Pamela L Lutsey1, Jeffrey R Misialek2, Thomas H Mosley3, Rebecca F Gottesman4, Naresh M Punjabi5, Eyal Shahar6, Richard MacLehose7, Rachel P Ogilvie7, David Knopman8, Alvaro Alonso9. 1. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. Electronic address: lutsey@umn.edu. 2. Division of Cardiology, University of Minnesota, Minneapolis, MN, USA. 3. Department of Geriatrics and Gerontology, University of Mississippi Medical Center, Jackson, MS, USA; Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA. 4. Department of Neurology, Johns Hopkins University, Baltimore, MD, USA. 5. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA. 6. Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA. 7. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. 8. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 9. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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.
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.
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