Sleep difficulties, incident dementia and all‐cause mortality among older adults across 8 years: Findings from the National Health and Aging Trends Study
Summary Sleep difficulties have been implicated in the development and progression of dementia and in all‐cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all‐cause mortality over 8 years of follow‐up among a nationally representative sample of...
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| Published in | Journal of sleep research Vol. 30; no. 6; pp. e13395 - n/a |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
01.12.2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0962-1105 1365-2869 1365-2869 |
| DOI | 10.1111/jsr.13395 |
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| Abstract | Summary
Sleep difficulties have been implicated in the development and progression of dementia and in all‐cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all‐cause mortality over 8 years of follow‐up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep “most nights” or “every night” in each study year. In each year, dementia was determined by either self‐reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all‐cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all‐cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65–75 years of age, 71% identified as non‐Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25–1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14–1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25–1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20–1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29–1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44–2.24) were associated with greater risk of all‐cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all‐cause mortality among older people. |
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| AbstractList | Summary
Sleep difficulties have been implicated in the development and progression of dementia and in all‐cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all‐cause mortality over 8 years of follow‐up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep “most nights” or “every night” in each study year. In each year, dementia was determined by either self‐reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all‐cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all‐cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65–75 years of age, 71% identified as non‐Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25–1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14–1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25–1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20–1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29–1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44–2.24) were associated with greater risk of all‐cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all‐cause mortality among older people. Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all-cause mortality over 8 years of follow-up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep "most nights" or "every night" in each study year. In each year, dementia was determined by either self-reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all-cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all-cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65-75 years of age, 71% identified as non-Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25-1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14-1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25-1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20-1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29-1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44-2.24) were associated with greater risk of all-cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all-cause mortality among older people. Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all-cause mortality over 8 years of follow-up among a nationally representative sample of older (≥65yrs) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample was comprised of 6,376 older adults that were representative of 32million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep “most night” or “every night” in each study year. In each year, dementia was determined by either self-reported diagnosis or performance on immediate and the delayed recall word and clock drawing tests, while all-cause mortality was determined by proxy. We conducted Cox proportional hazards modeling,adjusting for age, sex, marital status, and chronic conditions. In models predicting all-cause mortality, we also control for dementia. Among respondents at baseline, 19% were 65–75 years of age; 71% identified as non-Hispanic white; 59% were female. Difficulty initiating sleep (HR=1.49,95%CI:1.25–1.77), difficulty falling back asleep (HR=1.39,95%CI:1.14–1.70), and concurrent sleep difficulties (HR=1.58,95%CI: 1.25–1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR=1.44,95%CI:1.20–1.72), difficulty falling back asleep (HR=1.56,95%CI:1.29–1.89), and concurrent sleep difficulties (HR=1.80,95%CI:1.44–2.24) were associated with greater risk of all-cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all-cause mortality among older people. Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all-cause mortality over 8 years of follow-up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep "most nights" or "every night" in each study year. In each year, dementia was determined by either self-reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all-cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all-cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65-75 years of age, 71% identified as non-Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25-1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14-1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25-1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20-1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29-1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44-2.24) were associated with greater risk of all-cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all-cause mortality among older people.Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between sleep difficulties, incident dementia and all-cause mortality over 8 years of follow-up among a nationally representative sample of older (≥65 years) adults in the United States. We used data collected from the National Health and Aging Trends Study (NHATS) from 2011 to 2018, a prospective cohort study of Medicare beneficiaries. At baseline, the NHATS sample comprised 6,376 older adults who were representative of 32 million older adults. Respondents reported routine difficulty initiating sleep or difficulty falling back asleep "most nights" or "every night" in each study year. In each year, dementia was determined by either self-reported diagnosis or performance on immediate and delayed recall word and clock drawing tests, whereas all-cause mortality was determined by proxy. We conducted Cox proportional hazards modelling, adjusting for age, sex, marital status and chronic conditions. In models predicting all-cause mortality, we also controlled for dementia. Among respondents at baseline, 19% were 65-75 years of age, 71% identified as non-Hispanic white and 59% were female. Difficulty initiating sleep (hazard ratio [HR], 1.49; 95% confidence interval [CI],1.25-1.77), difficulty falling back asleep (HR, = 1.39; 95% CI,1.14-1.70) and concurrent sleep difficulties (HR, 1.58; 95% CI, 1.25-1.99) were associated with greater risk of dementia. Difficulty initiating sleep (HR, 1.44; 95% CI,1.20-1.72), difficulty falling back asleep (HR, 1.56; 95% CI,1.29-1.89), and concurrent sleep difficulties (HR, 1.80; 95% CI, 1.44-2.24) were associated with greater risk of all-cause mortality. Our findings demonstrate that reported difficulties are prospectively associated with an increased risk of dementia and all-cause mortality among older people. |
| Author | Quan, Stuart F. Czeisler, Charles A. Wang, Wei Barger, Laura K. Robbins, Rebecca Weaver, Matthew D. |
| AuthorAffiliation | 2 Division of Sleep Medicine, Harvard Medical School, Boston, MA USA 1 Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA |
| AuthorAffiliation_xml | – name: 1 Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA USA – name: 2 Division of Sleep Medicine, Harvard Medical School, Boston, MA USA |
| Author_xml | – sequence: 1 givenname: Rebecca orcidid: 0000-0003-0288-2505 surname: Robbins fullname: Robbins, Rebecca email: Rrobbins4@bwh.harvard.edu organization: Harvard Medical School – sequence: 2 givenname: Matthew D. orcidid: 0000-0003-3578-336X surname: Weaver fullname: Weaver, Matthew D. organization: Harvard Medical School – sequence: 3 givenname: Laura K. orcidid: 0000-0001-8547-7331 surname: Barger fullname: Barger, Laura K. organization: Harvard Medical School – sequence: 4 givenname: Wei surname: Wang fullname: Wang, Wei organization: Harvard Medical School – sequence: 5 givenname: Stuart F. orcidid: 0000-0002-9474-7679 surname: Quan fullname: Quan, Stuart F. organization: Harvard Medical School – sequence: 6 givenname: Charles A. orcidid: 0000-0002-7408-1849 surname: Czeisler fullname: Czeisler, Charles A. organization: Harvard Medical School |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34080234$$D View this record in MEDLINE/PubMed |
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| Copyright | 2021 European Sleep Research Society 2021 European Sleep Research Society. |
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| Keywords | gerontology sleep medicine geriatric medicine sleep difficulties insomnia |
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| Notes | Funding information This work was supported by the NIH grant numbers: K01HL150339 (RR), R01OH011773 (MDW, LKB), P01AG009975 (CAC) and R56HL151637 (MDW). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contribution: All authors had access to the data and a role in writing the manuscript. |
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Sleep difficulties have been implicated in the development and progression of dementia and in all‐cause mortality. This study examines the relationship... Sleep difficulties have been implicated in the development and progression of dementia and in all‐cause mortality. This study examines the relationship between... Sleep difficulties have been implicated in the development and progression of dementia and in all-cause mortality. This study examines the relationship between... |
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| SubjectTerms | Aged Aging Dementia - epidemiology Female geriatric medicine gerontology Humans insomnia Medicare Prospective Studies sleep difficulties Sleep Initiation and Maintenance Disorders - epidemiology sleep medicine United States - epidemiology |
| Title | Sleep difficulties, incident dementia and all‐cause mortality among older adults across 8 years: Findings from the National Health and Aging Trends Study |
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