Abstract
In this study, we examined the existence of relationship between sleep quality and dementia in subjects aged 90 years and above. The sample included 216 men and 444 women. Dementia and sleep quality were measured with 30-item mini-mental state examination (MMSE) and the Pittsburgh sleep quality index, respectively. Subjects with dementia had higher sleep quality score (7.83 ± 2.15 vs. 5.22 ± 2.49; P < 0.0001), longer sleep latency (50.97 ± 21.33 vs. 37.61 ± 12.53; P < 0.0001), and a lower sleep efficiency percentage (73.95 ± 8.783 vs. 81.32 ± 10.21; P < 0.0001) and more likely to report poor sleep quality (25.42 vs.17.13 %; P = 0.035). Subjects with poor sleep quality had significantly lower MMSE scores (P = 0.007) and higher prevalence of dementia (P = 0.042). Multiple logistic regressions were performed by adjusting clinical factors that are thought to be associated with dementia or sleep quality. We found that poor sleep quality was a risk factor for dementia (unadjusted odds ratio (OR) 1.719, 95 % confidence interval (CI) 1.138–2.597; adjusted OR 1.759, 95 % CI 1.012–3.057). There was no significant difference in MMSE scores (11.25 ± 3.40, 16.26 ± 5.14, and 15.43 ± 5.51; P = 0.105) among participants with daily average sleep durations of <5, 5–9, and >9 h, respectively. Among Chinese nonagenarians and centenarians, dementia was correlated with poor sleep quality, longer sleep latency, and lower sleep efficiency percentage.
Similar content being viewed by others
References
Aldrich MS, Foster NL, White RF, Bluemlein L, Prokopowicz G (1989) Sleep abnormalities in progressive supranuclear palsy. Ann Neurol 25:577–581
Bastos Leite AJ, Scheltens P, Barkhof F (2004) Pathological aging of the brain: an overview. Top Magn Reson Imaging 15:369–389
Benito-León J, Bermejo-Pareja F, Vega S, Louis E (2009) Total daily sleep duration and the risk of dementia: a prospective population-based study. Eur J Neurol 16:990–997
Bloom HG, Ahmed I, Alessi CA, Ancoli-Israel S, Buysse DJ, Kryger MH et al (2009) Evidence-based recommendations for the assessment and management of sleep disorders in older persons. J Am Geriatr Soc 57:761–789
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213
Dauvilliers Y (2007) Insomnia in patients with neurodegenerative conditions. Sleep Med 8:S27–S34
Gu D, Sautter J, Pipkin R, Zeng Y (2010) Sociodemographic and health correlates of sleep quality and duration among very old Chinese. Sleep 33:601–610
Haimov I, Hanuka E, Horowitz Y (2008) Chronic insomnia and cognitive functioning among older adults. Behav Sleep Med 6:32–54
Hasan S, Dauvilliers Y, Mongrain V, Franken P, Tafti M (2012) Age-related changes in sleep in inbred mice are genotype dependent. Neurobiol Aging 33:195.e13–26
Huang CQ, Dong BR, Zhang YL, Wu HM, Liu QX, Flaherty JH (2009) Cognitive impairment and hypertension among Chinese nonagenarians and centenarians. Hypertens Res 32:554–558
Jean-Louis G, Kripke DF, Ancoli-Israel S, Klauber MR, Sepulveda RS, Mowen MA et al (2000) Circadian sleep, illumination, and activity patterns in women: influences of aging and time reference. Physiol Behav 68:347–352
Ji-Rong Y, Bi-Rong D, Chang-Quan H, Zhen-Chan L, Hong-Mei W, Yan-Ling Z (2010) Pro12Ala polymorphism in PPAR-γ2 and dementia in Chinese nonagenarians/centenarians. Age (Dordr) 32:397–404
Liu X, Liu L (2005) Sleep habits and insomnia in a sample of elderly persons in China. Sleep 28:1579–1587
Loerbroks A, Debling D, Amelang M, Stürmer T (2010) Nocturnal sleep duration and cognitive impairment in a population-based study of older adults. Int J Geriatr Psychiatry 25:100–109
Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls. JAMA 261:2663–2668
Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV (2004) Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 27:1255–1273
Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB et al (2007) Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology 29:125–132
Poewe W (2005) Treatment of dementia with Lewy bodies and Parkinson's disease dementia. Mov Disord 20:S77–S82
Redline S, Kirchner HL, Quan SF, Gottlieb DJ, Kapur V, Newman A (2004) The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Arch Intern Med 164:406–418
Riegel B, Weaver TE (2009) Poor sleep and impaired self-care: towards a comprehensive model linking sleep, cognition, and heart failure outcomes. Eur J Cardiovasc Nurs 8:337–344
Rose KM, Fagin CM, Lorenz R (2010) Sleep disturbances in dementia: what they are and what to do. J Gerontol Nurs 36:9–14
Shochat T, Tzischinsky O, Oksenberg A, Peled R (2007) Validation of the Pittsburgh sleep quality index Hebrew translation (PSQI-H) in a sleep clinic sample. Isr Med Assoc J 9:853–856
Tafaro L, Cicconetti P, Baratta A, Bruckner N, Ettorre E, Marigliano V, Cacciafesta M (2007) Sleep quality of centenarians: cognitive and survival implications. Arch Gerontol Geriatr 44:385–389
Tombaugh TN, McIntyre NJ (1992) The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 40:922–935
Uhlmann RF, Larson EB (1991) Effect of education on the mini-mental state examination as a screening test for dementia. J Am Geriatr Soc 39:876–880
Wolkove N, Elkholy O, Baltzan M, Palayew M (2007a) Sleep and aging: 1. Sleep disorders commonly found in older people. CMAJ 176:1299–1304
Wolkove N, Elkholy O, Baltzan M, Palayew M (2007b) Sleep and aging: 2. Management of sleep disorders in older people. CMAJ 176:1449–1454
Wu YH, Swaab DF (2007) Disturbance and strategies for reactivation of the circadian rhythm system in aging and Alzheimer's disease. Sleep Med 8:623–636
Yu JM, Tseng IJ, Yuan RY, Sheu JJ, Liu HC, Hu CJ (2009) Low sleep efficiency in patients with cognitive impairment. Acta Neurol Taiwan 18:91–97
Yumino D, Wang H, Floras JS, Newton GE, Mak S, Ruttanaumpawan P et al (2009) Prevalence and physiological predictors of sleep apnea in patients with heart failure and systolic dysfunction. J Card Fail 15:279–285
Zisberg A, Gur-Yaish N, Shochat T (2010) Contribution of routine to sleep quality in community elderly. Sleep 33:509–514
Acknowledgments
This work was supported by the Discipline Construction Foundation of Sichuan University and by grants from the Project of Science and Technology Bureau of Sichuan Province (2006Z09-006-4) and the Construction Fund for Subjects of West China Hospital of Sichuan University (XK05001). The authors would like to thank the staff of the Department of Geriatrics Medicine, West China Hospital and Dujiangyan Hospital, and all participants (as well as their legal proxies) for their great contribution. Dr. Joey Kwong (the Chinese University of Hong Kong, Hong Kong) is especially acknowledged for his language assistance.
Author information
Authors and Affiliations
Corresponding author
Additional information
Yue Jirong and Huang Changquan contributed equally to the current study.
About this article
Cite this article
Jirong, Y., Changquan, H., Hongmei, W. et al. Association of sleep quality and dementia among long-lived Chinese older adults. AGE 35, 1423–1432 (2013). https://doi.org/10.1007/s11357-012-9432-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11357-012-9432-8