neurodegenerative disorders via approaches that normalize circadian in the context of precision medicine. In this review, we discuss the implications of circadian disruption and sleep disorders in neurodegenerative diseases by summarizing evidence from both human and animal studies, focusing on the bidirectional links of sleep and circadian rhythms with prevalent forms of neurodegeneration. These findings provide valuable insights into the pathogenesis of neurodegenerative diseases and suggest a promising role of circadian-based interventions.
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6
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Drakatos P, Olaithe M, Verma D, Ilic K, Cash D, Fatima Y, Higgins S, Young AH, Chaudhuri KR, Steier J, Skinner T, Bucks R, Rosenzweig I. Periodic limb movements during sleep: a narrative review. J Thorac Dis 2022; 13:6476-6494. [PMID: 34992826 PMCID: PMC8662505 DOI: 10.21037/jtd-21-1353] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/20/2021] [Indexed: 01/02/2023]
Abstract
Objective Using narrative review techniques, this paper evaluates the evidence for separable underlying patho-mechanisms of periodic limb movements (PLMs) to separable PLM motor patterns and phenotypes, in order to elucidate potential new treatment modalities. Background Periodic limb movement disorder (PLMD) is estimated to occur in 5–8% of the paediatric population and 4–11% of the general adult population. Due to significant sleep fragmentation, PLMD can lead to functional impairment, including hyperactivity and delayed language development in children, and poor concentration and work performance in adults. Longitudinal data demonstrate that those with PLMD are at greater risk of depression and anxiety, and a 4-fold greater risk of developing dementia. PLMD has been extensively studied over the past two decades, and several key insights into the genetic, pathophysiological, and neural correlates have been proposed. Amongst these proposals is the concept of separable PLM phenotypes, proposed on the basis of nocturnal features such as the ratio of limb movements and distribution throughout the night. PLM phenotype and presentation, however, varies significantly depending on the scoring utilized and the nocturnal features examined, across age, and co-morbid clinical conditions. Furthermore, associations between these phenotypes with major neurologic and psychiatric disorders remain controversial. Methods In order to elucidate potential divergent biological pathways that may help clarify important new treatment modalities, this paper utilizes narrative review and evaluates the evidence linking PLM motor patterns and phenotypes with hypothesised underlying patho-mechanisms. Distinctive, underlying patho-mechanisms include: a pure motor mechanism originating in the spinal cord, iron deficiency, dopamine system dysfunction, thalamic glutamatergic hyperactivity, and a more cortical-subcortical interplay. In support of the latter hypothesis, PLM rhythmicity appears tightly linked to the microarchitecture of sleep, not dissimilarly to the apnoeic/hypopneic events seen in obstructive sleep apnea (OSA). Conclusions This review closes with a proposal for greater investigation into the identification of potential, divergent biological pathways. To do so would require prospective, multimodal imaging clinical studies which may delineate differential responses to treatment in restless legs syndrome (RLS) without PLMS and PLMS without RLS. This could pave the way toward important new treatment modalities.
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Affiliation(s)
- Panagis Drakatos
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK.,Sleep Disorders Centre, Guy's and St Thomas' Hospital, GSTT NHS, London, UK.,Faculty of Life and Sciences Medicine, King's College London, London, UK
| | - Michelle Olaithe
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Dhun Verma
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK
| | - Katarina Ilic
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK.,BRAIN, Imaging Centre, CNS, King's College London, London, UK
| | - Diana Cash
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK.,BRAIN, Imaging Centre, CNS, King's College London, London, UK
| | - Yaqoot Fatima
- Institute for Social Science Research, University of Queensland, Brisbane, Australia.,Centre for Rural and Remote Health, James Cook University, Mount Isa, Australia
| | - Sean Higgins
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK.,Sleep Disorders Centre, Guy's and St Thomas' Hospital, GSTT NHS, London, UK
| | - Allan H Young
- School of Academic Psychiatry, King's College London, London, UK
| | - K Ray Chaudhuri
- King's College London and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Joerg Steier
- Sleep Disorders Centre, Guy's and St Thomas' Hospital, GSTT NHS, London, UK.,Faculty of Life and Sciences Medicine, King's College London, London, UK
| | - Timothy Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark.,La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Romola Bucks
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia.,The Raine Study, University of Western Australia, Perth, Australia
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King's College London, London, UK.,Sleep Disorders Centre, Guy's and St Thomas' Hospital, GSTT NHS, London, UK
