Sleep characteristics and risk of dementia and Alzheimer's disease: The Atherosclerosis Risk in Communities Study

Pamela L. Lutsey, Jeffrey R. Misialek, Thomas H. Mosley, Rebecca F. Gottesman, Naresh M. Punjabi, Eyal Shahar, Richard MacLehose, Rachel P. Ogilvie, David Knopman, Alvaro Alonso

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Introduction: This study tested the hypotheses that late-midlife obstructive sleep apnea (OSA) and short and long sleep duration are associated with dementia over 15 years of follow-up. Methods: A total of 1667 Atherosclerosis Risk in Communities Study participants underwent in-home polysomnography (1996-1998) and were followed for dementia. Dementia was defined by (1) hospitalization diagnosis codes (1996-2012) and (2) a comprehensive neurocognitive examination (2011-2013) with adjudication. Results: OSA and sleep duration were not associated with risk of incident dementia. When using adjudicated outcomes, severe OSA (≥30 vs. <5 apnea-hypopnea events/hour) was associated with higher risk of all-cause dementia (risk ratio [95% confidence interval], 2.35 [1.06-5.18]) and Alzheimer's disease dementia (1.66 [1.03-2.68]); associations were attenuated with cardiovascular risk factor adjustment. Sleeping <7 versus 8 to ≤9 hours was associated with higher risk of all-cause dementia (2.00 [1.03-3.86]). Discussion: When adjudicated outcome definitions were used, late-midlife OSA and short sleep duration were associated with all-cause and Alzheimer's disease dementia in later life.

Original languageEnglish (US)
JournalAlzheimer's and Dementia
DOIs
StateAccepted/In press - 2017

Fingerprint

Dementia
Atherosclerosis
Alzheimer Disease
Sleep
Obstructive Sleep Apnea
Risk Adjustment
Polysomnography
Apnea
Hospitalization
Odds Ratio
Confidence Intervals

Keywords

  • Alzheimer's disease
  • Atherosclerosis Risk in Communities (ARIC) Study
  • Dementia
  • Mild cognitive impairment
  • Obstructive sleep apnea
  • Sleep duration
  • Sleep Heart Health Study (SHHS)

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Geriatrics and Gerontology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health

Cite this

Sleep characteristics and risk of dementia and Alzheimer's disease : The Atherosclerosis Risk in Communities Study. / Lutsey, Pamela L.; Misialek, Jeffrey R.; Mosley, Thomas H.; Gottesman, Rebecca F.; Punjabi, Naresh M.; Shahar, Eyal; MacLehose, Richard; Ogilvie, Rachel P.; Knopman, David; Alonso, Alvaro.

In: Alzheimer's and Dementia, 2017.

Research output: Contribution to journalArticle

Lutsey, PL, Misialek, JR, Mosley, TH, Gottesman, RF, Punjabi, NM, Shahar, E, MacLehose, R, Ogilvie, RP, Knopman, D & Alonso, A 2017, 'Sleep characteristics and risk of dementia and Alzheimer's disease: The Atherosclerosis Risk in Communities Study', Alzheimer's and Dementia. https://doi.org/10.1016/j.jalz.2017.06.2269
Lutsey, Pamela L. ; Misialek, Jeffrey R. ; Mosley, Thomas H. ; Gottesman, Rebecca F. ; Punjabi, Naresh M. ; Shahar, Eyal ; MacLehose, Richard ; Ogilvie, Rachel P. ; Knopman, David ; Alonso, Alvaro. / Sleep characteristics and risk of dementia and Alzheimer's disease : The Atherosclerosis Risk in Communities Study. In: Alzheimer's and Dementia. 2017.
@article{3ac24d3ecb2a43dab1405087f88d6fbb,
title = "Sleep characteristics and risk of dementia and Alzheimer's disease: The Atherosclerosis Risk in Communities Study",
abstract = "Introduction: This study tested the hypotheses that late-midlife obstructive sleep apnea (OSA) and short and long sleep duration are associated with dementia over 15 years of follow-up. Methods: A total of 1667 Atherosclerosis Risk in Communities Study participants underwent in-home polysomnography (1996-1998) and were followed for dementia. Dementia was defined by (1) hospitalization diagnosis codes (1996-2012) and (2) a comprehensive neurocognitive examination (2011-2013) with adjudication. Results: OSA and sleep duration were not associated with risk of incident dementia. When using adjudicated outcomes, severe OSA (≥30 vs. <5 apnea-hypopnea events/hour) was associated with higher risk of all-cause dementia (risk ratio [95{\%} confidence interval], 2.35 [1.06-5.18]) and Alzheimer's disease dementia (1.66 [1.03-2.68]); associations were attenuated with cardiovascular risk factor adjustment. Sleeping <7 versus 8 to ≤9 hours was associated with higher risk of all-cause dementia (2.00 [1.03-3.86]). Discussion: When adjudicated outcome definitions were used, late-midlife OSA and short sleep duration were associated with all-cause and Alzheimer's disease dementia in later life.",
keywords = "Alzheimer's disease, Atherosclerosis Risk in Communities (ARIC) Study, Dementia, Mild cognitive impairment, Obstructive sleep apnea, Sleep duration, Sleep Heart Health Study (SHHS)",
author = "Lutsey, {Pamela L.} and Misialek, {Jeffrey R.} and Mosley, {Thomas H.} and Gottesman, {Rebecca F.} and Punjabi, {Naresh M.} and Eyal Shahar and Richard MacLehose and Ogilvie, {Rachel P.} and David Knopman and Alvaro Alonso",
year = "2017",
doi = "10.1016/j.jalz.2017.06.2269",
language = "English (US)",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Sleep characteristics and risk of dementia and Alzheimer's disease

