The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index; none of the 31 sources its claims cite is checked for support yet.
Sleep architecture and the risk of incident dementia in the community
Open accessAbstract
OBJECTIVE: Sleep disturbance is common in dementia, although it is unclear whether differences in sleep architecture precede dementia onset. We examined the associations between sleep architecture and the prospective risk of incident dementia in the community-based Framingham Heart Study (FHS). METHODS: Our sample comprised a subset of 321 FHS Offspring participants who participated in the Sleep Heart Health Study between 1995 and 1998 and who were aged over 60 years at the time of sleep assessment (mean age 67 ± 5 years, 50% male). Stages of sleep were quantified using home-based polysomnography. Participants were followed for a maximum of 19 years for incident dementia (mean follow-up 12 ± 5 years). RESULTS: We observed 32 cases of incident dementia; 24 were consistent with Alzheimer disease dementia. After adjustments for age and sex, lower REM sleep percentage and longer REM sleep latency were both associated with a higher risk of incident dementia. Each percentage reduction in REM sleep was associated with approximately a 9% increase in the risk of incident dementia (hazard ratio 0.91; 95% confidence interval 0.86, 0.97). The magnitude of association between REM sleep percentage and dementia was similar following adjustments for multiple covariates including vascular risk factors, depressive symptoms, and medication use, following exclusions for persons with mild cognitive impairment at baseline and following exclusions for early converters to dementia. Stages of non-REM sleep were not associated with dementia risk. CONCLUSIONS: Despite contemporary interest in slow-wave sleep and dementia pathology, our findings implicate REM sleep mechanisms as predictors of clinical dementia.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In community-dwelling Framingham Heart Study Offspring participants older than 60, lower REM sleep percentage and longer REM sleep latency were prospectively associated with higher incident dementia risk over a mean 12 years. Non-REM sleep stages were not associated with dementia risk, implicating REM sleep mechanisms rather than slow-wave sleep.
Key findings
- Among 321 participants (mean age 67 ± 5 years, 50% male; mean follow-up 12 ± 5 years, maximum 19 years), there were 32 incident all-cause dementia cases, including 24 Alzheimer disease (AD) dementia cases.
- Each 1% lower REM sleep percentage was associated with approximately a 9% higher risk of incident all-cause dementia: age/sex-adjusted HR 0.91 (95% CI 0.86–0.97, p = 0.004); fully adjusted HR 0.91 (95% CI 0.85–0.98, p = 0.01). AD dementia results were similar (age/sex-adjusted HR 0.92, 95% CI 0.86–0.99, p = 0.02).
- The lowest vs highest tertile of REM sleep latency was associated with lower all-cause dementia risk in model 1 (HR 0.37, 95% CI 0.14–0.97) and model 2 (HR 0.26, 95% CI 0.08–0.85). Higher wake after sleep onset was associated with increased risk only in model 2 (HR 2.08, 95% CI 1.02–4.23). Stages 1, 2, and slow-wave sleep were not significantly associated with dementia risk.
- Sensitivity analyses excluding MCI at baseline or early converters did not materially change the REM sleep association. Excluding persons with high REM arousals due to hypopnea attenuated the association (all-cause dementia HR 0.94, 95% CI 0.88–1.01, p = 0.09). An APOE ε4 by REM sleep percentage interaction was found for AD dementia (p = 0.05), with lower REM sleep associated in ε4 noncarriers (HR 0.88, 95% CI 0.80–0.96) but not carriers (HR 0.99, 95% CI 0.90–1.08), though the authors caution interpretation.
Methods
- Prospective cohort study using a subset of 321 Framingham Heart Study Offspring participants aged over 60 at the time of home-based polysomnography in the Sleep Heart Health Study (1995–1998); exclusions from 699 Offspring participants included age <60, prevalent dementia, no dementia follow-up, and missing PSG data.
- Sleep stages were scored in 30-second epochs using Rechtschaffen and Kales criteria; primary exposures were percentage of time in stage 1, stage 2, slow-wave sleep (stages 3 and 4 combined), and REM sleep, with secondary measures of sleep continuity, fragmentation, and sleep-disordered breathing.
- Incident dementia was ascertained through Framingham Heart Study surveillance, MMSE screening, neuropsychological/neurologic evaluations, and dementia review committee adjudication using DSM-IV; AD dementia used NINCDS-ADRDA criteria. Cox proportional hazards models were used: model 1 adjusted for age and sex; model 2 additionally adjusted for BMI, education, APOE ε4, systolic blood pressure, smoking, diabetes, heart disease, depressive symptoms, and medication use.
Limitations
- The paper states small sample size and small number of incident events, limiting power to detect weaker associations with other sleep exposures, including the AHI ≥15 threshold; the sample was of Caucasian descent, so generalizability to other ethnic groups is unclear.
