Alders Peter, Kok Almar, van Zutphen Elisabeth M, Claassen Jurgen A H R, Deeg Dorly J H
Erasmus School of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, Rotterdam 3000 DR, The Netherlands.
Department of Psychiatry, Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1118, Amsterdam 1081 HZ, The Netherlands.
J Prev Alzheimers Dis. 2025 Feb;12(2):100024. doi: 10.1016/j.tjpad.2024.100024. Epub 2025 Jan 1.
Few studies have addressed the association of sleep disturbances with incident dementia with long lag times. We add to this literature by investigating how lag times varying from 2.2 to 23.8 years affect the relationship between sleep disturbance and incident dementia in a Dutch cohort study on aging.
Using eight waves of data from the Longitudinal Aging Study Amsterdam, we investigated the association of hours of sleep, difficulty falling asleep, interrupted sleep, and waking up early with incident dementia. For dementia an algorithm was used based on repeated measurements of cognitive tests and other data sources that provide strong indications of dementia. Sleep disturbances were assessed with a self-report questionnaire.
Of 2,218 participants, 237 (11%) developed dementia in the period 1992/3 to 2015/6. Participants ≥70 years more often reported sleep disturbances compared to those <70. Only for a short lag time (3 years), sleeping ≥9 h was associated with incident dementia. Sleeping ≤6 h, interrupted sleep and waking up early were associated with incident dementia, particularly for lag times ≥15 years.
We found that the association of sleep disturbances with incident dementia becomes stronger with longer lag times (particularly ≥15 years). Studies with lag times <15 years may suffer from reverse causation due to the changes in sleep patterns caused by the prodromal phase of neurodegenerative disease. The association of sleeping ≥9 h and the incidence of dementia in analyses with a short lag time seem to be the result of reverse causation.
很少有研究探讨睡眠障碍与发病延迟时间较长的痴呆症之间的关联。在一项荷兰老龄化队列研究中，我们通过调查2.2至23.8年不等的延迟时间如何影响睡眠障碍与痴呆症发病之间的关系，为这一文献增添了内容。
利用阿姆斯特丹纵向老龄化研究的八波数据，我们调查了睡眠时间、入睡困难、睡眠中断和早醒与痴呆症发病之间的关联。对于痴呆症，使用了一种基于认知测试重复测量和其他提供痴呆症有力指征的数据源的算法。睡眠障碍通过自我报告问卷进行评估。
在2218名参与者中，237人（11%）在1992/3年至2015/6年期间患上了痴呆症。与70岁以下的参与者相比，70岁及以上的参与者更常报告睡眠障碍。仅在较短的延迟时间（3年）内，睡眠时间≥9小时与痴呆症发病有关。睡眠时间≤6小时、睡眠中断和早醒与痴呆症发病有关，尤其是在延迟时间≥15年时。
我们发现，睡眠障碍与痴呆症发病之间的关联随着延迟时间的延长（尤其是≥15年）而变得更强。延迟时间<15年的研究可能由于神经退行性疾病前驱期引起的睡眠模式变化而存在反向因果关系。在短延迟时间分析中，睡眠时间≥9小时与痴呆症发病率之间的关联似乎是反向因果关系的结果。
