Andrew J Westwood1, Alexa Beiser1, Nikita Jain1, Jayandra J Himali1, Charles DeCarli1, Sanford H Auerbach1, Matthew P Pase2, Sudha Seshadri2. 1. From the Department of Neurology (A.J.W., A.B., J.J.H., S.H.A., M.P.P., S.S.), Boston University School of Medicine; Department of Biostatistics (A.B., J.J.H.), Boston University School of Public Health; Framingham Heart Study (A.B., J.J.H., S.H.A., M.P.P., S.S.); Department of Neuroscience (N.J.), Boston University, MA; University of California at Davis (C.D.), Sacramento; and Center for Human Psychopharmacology (M.P.P.), Swinburne University of Technology, Australia. 2. From the Department of Neurology (A.J.W., A.B., J.J.H., S.H.A., M.P.P., S.S.), Boston University School of Medicine; Department of Biostatistics (A.B., J.J.H.), Boston University School of Public Health; Framingham Heart Study (A.B., J.J.H., S.H.A., M.P.P., S.S.); Department of Neuroscience (N.J.), Boston University, MA; University of California at Davis (C.D.), Sacramento; and Center for Human Psychopharmacology (M.P.P.), Swinburne University of Technology, Australia. matthewpase@gmail.com suseshad@bu.edu.
Abstract
OBJECTIVE: To evaluate the association between sleep duration and the risk of incident dementia and brain aging. METHODS: Self-reported total hours of sleep were examined in the Framingham Heart Study (n = 2,457, mean age 72 ± 6 years, 57% women) as a 3-level variable: <6 hours (short), 6-9 hours (reference), and >9 hours (long), and was related to the risk of incident dementia over 10 years, and cross-sectionally to total cerebral brain volume (TCBV) and cognitive performance. RESULTS: We observed 234 cases of all-cause dementia over 10 years of follow-up. In multivariable analyses, prolonged sleep duration was associated with an increased risk of incident dementia (hazard ratio [HR] 2.01; 95% confidence interval [CI] 1.24-3.26). These findings were driven by persons with baseline mild cognitive impairment (HR 2.83; 95% CI 1.06-7.55) and persons without a high school degree (HR 6.05; 95% CI 3.00-12.18). Transitioning to sleeping >9 hours over a mean period of 13 years before baseline was associated with an increased risk of all-cause dementia (HR 2.43; 95% CI 1.44-4.11) and clinical Alzheimer disease (HR 2.20; 95% CI 1.17-4.13). Relative to sleeping 6-9 hours, long sleep duration was also associated cross-sectionally with smaller TCBV (β ± SE, -1.08 ± 0.41 mean units of TCBV difference) and poorer executive function (β ± SE, -0.41 ± 0.13 SD units of Trail Making Test B minus A score difference). CONCLUSIONS: Prolonged sleep duration may be a marker of early neurodegeneration and hence a useful clinical tool to identify those at a higher risk of progressing to clinical dementia within 10 years.
OBJECTIVE: To evaluate the association between sleep duration and the risk of incident dementia and brain aging. METHODS: Self-reported total hours of sleep were examined in the Framingham Heart Study (n = 2,457, mean age 72 ± 6 years, 57% women) as a 3-level variable: <6 hours (short), 6-9 hours (reference), and >9 hours (long), and was related to the risk of incident dementia over 10 years, and cross-sectionally to total cerebral brain volume (TCBV) and cognitive performance. RESULTS: We observed 234 cases of all-cause dementia over 10 years of follow-up. In multivariable analyses, prolonged sleep duration was associated with an increased risk of incident dementia (hazard ratio [HR] 2.01; 95% confidence interval [CI] 1.24-3.26). These findings were driven by persons with baseline mild cognitive impairment (HR 2.83; 95% CI 1.06-7.55) and persons without a high school degree (HR 6.05; 95% CI 3.00-12.18). Transitioning to sleeping >9 hours over a mean period of 13 years before baseline was associated with an increased risk of all-cause dementia (HR 2.43; 95% CI 1.44-4.11) and clinical Alzheimer disease (HR 2.20; 95% CI 1.17-4.13). Relative to sleeping 6-9 hours, long sleep duration was also associated cross-sectionally with smaller TCBV (β ± SE, -1.08 ± 0.41 mean units of TCBV difference) and poorer executive function (β ± SE, -0.41 ± 0.13 SD units of Trail Making Test B minus A score difference). CONCLUSIONS: Prolonged sleep duration may be a marker of early neurodegeneration and hence a useful clinical tool to identify those at a higher risk of progressing to clinical dementia within 10 years.
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