Five-year change in sleep duration and incident Alzheimer's Disease and Related Dementias among lower-income older adults

Authors

Hui Shi
Loren Lipworth
Qian Xiao
Xijing Han
Michael Mumma
Laura M Keohane
Danxia Yu
Corey J Bolton
Derek B Archer
Timothy J Hohman
Kelsie M Full

Language

English

Publication Date

9-1-2025

Journal

Alzheimer's & Dementia

DOI

10.1002/alz.70678

PMID

40959862

PMCID

PMC12441739

PubMedCentral® Posted Date

9-17-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: Little is known about change in sleep duration over time and Alzheimer's Disease and Related Dementias (ADRD) risk.

Methods: ADRD cases were identified among Southern Community Cohort Study participants enrolled in Medicare. Sleep duration was reported at enrollment and first study follow-up and categorized (short (< 7 hours), recommended (7-9) and long (> 9)), change was calculated between timepoints. Adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs, 95% CIs) for incident ADRD.

Results: We identified 2,093 ADRD cases among 17,945 participants. Compared to maintaining optimal sleep duration (7-9 hours) over 5 years, suboptimal changes were associated with 20-69% greater ADRD risk: adjusted HR (95% CI) was 1.50 (1.23-1.82) for long-recommended, 1.56 (1.21-2.01) for long-long, 1.69 (1.25-2.27) for long-short, 1.49 (1.16-1.91) for short-long, and 1.20 (1.06-1.36) for short-short.

Discussion: Suboptimal 5-year change in sleep durations were associated with ADRD risk among lower-income adults underrepresented in ADRD research.

Highlights: The study calculated 5-year change in sleep duration in a large community-based cohort of predominately lower-income adults. Cases of Alzheimer's Disease and Related Dementias (ADRD) were ascertained from Medicare claims data among 17,945 participants with up to 12 years of follow-up. Compared to maintaining 7-9 hours of sleep, older adults with suboptimal sleep categories were consistently at a greater risk of ADRD.

Keywords

Humans, Female, Male, Alzheimer Disease, Aged, Poverty, United States, Incidence, Sleep, Medicare, Dementia, Cohort Studies, Aged, 80 and over, Risk Factors, Time Factors, Sleep Duration, change in sleep duration, dementia, health disparities, longitudinal study

Published Open-Access

yes

Recommended Citation

Shi, Hui; Lipworth, Loren; Xiao, Qian; et al., "Five-year change in sleep duration and incident Alzheimer's Disease and Related Dementias among lower-income older adults" (2025). Faculty, Staff and Student Publications. 1348.
https://digitalcommons.library.tmc.edu/uthsph_docs/1348