- The paper states no information on shift work, preventing ascertainment of circadian rhythm sleep disorders.
- Evident from the text: the APOE ε4 interaction for AD dementia was based on small event counts and overlapping confidence intervals; the single baseline PSG cannot capture changes in sleep architecture over follow-up, and observational design leaves potential residual confounding.
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Claims the paper makes
22 Own result · 17 Sources not found · 5 Own method · 5 Own interpretation
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The exclusion of persons with a high number of arousals from REM sleep attenuated the HR linking REM sleep percentage to incident dementia”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The magnitude of association between REM sleep percentage and dementia was similar following adjustments for multiple covariates including vascular risk factors, depressive symptoms, and medication use”
plainn = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“no such APOE e4 by REM sleep percentage interaction was identified when predicting all-cause dementia.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this attenuation appeared to be due to arousals resulting from hypopnea rather than obstructive apnea.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“following exclusions for persons with mild cognitive impairment at baseline”
plainn = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After adjustment for age and sex, each percentage decrease in REM sleep was associated with approximately a 9% increase in the risk of incident dementia.”
- Also stated in: § Abstract · plain
“Each percentage reduction in REM sleep was associated with approximately a 9% increase in the risk of incident dementia (hazard ratio 0.91; 95% confidence interval 0.86, 0.97).”
plaincorrelationaln = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Abstract · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lower REM sleep percentage was associated with an increased risk of all-cause dementia across both statistical models (table 3).”
plaincorrelationaln = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Stages of non-REM sleep were not associated with dementia risk.”
- Also stated in: § Sample overview. · plain
“Stages 1, 2, and SWS were not significantly associated with dementia risk.”
plainn = 32- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Sample overview. · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“following exclusions for early converters to dementia.”
plainn = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Separate exclusions for those with an early or late chronotype resulted in minimal change to the observed association between REM sleep percentage and incident dementia (table 4).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found an APOE e4 allele status by REM sleep percentage interaction when predicting incident AD dementia (p 5 0.05).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If we consider only those persons who developed new-onset dementia during follow-up, persons who spent a greater proportion of their time in REM sleep took longer to develop dementia (r 5 0.37, p 5 0.04).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lowest vs highest tertile of REM sleep latency was associated with a lower risk of all-cause dementia in model 1 (hazard ratio [HR] 0.37; 95% confidence interval [CI] 0.14-0.97)and model 2 (HR 0.26; 95% CI 0.08-0.85).”
plaincorrelationaln = 32 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“In support of our findings, patients with dementia display less REM sleep on average as compared to controls without dementia.2,3”
What the sources say
- Not matchedcites [2]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Not matched
In the paper
“In a substudy of the Study of Osteoporotic Fractures, sleep-disordered breathing (defined as an AHI $15) was associated with the risk of incident clinical cognitive impairment and dementia (as a combined outcome) over a median of 5 years follow-up.17”
What the sources say
- Not matchedcites [17]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Not matched
In the paper
“In the Rush Memory and Aging Project, 10 consecutive days of actigraphy-assessed sleep fragmentation was associated with an increased risk of AD over a mean of 3 years follow-up.18”
What the sources say
- Not matchedcites [18]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The Framingham Heart Study (FHS) monitors incident dementia through continuous surveillance of the cohort.12”
- Also stated in: § Ascertainment of incident dementia. · plain
“The committee adjudicates a diagnosis of dementia in line with the DSM-IV.15”
What the sources say
- Not matchedcites [12]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [13]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [15]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Ascertainment of incident dementia. · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our results add to these studies by demonstrating that less REM sleep is associated prospectively with an increased risk of incident dementia among community-dwelling individuals.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Such findings suggest that the association between REM sleep and dementia was not simply the result of neurologic changes that occurred in the late prodromal phase of dementia.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
In the paper
“In the Osteoporotic Fractures in Men Study, men with the lowest (vs highest) quartile of REM sleep percentage experienced more than twice the annual rate of decline in modified MMSE scores.22”
What the sources say
- Not matchedcites [22]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Not matched
- It may state two separate claims as one. 17
- The quote only partly states this claim. 1
- Probably not a substantial claim. 16
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After stratifying the results, lower REM sleep percentage was associated with a higher risk of incident AD dementia in e4 noncarriers (HR 0.88, 95% CI 0.80-0.96,p 5 0.006, events/n 5 14/245) but not carriers (HR 0.99, 95% CI 0.90-1.08,p 5 0.75, events/n 5 10/71).”
