Insomnia and risk of dementia in older adults: Systematic review and meta-analysis

Almondes, Katie Moraes de; Costa, Mônica Vieira; Malloy-Diniz, Leandro Fernandes; Diniz, Breno S.

doi:10.1016/j.jpsychires.2016.02.021

Cited by 169 publications

(108 citation statements)

References 25 publications

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“…The high prevalence of sleep disturbance in dementia and MCI has been previously observed [8,42] and some studies suggest it may be associated with progression to dementia, possibly involving vascular etiology [43,44].…”

Section: Clusters Of Neuropsychiatric Symptomsmentioning

confidence: 86%

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

Mortby

Burns

Eramudugolla

et al. 2017

JAD

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Abstract.Background: Neuropsychiatric symptoms (NPS) are common in older adults with cognitive impairment, yet little is known about population-based prevalence and clinical implications of co-morbid symptom presentation across the spectrum from normal cognition to dementia. Objective: To characterize the prevalence of NPS and explore the clinical implications of co-morbid symptom presentation. Methods: Cross-sectional study of 1,417 older adults (aged 73-79) with dementia (n = 40); with mild cognitive impairment (MCI; n = 133); who are 'cognitively normal, but-at-risk' (CN-AR; n = 397); and who are cognitively normal (n = 847). NPS were assessed by the Neuropsychiatric Inventory. Cluster analyses were conducted using a latent class analysis (LCA). Results: NPS are highly prevalent across the cognitive function spectrum (30.8%-80%). NPS were associated with a 3-fold increased risk of dementia, a 2-fold increased risk of MCI, and a 1.5-times increased risk of CN-AR. Each additional co-morbid symptom was associated with an additional 1.5-times increased risk of dementia, but not MCI or CN-AR. LCA revealed four distinctive sub-populations: 1) frontal/low comorbidity; 2) high prevalence/high comorbidity; 3) affective/low comorbidity; and 4) sleep/low comorbidity. Conclusion: Our findings confirm previous reports on the prevalence of NPS in community-based samples and are consistent with the profiles of NPS domain characteristics of MCI and dementia. Number of co-morbid NPS and not symptom clusters are associated with increased risk of dementia. Understanding such patterns will help inform our understanding of mild behavioral disorders and assist with clinical assessment.

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Section: Clusters Of Neuropsychiatric Symptomsmentioning

confidence: 86%

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

Mortby

Burns

Eramudugolla

et al. 2017

JAD

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“…The occurrence and development of insomnia is related to various risk factors, and there is a mutual influence between them. It is reported that insomnia seriously impacts depression and anxiety among the elderly . The relationship has also been demonstrated between insomnia and increased risks for dementia, acute myocardial infarction, hypertension and diabetes .…”

Section: Introductionmentioning

confidence: 99%

The prevalence and clinical risk factors of insomnia in the Chinese elderly based on comprehensive geriatric assessment in Chongqing population

Zou

Chen

et al. 2019

Psychogeriatrics

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Background Insomnia is a major public health problem affecting older people. This study aimed to investigate the prevalence and clinical risk factors of insomnia in a representative sample of Chinese elderly (≥ 60 years) in Chongqing. Methods A cross‐sectional study based on comprehensive geriatric assessment was conducted from January 2013 to February 2014. A questionnaire on sleep status was provided to each patient and insomnia was assessed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria. A multivariate logistic regression model was used to illustrate risk factors correlated with insomnia. Results Of the total 597 participants, 55.4% suffered from insomnia. The prevalence of insomnia in men and women was 48.2% and 63.2%, respectively. Coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression and cognitive decline were identified as risk factors associated with insomnia. Hypertension, diabetes, hyperlipidaemia, headache, age and education level were not observed to be significantly associated with insomnia. Conclusions Insomnia is highly prevalent among the elderly in Chongqing, and shows a positive correlation to coronary heart disease, dizziness, chronic pain, anorexia, malnutrition, depression, cognitive impairment. Moreover, women are more likely to experience insomnia than men.

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“…Although Chen et al presented some biological mechanisms on the association between short sleep duration and MCI/dementia in older women, further study is needed to confirm the association. Second, the authors used self-reported sleep duration, and sleep evaluation methods should be handled with caution for the risk assessment of cognitive decline or MCI/dementia [3,4]. Deterioration of sleep was predominantly progressed by psychological distress, and causal association between sleep loss and subsequent cognitive decline or MCI/dementia would be mediated not only by depression but also anxiety [5].…”

Section: To the Editormentioning

confidence: 99%

Sleep duration and cognitive impairment in older adults

Kawada

2016

Aging Clin Exp Res

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Malek-Ahmadi et al. [1] evaluated the association between self-reported sleep duration and cognitive impairment in 189 cognitively normal older adults. Adjusted odds ratio (95 % confidence interval) of short sleep duration (B7 h) against long sleep duration (C 9h) for cognitive impairment was 0.86 (0.76-0.98). The authors concluded that old subjects with long sleep duration had a risk of decreased cognitive performance. I have two comments on their study.First, Chen et al. [2] reported the association between self-reported sleep duration and cognitive decline or mild cognitive impairment (MCI)/dementia in older women. Although they concluded that both short and long sleep duration had a risk for cognitive decline and MCI/dementia, adjusted hazard ratio of short sleep duration against normal sleep duration for MCI/dementia only showed statistical significance. Although Chen et al. presented some biological mechanisms on the association between short sleep duration and MCI/dementia in older women, further study is needed to confirm the association. Second, the authors used self-reported sleep duration, and sleep evaluation methods should be handled with caution for the risk assessment of cognitive decline or MCI/dementia [3,4]. Deterioration of sleep was predominantly progressed by psychological distress, and causal association between sleep loss and subsequent cognitive decline or MCI/dementia would be mediated not only by depression but also anxiety [5]. In addition, classification of self-reported short (long) sleep duration needs validation study. Furthermore, Malek-Ahmadi et al. handled cognitively normal older adults. Taken together, the association between sleep duration and cognitive impairment should be evaluated by a cohort or intervention study to confirm the causal association .

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Insomnia and risk of dementia in older adults: Systematic review and meta-analysis

Cited by 169 publications

References 25 publications

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

Neuropsychiatric Symptoms and Cognitive Impairment: Understanding the Importance of Co-Morbid Symptoms

The prevalence and clinical risk factors of insomnia in the Chinese elderly based on comprehensive geriatric assessment in Chongqing population

Sleep duration and cognitive impairment in older adults

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