Increased risk of dementia in patients with non-apnea sleep disorder

Pi-Shan Sung, Chih Ching Yeh, Liang-Chao Wang, Peir Haur Hung, Chih Hsin Muo, Fung Chang Sung, Chih-Hung Chen, Kuen-Jer Tsai

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Sleep disorders other than sleep apnea (non-apnea sleep disorder, NSD), esp. insomnia and excessive daytime sleepiness, has been reported to induce higher risk of cognitive decline and dementia in previous longitudinal follow-up studies. However, large-scale nationwide populationbased study may further confirm the association between NSD and dementia. Methods: It was a nationwide population-based retrospective study. We used data from Taiwan’s National Health Insurance Research Database (NHIRD) between January 2000 and December 2011. The NSD cohort comprised 92,079 patients aged over 20 years with no preexisting dementia. The comparison cohort was propensity-score matched 1:1 with 92079 controls. Incident dementia cases were identified to the end of 2011. The NSD cohort to non-NSD cohort adjusted hazard ratios (aHRs) of dementia were assessed using multivariable Cox proportional hazards regression analysis. Results: Incidence of dementia was 4.19 and 2.95 per 1,000 person-years in the NSD and non-NSD cohorts, respectively, with an aHR of 1.46 (95% CI=1.38–1.54; p<0.0001). Risk of dementia was higher in both gender and whole age subgroup, with slightly higher in men (aHR: 1.48, 95% CI=1.35–1.62, p<0.0001) and in the younger population (aHR: 2.79, 95% CI=1.63–4.78, p<0.0001). Dementia was most likely to occur in the first year of follow-up (aHR: 1.73, 95% CI=1.49–2.02; p<0.0001), but dementia risk remained high 5 years after NSD diagnosis compared to controls (aHR: 1.44, 95% CI=1.32–1.57; p<0.0001). Conclusion: NSD may be an early indicator of decline in cognitive functioning and onset of dementia in the short-term period. It also carries a higher risk for dementia in the long run. Patients with NSD should require close monitoring for cognitive decline.

Original languageEnglish
Pages (from-to)309-316
Number of pages8
JournalCurrent Alzheimer research
Volume14
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1

Fingerprint

Dementia
Sleep Wake Disorders
Propensity Score
Sleep Apnea Syndromes
National Health Programs
Sleep Initiation and Maintenance Disorders
Population
Retrospective Studies
Regression Analysis
Databases
Incidence
Research

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Sung, Pi-Shan ; Yeh, Chih Ching ; Wang, Liang-Chao ; Hung, Peir Haur ; Muo, Chih Hsin ; Sung, Fung Chang ; Chen, Chih-Hung ; Tsai, Kuen-Jer. / Increased risk of dementia in patients with non-apnea sleep disorder. In: Current Alzheimer research. 2017 ; Vol. 14, No. 3. pp. 309-316.
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abstract = "Background: Sleep disorders other than sleep apnea (non-apnea sleep disorder, NSD), esp. insomnia and excessive daytime sleepiness, has been reported to induce higher risk of cognitive decline and dementia in previous longitudinal follow-up studies. However, large-scale nationwide populationbased study may further confirm the association between NSD and dementia. Methods: It was a nationwide population-based retrospective study. We used data from Taiwan’s National Health Insurance Research Database (NHIRD) between January 2000 and December 2011. The NSD cohort comprised 92,079 patients aged over 20 years with no preexisting dementia. The comparison cohort was propensity-score matched 1:1 with 92079 controls. Incident dementia cases were identified to the end of 2011. The NSD cohort to non-NSD cohort adjusted hazard ratios (aHRs) of dementia were assessed using multivariable Cox proportional hazards regression analysis. Results: Incidence of dementia was 4.19 and 2.95 per 1,000 person-years in the NSD and non-NSD cohorts, respectively, with an aHR of 1.46 (95{\%} CI=1.38–1.54; p<0.0001). Risk of dementia was higher in both gender and whole age subgroup, with slightly higher in men (aHR: 1.48, 95{\%} CI=1.35–1.62, p<0.0001) and in the younger population (aHR: 2.79, 95{\%} CI=1.63–4.78, p<0.0001). Dementia was most likely to occur in the first year of follow-up (aHR: 1.73, 95{\%} CI=1.49–2.02; p<0.0001), but dementia risk remained high 5 years after NSD diagnosis compared to controls (aHR: 1.44, 95{\%} CI=1.32–1.57; p<0.0001). Conclusion: NSD may be an early indicator of decline in cognitive functioning and onset of dementia in the short-term period. It also carries a higher risk for dementia in the long run. Patients with NSD should require close monitoring for cognitive decline.",
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Increased risk of dementia in patients with non-apnea sleep disorder. / Sung, Pi-Shan; Yeh, Chih Ching; Wang, Liang-Chao; Hung, Peir Haur; Muo, Chih Hsin; Sung, Fung Chang; Chen, Chih-Hung; Tsai, Kuen-Jer.

