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

• Type of Material: Article
• Authors: Pamela L. Lutsey, University of Minnesota; Jeffrey R. Misialek, University of Minnesota; Thomas H. Mosley, University of Mississippi; Rebecca F. Gottesman, Johns Hopkins University; Naresh M. Punjabi, Johns Hopkins University; Eyal Shahar, University of Arizona; Richard MacLehose, University of Minnesota; Rachel P. Ogilvie, University of Minnesota; David Knopman, Mayo Clinic; Alvaro Alonso, Emory University
• Language: English
• Date: 2018-02-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 the Alzheimer's Association
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jalz.2017.06.2269
• Title of Journal or Parent Work: Alzheimer's and Dementia
• ISSN: 1552-5260
• Volume: 14
• Issue: 2
• Start Page: 157
• End Page: 166
• Grant/Funding Information: Neurocognitive data is collected by U01 HL096812, HL096814, HL096899, HL096902, HL096917 from the NHLBI and the National Institute of Neurological Disorders and Stroke, and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI.; The ARIC portion of the SHHS was supported by National Heart, Lung, and Blood Institute cooperative agreements U01HL53934 (University of Minnesota) and U01HL64360 (Johns Hopkins University).; Ms. Ogilvie was supported by a National Heart Lung and Blood Training Grant (T32 HL007779).; This study was additionally supported by grant R21 HL121412 to Dr. Pamela Lutsey.; The ARIC is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C).; This was not an industry supported study.
• Keywords: Sleep duration; Life Sciences & Biomedicine; MILD COGNITIVE IMPAIRMENT; APOE EPSILON-4 CARRIERS; BLOOD-PRESSURE; HEART HEALTH; Mild cognitive impairment; OLDER WOMEN; Obstructive sleep apnea; DIAGNOSTIC GUIDELINES; Science & Technology; DECLINE; Alzheimer's disease; Dementia; Clinical Neurology; Atherosclerosis Risk in Communities (ARIC) Study; NATIONAL INSTITUTE; APNEA; ASSOCIATION WORKGROUPS; Sleep Heart Health Study (SHHS); Neurosciences & Neurology
• Research Categories: Biology, Neuroscience; Psychology, Clinical

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.