Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Surgical Department, Innlandet Hospital Trust, Lillehammer, Norway.
J Sleep Res. 2023 Aug;32(4):e13820. doi: 10.1111/jsr.13820. Epub 2023 Jan 23.
Despite evidence suggesting that insomnia is associated with the risk of dementia and cognitive dysfunction, studies have shown mixed results. Dementia has a long prodromal phase, and studies with long follow-up are required to avoid reverse causality. In our 11-year follow-up study, we assessed whether probable insomnia disorder (PID) based on diagnostic criteria, and insomnia symptoms were associated with risk of all-cause dementia, Alzheimer's disease (AD) and cognition, measured with the Montreal Cognitive Assessment scale. We also examined if Apolipoprotein E genotype modified any associations with dementia through interaction. We analysed data from 7492 participants in the Norwegian Trøndelag Health Study. PID was not associated with all-cause dementia (odds ratio = 1.03, 95% confidence interval = 0.74-1.43), AD (odds ratio = 1.07, 95% confidence interval = 0.71-1.60) or Montreal Cognitive Assessment score (regression coefficient = 0.37, 95% confidence interval = -0.06 to 0.80). The insomnia symptom "difficulties maintaining sleep" was associated with a lower risk of all-cause dementia (odds ratio = 0.81, 95% confidence interval = 0.67-0.98), AD (odds ratio = 0.73, 95% confidence interval = 0.57-0.93), and better Montreal Cognitive Assessment score, mean 0.40 units (95% confidence interval = 0.15-0.64). No interaction with Apolipoprotein E genotype was found. PID and insomnia symptoms did not increase the risk of dementia in our study. More research with longer follow-up is needed, and future studies should explore if the associations to dementia risk vary across insomnia subtypes.
尽管有证据表明失眠与痴呆和认知功能障碍的风险相关，但研究结果却存在差异。痴呆症有一个很长的前驱期，需要进行长期随访的研究才能避免反向因果关系。在我们为期 11 年的随访研究中，我们评估了基于诊断标准的可能的失眠障碍（PID）和失眠症状是否与全因痴呆、阿尔茨海默病（AD）和认知（用蒙特利尔认知评估量表测量）的风险相关。我们还检查了载脂蛋白 E 基因型是否通过相互作用改变了与痴呆症的任何关联。我们分析了挪威特隆赫姆健康研究中 7492 名参与者的数据。PID 与全因痴呆（优势比=1.03，95%置信区间=0.74-1.43）、AD（优势比=1.07，95%置信区间=0.71-1.60）或蒙特利尔认知评估量表评分（回归系数=0.37，95%置信区间=0.06-0.80）无关。“维持睡眠困难”的失眠症状与全因痴呆（优势比=0.81，95%置信区间=0.67-0.98）、AD（优势比=0.73，95%置信区间=0.57-0.93）的风险降低以及蒙特利尔认知评估量表评分的提高（平均 0.40 个单位，95%置信区间=0.15-0.64）有关。未发现与载脂蛋白 E 基因型的相互作用。在我们的研究中，PID 和失眠症状并未增加痴呆症的风险。需要进行更多具有更长随访时间的研究，未来的研究应该探索失眠亚型与痴呆症风险的关联是否存在差异。
