Sleep characteristics and risk of dementia and Alzheimer's disease: The Atherosclerosis Risk in Communities Study
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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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No studies reported those who developed dementia soon after sleep duration ascertainment separately from those who developed it after longer periods.
“Some studies are noteworthy because of longer follow-up but no studies reported those who developed dementia soon after sleep duration ascertainment separately from those who developed it after longer periods. (280, 296-301)”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [298]
The Discussion describes approximately 15 years between sleep assessment and the neurocognitive exam, and Results §3.3 reports incident-dementia estimates without separating early from later cases. This supports the statement for this study, but the paper does not establish that no studies made that distinction. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn the US million woman study, there was no association between long sleep duration (>8 hours) or daytime napping and dementia on longer term follow-up after the first five years.
“Similarly, in the US million woman study there was no association between long sleep duration (>8 hours) or daytime napping and dementia on longer term follow-up after the first five years.(306)”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [306]
Results §3.3 reports no significant association between long sleep duration (≥9 hours) and incident dementia in the ARIC cohort, which supports only the general sleep-duration finding. This was not a “US million woman study”: the paper reports an ARIC sample of about 1,700 participants and does not report daytime napping or an analysis excluding the first five years of follow-up. Page numbers were not provided in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn that analysis, when adjudicated outcomes were used, severe obstructive sleep apnea was associated with risk of dementia in later life.
“however, when adjudicated outcomes were used, severe OSA was associated with risk of dementia in later life.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [840]
In another analysis of the same cohort, obstructive sleep apnea was not associated with risk of incident dementia.
“In another analysis of the same cohort, OSA was not associated with risk of incident dementia”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [840]
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References 46 · Cited by 198
- Authors
- Lutsey, P. L., Misialek, J. R., Mosley, T. H., Gottesman, R. F., Punjabi, N. M., Shahar, E., MacLehose, R., Ogilvie, R. P., Knopman, D., & Alonso, A.
- Affiliations
- University of Minnesota (US)
- University of Mississippi Medical Center (US)
- Johns Hopkins University (US)
- University of Arizona (US)
- Mayo Clinic (US)
- Department of Epidemiology, Rollins School of Public Health Emory University Atlanta GA USA
- Corresponding author
- Lutsey, Pamela L.
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2017-07-21
- Volume
- 14
- Issue
- 2
- Pages
- 157-166
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC5776061
- OpenAlex
- W2738106105
- Semantic Scholar
- 01308649105871223153002726135d6e5b9624c8
- Cited by
- 198
- References
- 46
- Citations by year
- 2026: 14 · 2025: 30 · 2024: 31 · 2023: 31 · 2022: 26 · 2021: 24 · 2020: 20 · 2019: 11 · 2018: 9 · 2017: 1 · 2012: 1
- FWCI
- 8.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, R01‐HL70825)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, sleep duration
- MeSH terms
- Aged, Alzheimer Disease, Dementia, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neurologic Examination, Residence Characteristics, Retrospective Studies, Risk Factors, Sleep Wake Disorders, Models, Statistical, Outcome Assessment, Health Care, Polysomnography, Atherosclerosis
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