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7
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Jin D, Choi JW. Sleep disorders and risk of dementia in patients with new-onset type 2 diabetes: A nationwide population-based cohort study. J Diabetes 2021; 13:101-110. [PMID: 32681712 DOI: 10.1111/1753-0407.13092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/21/2020] [Accepted: 07/10/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study examined the relationship between sleep disorders and the risk of dementia in patients with newly diagnosed type 2 diabetes. METHODS This study used the Korean Health Screening Cohort data and included 39 135 subjects aged ≥40 years with new-onset type 2 diabetes between 2004 and 2007, with follow-up throughout 2013. Sleep disorders were measured by F51(sleep disorders not due to a substance or known physiological condition) or G47(sleep disorders) under International Classification of Diseases, Tenth Revision (ICD-10) codes as a primary diagnosis, and the adjusted hazard ratio (AHR) and 95% CI of all-cause dementia, Alzheimer disease, vascular dementia, and other dementia were estimated using multivariable Cox proportional hazards regression models. RESULTS In the patients with type 2 diabetes with an age range between 42 and 84 years (M = 57.8, SD = 9.5), this study identified 2059 events of dementia during an average follow-up time of 5.7 years. In patients with type 2 diabetes, subjects with sleep disorders were associated with an increased risk of all-cause dementia (AHR, 1.46; 95% CI, 1.19-1.80), Alzheimer disease (AHR, 1.39; 95% CI, 1.02-1.88), and other dementia (AHR, 1.69; 95% CI, 1.23-2.31) compared to those without sleep disorders. Men (AHR, 1.93; 95% CI, 1.42-2.62) and older adults (AHR, 1.70; 95% CI, 1.35-2.15) with sleep disorders were associated with an increased risk of dementia than their counterparts without sleep disorders among patients with type 2 diabetes. CONCLUSIONS These findings suggest that sleep disorders are significantly associated with an increased risk of dementia in patients with new-onset type 2 diabetes.
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Affiliation(s)
- Dallae Jin
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Jae Woo Choi
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
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8
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Liang JH, Lu L, Li JY, Qu XY, Li J, Qian S, Wang YQ, Jia RX, Wang CS, Xu Y. Contributions of Modifiable Risk Factors to Dementia Incidence: A Bayesian Network Analysis. J Am Med Dir Assoc 2020; 21:1592-1599.e13. [PMID: 32563753 DOI: 10.1016/j.jamda.2020.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine and compare the contributions of modifiable risk factors (RFs) with the prevention of dementia in older adults. DESIGN A systematic review and Bayesian network meta-analysis (NMA). The observational group was set as a reference to collect all existing RFs and compare them with each other. SETTING AND PARTICIPANTS An exhaustive and comprehensive literature search strategy was used to identify relevant prospective cohort studies from several online databases from their inception to May 1, 2019. Participants without dementia were adults aged greater than 50 years. MEASURES The required data were extracted from the eligible studies to facilitate the Bayesian NMA. RESULTS Forty-three cohort studies with 277,294 participants were included in this NMA. Using the observation group as the reference, all defined RFs, except for antioxidants, were associated with lower risks of all-cause dementia [no sleep disturbances (odds ratio, OR 0.43, 95% credible interval, CrI 0.24-0.62), a high level of education (OR 0.50, 95% CrI 0.34-0.66), no history of diabetes (OR 0.57, 95% CrI 0.36-0.78), nonobese patients (OR 0.61, 95% CrI 0.39-0.83), no smoking history (OR 0.62, 95% CrI 0.45-0.79), living with family members (OR 0.67, 95% CrI 0.45-0.89), participation in physical exercise (OR 0.73, 95% CrI 0.46-0.94), abstinence from drinking (OR 0.78, 95% CrI 0.56-0.99), and no history of hypertension (OR 0.80, 95% CrI 0.65-0.96)]. CONCLUSIONS/RELEVANCE The findings provide reliable support for the hypothesis that modifiable somatic and lifestyle factors are strong predictors of all-cause dementia.
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Affiliation(s)
- Jing-Hong Liang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Lin Lu
- School of Nursing, Medical College of Soochow University, Suzhou, P.R. China
| | - Jia-Yu Li
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Xin-Yuan Qu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Jing Li
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Sheng Qian
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Ying-Quan Wang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Rui-Xia Jia
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Chun-Sheng Wang
- School of medicine, Huzhou University, Huzhou, P.R. China; Huzhou Central Hospital, Huzhou, P.R. China
| | - Yong Xu
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China; Department of Social medicine, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China; Departments of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China.
