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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

Rebecca Robbins1,2, Stuart F. Quan1,2, Matthew D. Weaver1,2, Gregory Bormes3, Laura K. Barger1,2, Charles A. Czeisler1,2
  • 1Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA
  • 2Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
  • 3Department of Mathematics, Boston College, Boston, MA 02467, USA
Received: September 15, 2020Accepted: December 29, 2020Published: February 11, 2021
https://doi.org/10.18632/aging.202591

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.

Abstract

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.