Research Paper Volume 13, Issue 3 pp 3254—3268
Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States
- 1 Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- 2 Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
- 3 Department of Mathematics, Boston College, Boston, MA 02467, USA
Received: September 15, 2020 Accepted: December 29, 2020 Published: February 11, 2021https://doi.org/10.18632/aging.202591
How to Cite
Copyright: © 2021 Robbins et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Sleep disturbance and deficiency are common among older adults and have been linked with dementia and all-cause mortality. Using nationally representative data, we examine the relationship between sleep disturbance and deficiency and their risk for incident dementia and all-cause mortality among older adults.
Methods: The National Health and Aging Trends Study (NHATS) is a nationally-representative longitudinal study of Medicare beneficiaries in the US age 65 and older. Surveys that assessed sleep disturbance and duration were administered at baseline. We examined the relationship between sleep disturbance and deficiency and incident dementia and all-cause mortality over the following 5 years using Cox proportional hazards modeling, controlling for confounders.
Results: Among the sample (n = 2,812), very short sleep duration (≤5 hours: HR = 2.04, 95% CI: 1.26 - 3.33) and sleep latency (>30 minutes: HR = 1.45, 95% CI: 1.03 - 2.03) were associated with incident dementia in adjusted Cox models. Difficulty maintaining alertness (“Some Days”: HR = 1.49, 95% CI: 1.13 - 1.94 and “Most/Every Day”: HR = 1.65, 95% CI: 1.17 - 2.32), napping (“Some days”: HR = 1.38, 95% CI: 1.03 - 1.85; “Most/Every Day”: HR = 1.73, 95% CI: 1.29 - 2.32), sleep quality (“Poor/Very Poor”: HR = 1.75, 95% CI: 1.17 - 2.61), and very short sleep duration (≤5 hours: HR = 2.38, 95% CI: 1.44 - 3.92) were associated with all-cause mortality in adjusted Cox models.
Conclusions: Addressing sleep disturbance and deficiency may have a positive impact on risk for incident dementia and all-cause mortality among older adults.
NHATS: National Health and Aging Trends Study; OSA: obstructive sleep apnea; PSQI: Pittsburgh Sleep Quality Index; US: United States of America.