Sleep Disturbance is Associated with Incident Dementia and Mortality
Roxanne Sterniczuk, Olga Theou, Benjamin Rusak, Kenneth J. Rockwood
Abstract
Roxanne Sterniczuk, Olga Theou, Benjamin Rusak, Kenneth J. Rockwood
Abstract
People with Alzheimer' s disease (AD) commonly complain of sleep disturbances, which are seen in a wide variety of conditions that become more common in late life. It is not known whether sleep-related symptoms are associated with AD independently of their association with other illnesses. Secondary analyses of sleep-related measures collected through the Survey of Health, Ageing and Retirement in Europe (SHARE; i.e., sleeping problems, fatigue, taking sleeping medication, and trouble sleeping or a change in pattern) were conducted on those who reported the absence of AD or dementia at baseline. A 'sleep disturbance index' (SDI) using sleep-related measures was created and compared to a frailty index reflecting overall health status. Each sleep measure independently predicted self-reported AD or dementia and mortality within ~4 years. Combined, the SDI was associated with an increased risk of developing AD or dementia (OR= 1.23, 95%CI = 1.11-1.36) and mortality (OR = 1.18, 95% CI = 1.12-1.24), and remained a strong factor for dementia when overall health status was added to the risk model (p = 0.054). These findings indicate that sleep disturbance may exist prior to the manifestation of other typical symptoms observed in AD (e.g., memory loss). Sleep-related questions may be useful for screening individuals at risk for dementia and may allow for the earlier detection of AD at the preclinical stage.
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People with Alzheimer' s disease (AD) commonly complain of sleep disturbances, which are seen in a wide variety of conditions that become more common in late life. It is not known whether sleep-related symptoms are associated with AD independently of their association with other illnesses. Secondary analyses of sleep-related measures collected through the Survey of Health, Ageing and Retirement in Europe (SHARE; i.e., sleeping problems, fatigue, taking sleeping medication, and trouble sleeping or a change in pattern) were conducted on those who reported the absence of AD or dementia at baseline. A 'sleep disturbance index' (SDI) using sleep-related measures was created and compared to a frailty index reflecting overall health status. Each sleep measure independently predicted self-reported AD or dementia and mortality within ~4 years. Combined, the SDI was associated with an increased risk of developing AD or dementia (OR= 1.23, 95%CI = 1.11-1.36) and mortality (OR = 1.18, 95% CI = 1.12-1.24), and remained a strong factor for dementia when overall health status was added to the risk model (p = 0.054). These findings indicate that sleep disturbance may exist prior to the manifestation of other typical symptoms observed in AD (e.g., memory loss). Sleep-related questions may be useful for screening individuals at risk for dementia and may allow for the earlier detection of AD at the preclinical stage.
Key concepts: Dementia, Sleep disorder, Sleep (system call), Medicine, Gerontology, Disease, Risk factor, Psychiatry