In: Current Alzheimer research, Vol. 14, No. 3, 01.03.2017, p. 309-316.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Increased risk of dementia in patients with non-apnea sleep disorder

AU - Sung, Pi-Shan

AU - Yeh, Chih Ching

AU - Wang, Liang-Chao

AU - Hung, Peir Haur

AU - Muo, Chih Hsin

AU - Sung, Fung Chang

AU - Chen, Chih-Hung

AU - Tsai, Kuen-Jer

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: Sleep disorders other than sleep apnea (non-apnea sleep disorder, NSD), esp. insomnia and excessive daytime sleepiness, has been reported to induce higher risk of cognitive decline and dementia in previous longitudinal follow-up studies. However, large-scale nationwide populationbased study may further confirm the association between NSD and dementia. Methods: It was a nationwide population-based retrospective study. We used data from Taiwan’s National Health Insurance Research Database (NHIRD) between January 2000 and December 2011. The NSD cohort comprised 92,079 patients aged over 20 years with no preexisting dementia. The comparison cohort was propensity-score matched 1:1 with 92079 controls. Incident dementia cases were identified to the end of 2011. The NSD cohort to non-NSD cohort adjusted hazard ratios (aHRs) of dementia were assessed using multivariable Cox proportional hazards regression analysis. Results: Incidence of dementia was 4.19 and 2.95 per 1,000 person-years in the NSD and non-NSD cohorts, respectively, with an aHR of 1.46 (95% CI=1.38–1.54; p<0.0001). Risk of dementia was higher in both gender and whole age subgroup, with slightly higher in men (aHR: 1.48, 95% CI=1.35–1.62, p<0.0001) and in the younger population (aHR: 2.79, 95% CI=1.63–4.78, p<0.0001). Dementia was most likely to occur in the first year of follow-up (aHR: 1.73, 95% CI=1.49–2.02; p<0.0001), but dementia risk remained high 5 years after NSD diagnosis compared to controls (aHR: 1.44, 95% CI=1.32–1.57; p<0.0001). Conclusion: NSD may be an early indicator of decline in cognitive functioning and onset of dementia in the short-term period. It also carries a higher risk for dementia in the long run. Patients with NSD should require close monitoring for cognitive decline.

AB - Background: Sleep disorders other than sleep apnea (non-apnea sleep disorder, NSD), esp. insomnia and excessive daytime sleepiness, has been reported to induce higher risk of cognitive decline and dementia in previous longitudinal follow-up studies. However, large-scale nationwide populationbased study may further confirm the association between NSD and dementia. Methods: It was a nationwide population-based retrospective study. We used data from Taiwan’s National Health Insurance Research Database (NHIRD) between January 2000 and December 2011. The NSD cohort comprised 92,079 patients aged over 20 years with no preexisting dementia. The comparison cohort was propensity-score matched 1:1 with 92079 controls. Incident dementia cases were identified to the end of 2011. The NSD cohort to non-NSD cohort adjusted hazard ratios (aHRs) of dementia were assessed using multivariable Cox proportional hazards regression analysis. Results: Incidence of dementia was 4.19 and 2.95 per 1,000 person-years in the NSD and non-NSD cohorts, respectively, with an aHR of 1.46 (95% CI=1.38–1.54; p<0.0001). Risk of dementia was higher in both gender and whole age subgroup, with slightly higher in men (aHR: 1.48, 95% CI=1.35–1.62, p<0.0001) and in the younger population (aHR: 2.79, 95% CI=1.63–4.78, p<0.0001). Dementia was most likely to occur in the first year of follow-up (aHR: 1.73, 95% CI=1.49–2.02; p<0.0001), but dementia risk remained high 5 years after NSD diagnosis compared to controls (aHR: 1.44, 95% CI=1.32–1.57; p<0.0001). Conclusion: NSD may be an early indicator of decline in cognitive functioning and onset of dementia in the short-term period. It also carries a higher risk for dementia in the long run. Patients with NSD should require close monitoring for cognitive decline.

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