T2 - The Atherosclerosis Risk in Communities Study

AU - Lutsey, Pamela L.

AU - Misialek, Jeffrey R.

AU - Mosley, Thomas H.

AU - Gottesman, Rebecca F.

AU - Punjabi, Naresh M.

AU - Shahar, Eyal

AU - MacLehose, Richard

AU - Ogilvie, Rachel P.

AU - Knopman, David

AU - Alonso, Alvaro

PY - 2017

Y1 - 2017

N2 - Introduction: This study tested the hypotheses that late-midlife obstructive sleep apnea (OSA) and short and long sleep duration are associated with dementia over 15 years of follow-up. Methods: A total of 1667 Atherosclerosis Risk in Communities Study participants underwent in-home polysomnography (1996-1998) and were followed for dementia. Dementia was defined by (1) hospitalization diagnosis codes (1996-2012) and (2) a comprehensive neurocognitive examination (2011-2013) with adjudication. Results: OSA and sleep duration were not associated with risk of incident dementia. When using adjudicated outcomes, severe OSA (≥30 vs. <5 apnea-hypopnea events/hour) was associated with higher risk of all-cause dementia (risk ratio [95% confidence interval], 2.35 [1.06-5.18]) and Alzheimer's disease dementia (1.66 [1.03-2.68]); associations were attenuated with cardiovascular risk factor adjustment. Sleeping <7 versus 8 to ≤9 hours was associated with higher risk of all-cause dementia (2.00 [1.03-3.86]). Discussion: When adjudicated outcome definitions were used, late-midlife OSA and short sleep duration were associated with all-cause and Alzheimer's disease dementia in later life.

AB - Introduction: This study tested the hypotheses that late-midlife obstructive sleep apnea (OSA) and short and long sleep duration are associated with dementia over 15 years of follow-up. Methods: A total of 1667 Atherosclerosis Risk in Communities Study participants underwent in-home polysomnography (1996-1998) and were followed for dementia. Dementia was defined by (1) hospitalization diagnosis codes (1996-2012) and (2) a comprehensive neurocognitive examination (2011-2013) with adjudication. Results: OSA and sleep duration were not associated with risk of incident dementia. When using adjudicated outcomes, severe OSA (≥30 vs. <5 apnea-hypopnea events/hour) was associated with higher risk of all-cause dementia (risk ratio [95% confidence interval], 2.35 [1.06-5.18]) and Alzheimer's disease dementia (1.66 [1.03-2.68]); associations were attenuated with cardiovascular risk factor adjustment. Sleeping <7 versus 8 to ≤9 hours was associated with higher risk of all-cause dementia (2.00 [1.03-3.86]). Discussion: When adjudicated outcome definitions were used, late-midlife OSA and short sleep duration were associated with all-cause and Alzheimer's disease dementia in later life.

KW - Alzheimer's disease

KW - Atherosclerosis Risk in Communities (ARIC) Study

KW - Dementia

KW - Mild cognitive impairment

KW - Obstructive sleep apnea

KW - Sleep duration

KW - Sleep Heart Health Study (SHHS)

UR - http://www.scopus.com/inward/record.url?scp=85028602281&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028602281&partnerID=8YFLogxK

U2 - 10.1016/j.jalz.2017.06.2269

DO - 10.1016/j.jalz.2017.06.2269

M3 - Article

C2 - 28738188

AN - SCOPUS:85028602281

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

SN - 1552-5260

ER -