plaincorrelationaln = 14 ·- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sleep onset latency, sleep efficiency, and the AHI were not related to dementia incidence in our sample (table e-1 at Neurology.org).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although higher total sleep time was associated with a lower risk of all-cause dementia (HR 0.994; 95% CI 0.989-0.999)and AD dementia (HR 0.993; 95% CI 0.987-0.999) in model 1, the effect sizes were small.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Higher wake after sleep onset was associated with an increased risk of incident allcause dementia in model 2 (HR 2.08; 95% CI 1.02-4.23)but not model 1 (HR 1.58; 95% CI 0.88-2.83).”
plaincorrelationaln = 32 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cases of dementia due to the synucleinopathies did not drive our results given that effect sizes were similar when examining incident all-cause dementia (which included 6 cases of dementia with Lewy bodies) and AD dementia (no cases of mixed AD with Lewy bodies, Parkinson disease, or multiple system atrophy).”
plainn = 6- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect sizes were similar for AD dementia.”
plainn = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results for absolute time in each sleep stage were consistent with our primary models, although effect sizes for time in REM sleep and dementia were less marked (table e-2).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Over a mean of 12 (SD 5) years of follow-up, we observed 32 cases of incident dementia, 24 of which were due to AD dementia.”
- Also stated in: § Abstract · plain
“We observed 32 cases of incident dementia; 24 were consistent with Alzheimer disease dementia.”
plainn = 32- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Abstract · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, even after excluding persons with a high number of arousals from REM sleep, each percentage reduction in REM sleep percentage was associated a nonstatistically significant 6% increase in all-cause dementia risk, suggesting contributions from other unmeasured factors.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“A populationbased study using PSG recently demonstrated that time in REM sleep is reduced in those with as compared to without cognitive impairment, perhaps as a result of sleep-disordered breathing.21”
What the sources say
- Not matchedcites [21]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Thus, loss of cholinergic function may underpin the association between reduced REM sleep and dementia risk, i.e., a healthy cholinergic system maintains REM sleep metrics better than a slowly degenerating cholinergic system.”
What the sources say
- Not matchedcites [25]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [26]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [27]
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hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“On the other hand, REM sleep is thought to promote synaptic consolidation and to upregulate the activity of immediate early genes implicated in synaptic plasticity.27,32”
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [32]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Model 1 included adjustments for age and sex.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Limitations of the current study include the small sample size and a small number of incident events.Consequently, we had limited power to detect weaker but potentially important associations with other sleep-related exposures and dementia.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“After confirming the proportionality of hazards assumption, we used SAS software V9.4 (SAS Institute, Cary, NC) to estimate Cox proportional hazards regression models.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“AD is well-known to be associated with loss of cholinergic function, from the degeneration of cholinergic projections in the basal forebrain and changes in acetylcholine release, high-affinity choline uptake, and acetylcholine receptor expression.28,29”
What the sources say
- Not matchedcites [28]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [29]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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Probably not a substantial claim.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, as our sample was of Caucasian decent, it is unclear how our results generalize to other ethnic groups.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Current research on sleep and AD is mostly focused on SWS.4,19,20”
What the sources say
- Not matchedcites [4]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [19]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [20]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect between REM sleep percentage and dementia was attenuated after excluding persons with a high number of arousals from REM sleep due to hypopneas, suggesting a possible contributing role of sleep-disordered breathing.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“REM sleep behavior disorder has been associated with dementia and is clinically diagnostic of dementia due to the synucleinopathies.24”
What the sources say
- Not matchedcites [24]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“REM sleep latency is also longer in patients with AD dementia as compared to controls with latency appearing to increase across categories of AD severity.3”
What the sources say
- Not matchedcites [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, our findings implicate less REM sleep, and not SWS, with the risk of dementia.”
- Also stated in: § Abstract · plain
“our findings implicate REM sleep mechanisms as predictors of clinical dementia.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Abstract · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Strengths of the current study include the population-based sample, rigorous surveillance for incident dementia, long duration of follow-up, and use of PSG to measure sleep architecture.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Cholinergic neurons are important determinants of REM sleep, 25,26 with cholinergic activity low during SWS and high during REM sleep.27”
What the sources say
- Not matchedcites [25]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [26]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
In the paper
“Briefly, sleep stages were scored in 30-second epochs by the criteria outlined by Rechtschaffen and Kales.11”
What the sources say
- Not matchedcites [11]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Thus, REM sleep may also buffer against synaptic loss and cognitive decline by assisting in the production of new connections and networks.”
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [32]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The methods, including scoring guidelines and reliability, have been published previously.[8][9][10]”
What the sources say
- Not matchedcites [8]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [9]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [10]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Model 2 included additional adjustments for body mass index, education (dichotomized at the level of college degree attainment), positivity for an APOE e4 allele, systolic blood pressure, current smoking, prevalent diabetes, prevalent heart disease, depressive symptoms”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“In the same study, REM sleep percentage was positively correlated with CSF levels of Ab1-42 in 48 patients with AD.”
