Increasing Sleepiness Linked to Dementia Risk in Oldest Old Women
THURSDAY, March 20, 2025 -- Increasing sleepiness is associated with increased dementia risk among oldest old women, according to a study published online March 19 in Neurology.
Sasha Milton, from the University of California San Francisco, and colleagues examined whether changes in 24-hour multidimensional sleep-wake activity are associated with mild cognitive impairment (MCI) and dementia in a study involving 733 oldest old women (mean age, 82.5 ± 2.9 years).
By the follow-up visit at five years, 22.4 and 12.7 percent of the participants developed MCI and dementia, respectively. The researchers identified three sleep-wake change profiles: stable sleep, which was characterized by stability or small improvements; declining nighttime sleep, characterized by decreases in quality and duration of nighttime sleep, moderate increases in napping, and worsening circadian rest-activity rhythms (RARs); and increasing sleepiness, characterized by large increases in duration and quality of daytime and nighttime sleep and worsening circadian RARs (43.8, 34.9, and 21.3 percent, respectively). Women with increasing sleepiness had about double the risk for dementia compared with those with stable sleep after adjustment for age, education, race, body mass index, diabetes, hypertension, myocardial infarction, antidepressant use, and baseline cognition (odds ratio, 2.21). Individual associations with dementia were seen for sleep efficiency, wake after sleep onset, nap duration, and nap frequency. There were no associations seen for sleep-wake change profiles or individual parameters with MCI.
"Change in multidimensional 24-hour sleep-wake activity may be intertwined with cognitive aging and may serve as an early marker or risk factor for dementia in the oldest old," the authors write.
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