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Sleep disturbances and later cognitive status: a multi-centre study

Journal article
Authors S. Sindi
L. Johansson
Johan Skoog
A. D. Mattsson
L. Sjoberg
H. X. Wang
L. Fratiglioni
J. Kulmala
H. Soininen
A. Solomon
Boo Johansson
Ingmar Skoog
M. Kivipelto
I. Kareholt
Published in Sleep Medicine
Volume 52
Issue December
Pages 26-33
ISSN 1389-9457
Publication year 2018
Published at Institute of Neuroscience and Physiology
Department of Psychology
Centre for Ageing and Health (Agecap)
Pages 26-33
Language en
Keywords Sleep disturbances, Insomnia, Nightmares, Cognition, Cognitive status, mini-mental-state, older-adults, daytime sleepiness, risk-factors, later, life, decline, disorders, insomnia, impairment, nightmares, Neurosciences & Neurology, lstein mf, 1975, journal of psychiatric research, v12, p189, iences, v72, p1044
Subject categories Neurosciences


Objective: To investigate the associations between sleep disturbances in mid-life and late-life and late-life cognitive status. Methods: In four population-based studies (three Swedish studies: H70 study, Kungsholmen Project (KP) and The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD); and one Finnish study: Cardiovascular Risk Factors, Aging and Dementia (CAIDE)), participants provided self-reports on insomnia, nightmares and general sleep problems. Late-life cognitive status was measured by the Mini Mental State Exam (MMSE). The associations between late-life sleep disturbances and cognition 3-11 years later were investigated across all studies (n = 3210). Mean baseline ages were 70 (CAIDE, H70 and SWEOLD), and 84 years (KP). Additional analyses examined the association between midlife sleep and late-life cognition using CAIDE (21 and 31 years follow-up, n = 1306, mean age 50 years), and SWEOLD (20-24 years follow-up, n = 2068, mean age 58 years). Ordered logistic regressions, adjusted for potential baseline confounders, were used in the analyses. Results: Late-life sleep disturbances were associated with poorer cognition after 3-11 years (fully adjusted beta = -0.12, 95% CI = -0.24 to -0.01). Midlife nightmares and insomnia were also associated with lower MMSE scores (fully adjusted beta = -0.28, 95% CI = -0.49 to -0.07 and beta = -0.20, 95% CI = -0.39 to -0.01), although the latter association was attenuated after adjusting for lifestyle/health-related confounders. Midlife general sleep problems were not associated with late-life MMSE performance. Conclusions: Sleep disturbances and midlife nightmares were associated with lower MMSE scores, which suggests that sleep disturbances in earlier life stages can be associated with worse late-life cognition. (c) 2017 Published by Elsevier B.V.

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