What the sources say
- Not matchedcites [3]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelationaln = 48- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper relies on this without support.
Sleep disturbance is common in dementia.
“Sleep disturbance is common in dementia, although it is unclear whether differences in sleep architecture precede dementia onset.”
The paper relies on this without support.
It is unclear whether differences in sleep architecture precede dementia onset.
“Sleep disturbance is common in dementia, although it is unclear whether differences in sleep architecture precede dementia onset.”
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984) · Neurology · doi:10.1212/wnl.34.7.939 · Cited by 27,915
Hirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,012
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589
Older Adults' Reasons for Using Technology while Aging in Place
Peek, S. T. M., Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S., Aarts, S., van Hoof, J., Vrijhoef, H. J., & Wouters, E. (2015) · Gerontology · doi:10.1159/000430949 · Cited by 19,852
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,766
Sensitivity and False Alarm Rate of a Fall Sensor in Long-Term Fall Detection in the Elderly
Kangas, M., Korpelainen, R., Vikman, I., Nyberg, L., & Jämsä, T. J. (2014) · Gerontology · doi:10.1159/000362720 · Cited by 19,007
Rechtschaffen, A. (1968) · Medical Entomology and Zoology · Cited by 11,772
Sleep Drives Metabolite Clearance from the Adult Brain
Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., O’Donnell, J., Christensen, D. J., Nicholson, C., Iliff, J. J., et al. (2013) · Science · doi:10.1126/science.1241224 · Cited by 5,411
Cited by
Sorted by citations
Xu, W., Tan, C., Zou, J., Cao, X., & Tan, L. (2019) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2019-321896 · Cited by 349
Sharma, R. A., Varga, A. W., Bubu, O. M., Pirraglia, E., Kam, K., Parekh, A., Wohlleber, M. E., Miller, M. D., Andrade, A. G., Lewis, C., et al. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201704-0704oc · Cited by 259
The Relationship between Obstructive Sleep Apnea and Alzheimer’s Disease
Andrade, A. G., Bubu, O. M., Varga, A. W., & Osorio, R. S. (2018) · Journal of Alzheimer's Disease · doi:10.3233/jad-179936 · Cited by 216
della Monica, C., Johnsen, S., Atzori, G., Groeger, J. A., & Dijk, D. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00255 · Cited by 194
Macro and micro sleep architecture and cognitive performance in older adults
Djonlagic, I. E., Mariani, S., Fitzpatrick, A. L., van der Klei, V. M. G. T. H., Johnson, D. A., Wood, A. C., Seeman, T. E., Nguyen, H. T., Prerau, M. J., Luchsinger, J. A., et al. (2020) · Nature Human Behaviour · doi:10.1038/s41562-020-00964-y · Cited by 184
Metadata
- Authors
- Pase, M. P., Himali, J. J., Grima, N. A., Beiser, A. S., Satizabal, C. L., Aparicio, H. J., Thomas, R. J., Gottlieb, D. J., Auerbach, S. H., & Seshadri, S.
- Affiliations
- Boston University (US)
- From the Department of Neurology (M.P.P., J.J.H., A.S.B., C.L.S., H.J.A., S.H.A., S.S.), Boston University School of Medicine; Framingham Heart Study (M.P.P., J.J.H., A.S.B., C.L.S., H.J.A., S.H.A., S.S.), MA; Centre for Human Psychopharmacology (M.P.P.), Swinburne University of Technology, Australia; Department of Biostatistics (J.J.H., A.S.B.), Boston University School of Public Health; Cognitive Neurology Unit (N.A.G.) and Division of Pulmonary, Critical Care, and Sleep Medicine, Department of...
- ORCID
- Venue
- Neurology
- Published
- 2017-09-19
- Volume
- 89
- Issue
- 12
- Pages
- 1244-1250
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC5606917
- OpenAlex
- W2747891109
- Cited by
- 241
- References
- 39
- Citations by year
- 2026: 33 · 2025: 32 · 2024: 25 · 2023: 31 · 2022: 21 · 2021: 27 · 2020: 26 · 2019: 23 · 2018: 17 · 2017: 5
- FWCI
- 14.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Funders
- National Institute on Aging (P30AG010129, U01AG049505, U01AG052409, R01AG054076, R01AG049607, R01AG033193, T32AG036697)
- National Institute of Neurological Disorders and Stroke (UH2NS100605, L30 NS093634, R01NS017950)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep architecture, incident dementia, REM sleep, REM latency, Alzheimer's disease, dementia risk, NREM sleep, slow-wave sleep, sleep disorders, Sleep Heart Health Study
- MeSH terms
- Aged, Dementia, Female, Follow-Up Studies, Humans, Male, Massachusetts, Middle Aged, Risk, Sleep Wake Disorders, Sleep, REM, Polysomnography
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-11-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-11-07 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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