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9
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Jee HJ, Shin W, Jung HJ, Kim B, Lee BK, Jung YS. Impact of Sleep Disorder as a Risk Factor for Dementia in Men and Women. Biomol Ther (Seoul) 2020; 28:58-73. [PMID: 31838834 PMCID: PMC6939686 DOI: 10.4062/biomolther.2019.192] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/30/2022] Open
Abstract
Sleep is an essential physiological process, especially for proper brain function through the formation of new pathways and processing information and cognition. Therefore, when sleep is insufficient, this can result in pathophysiologic conditions. Sleep deficiency is a risk factor for various conditions, including dementia, diabetes, and obesity. Recent studies have shown that there are differences in the prevalence of sleep disorders between genders. Insomnia, the most common type of sleep disorder, has been reported to have a higher incidence in females than in males. However, sex/gender differences in other sleep disorder subtypes are not thoroughly understood. Currently, increasing evidence suggests that gender issues should be considered important when prescribing medicine. Therefore, an investigation of the gender-dependent differences in sleep disorders is required. In this review, we first describe sex/gender differences not only in the prevalence of sleep disorders by category but in the efficacy of sleep medications. In addition, we summarize sex/gender differences in the impact of sleep disorders on incident dementia. This may help understand gender-dependent pathogenesis of sleep disorders and develop therapeutic strategies in men and women.
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Affiliation(s)
- Hye Jin Jee
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea.,Research Institute of Pharmaceutical Sciences and Technology, Ajou University, Suwon 16499, Republic of Korea
| | - Wonseok Shin
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Ho Joong Jung
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Baekgyu Kim
- Graduate School of Global Pharmaceutical Industry and Clinical Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Bo Kyung Lee
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea
| | - Yi-Sook Jung
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea.,Research Institute of Pharmaceutical Sciences and Technology, Ajou University, Suwon 16499, Republic of Korea.,Graduate School of Global Pharmaceutical Industry and Clinical Pharmacy, Ajou University, Suwon 16499, Republic of Korea
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Tzeng NS, Chung CH, Lin FH, Yeh CB, Huang SY, Lu RB, Chang HA, Kao YC, Yeh HW, Chiang WS, Chou YC, Tsao CH, Wu YF, Chien WC. Risk of Dementia in Adults With ADHD: A Nationwide, Population-Based Cohort Study in Taiwan. J Atten Disord 2019. [PMID: 28629260 DOI: 10.1177/1087054717714057] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between adults with ADHD and the risk of developing dementia. METHOD Utilizing National Health Insurance Research Database of Taiwan, ADHD patients were identified and compared with age- and gender-matched controls (1:3). RESULTS Of the study participants, 37 (5.48%) developed dementia compared with 81 (4.0%) in the control group. Cox proportional hazards regression analysis revealed that the study participants were more likely to develop dementia. The crude hazard ratio (HR) is 3.418 (95% confidence interval [CI] = [2.289, 5.106], p < .001), and adjusted HR is 4.008 (95% CI = [2.526, 6.361], p < .001) in risk of developing dementia after adjusted for age, gender, comorbidities, geographical area of residence, urbanization level of residence, and monthly income. CONCLUSION Adults with ADHD have a 3.4-fold risk of developing dementia, and other large or national data sets should be explored to support the current findings.
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Affiliation(s)
- Nian-Sheng Tzeng
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- 3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.,4 Department of Medical Research, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,5 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China
| | - Fu-Huang Lin
- 3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chin-Bin Yeh
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - San-Yuan Huang
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ru-Band Lu
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,6 Department of Psychiatry, College of Medicine & Hospital, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - Hsin-An Chang
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yu-Chen Kao
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,7 Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Hui-Wen Yeh
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,8 Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsin-Chu, Taiwan, Republic of China.,9 Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan, Republic of China
| | - Wei-Shan Chiang
- 1 Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,10 Department and Institute of Mathematics, Tamkang University, New Taipei City, Taiwan, Republic of China
| | - Yu-Ching Chou
- 3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chang-Huei Tsao
- 4 Department of Medical Research, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,11 Department and Institute of Microbiology and Immunology, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yung-Fu Wu
- 4 Department of Medical Research, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wu-Chien Chien
- 3 School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.,4 Department of Medical Research, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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Sleep disturbances increase the risk of dementia: A systematic review and meta-analysis. Sleep Med Rev 2018; 40:4-16. [PMID: 28890168 DOI: 10.1016/j.smrv.2017.06.010] [Citation(s) in RCA: 478] [Impact Index Per Article: 79.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/29/2017] [Accepted: 06/28/2017] [Indexed: 11/23/2022]
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13
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Abstract
Sleep disorders and neurologic illness are common and burdensome in their own right; when combined, they can have tremendous negative impact at an individual level as well as societally. The socioeconomic burden of sleep disorders and neurologic illness can be identified, but the real cost of these conditions lies far beyond the financial realm. There is an urgent need for comprehensive care and support systems to help with the burden of disease. Further research in improving patient outcomes in those who suffer with these conditions will help patients and their families, and society in general.
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