TY - JOUR
T1 - Objective short sleep duration increases the risk of all-cause mortality associated with possible vascular cognitive impairment
AU - Fernandez-Mendoza, Julio
AU - He, Fan
AU - Calhoun, Susan L.
AU - Vgontzas, Alexandros N.
AU - Liao, Duanping
AU - Bixler, Edward O.
N1 - Funding Information:
American Heart Association, USA Award Number 14SDG19830018 (PI: Fernandez-Mendoza) and National Heart, Lung, and Blood Institute, USA of the National Institutes of Health, USA Awards Number R01HL51931 and R01HL40916 (PI: Bixler).
Publisher Copyright:
© 2019 National Sleep Foundation
PY - 2020/2
Y1 - 2020/2
N2 - Objectives: Cognitive impairment is a leading cause of disability worldwide, and cardiometabolic conditions are key contributors to its development. Short sleep is also a potential contributor to brain health; however, its role in predicting mortality remains poorly understood. We investigated whether objective short sleep duration increases the risk of all-cause mortality associated with coexisting cognitive impairment and cardiometabolic conditions, i.e., possible vascular cognitive impairment (VCI). Design: This is a longitudinal study. Setting: This is a population-based, in-lab study. Participants: A total of 1,524 adults (aged 48.9±13.4 years, 53.4% women) from the Penn State Adult Cohort were included in the study. Measurements: All-cause mortality was estimated after 19.1±5.1 years of follow-up. Neuropsychological testing was performed to ascertain cognitive impairment. Clinical history and physical examination were performed to ascertain stage 2 hypertension, type 2 diabetes, heart disease, and stroke. Possible VCI was defined as the presence of any of these cardiometabolic conditions and cognitive impairment. In-lab, 8-hour polysomnography (PSG) was performed to ascertain short sleep duration (i.e., <6 hours). Results: Multivariable-adjusted Cox proportional-hazard models showed that the risk of all-cause mortality associated with cardiometabolic conditions (n=864) and possible VCI (n=122) was significantly increased in those who slept <6 hours at baseline (hazards ratio [HR] = 1.79, 95% confidence interval [CI] = 1.28-2.51 and HR = 4.01, 95% CI = 2.66-6.05, respectively), while it was negligible in those who slept ≥6 hours (HR = 1.44, 95% CI = 0.99-2.09 and HR = 1.41, 95% CI = 0.70-2.83, respectively). Conclusions: Objective short sleep duration predicts the mortality prognosis of adults with possible VCI. Sleep duration and cognition should be objectively evaluated in patients presenting with a cluster of cardiometabolic conditions and sleep and cognitive complaints. Short sleep is a useful risk factor in the prediction of adverse cardiometabolic and brain health outcomes.
AB - Objectives: Cognitive impairment is a leading cause of disability worldwide, and cardiometabolic conditions are key contributors to its development. Short sleep is also a potential contributor to brain health; however, its role in predicting mortality remains poorly understood. We investigated whether objective short sleep duration increases the risk of all-cause mortality associated with coexisting cognitive impairment and cardiometabolic conditions, i.e., possible vascular cognitive impairment (VCI). Design: This is a longitudinal study. Setting: This is a population-based, in-lab study. Participants: A total of 1,524 adults (aged 48.9±13.4 years, 53.4% women) from the Penn State Adult Cohort were included in the study. Measurements: All-cause mortality was estimated after 19.1±5.1 years of follow-up. Neuropsychological testing was performed to ascertain cognitive impairment. Clinical history and physical examination were performed to ascertain stage 2 hypertension, type 2 diabetes, heart disease, and stroke. Possible VCI was defined as the presence of any of these cardiometabolic conditions and cognitive impairment. In-lab, 8-hour polysomnography (PSG) was performed to ascertain short sleep duration (i.e., <6 hours). Results: Multivariable-adjusted Cox proportional-hazard models showed that the risk of all-cause mortality associated with cardiometabolic conditions (n=864) and possible VCI (n=122) was significantly increased in those who slept <6 hours at baseline (hazards ratio [HR] = 1.79, 95% confidence interval [CI] = 1.28-2.51 and HR = 4.01, 95% CI = 2.66-6.05, respectively), while it was negligible in those who slept ≥6 hours (HR = 1.44, 95% CI = 0.99-2.09 and HR = 1.41, 95% CI = 0.70-2.83, respectively). Conclusions: Objective short sleep duration predicts the mortality prognosis of adults with possible VCI. Sleep duration and cognition should be objectively evaluated in patients presenting with a cluster of cardiometabolic conditions and sleep and cognitive complaints. Short sleep is a useful risk factor in the prediction of adverse cardiometabolic and brain health outcomes.
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U2 - 10.1016/j.sleh.2019.09.003
DO - 10.1016/j.sleh.2019.09.003
M3 - Article
C2 - 31759934
AN - SCOPUS:85078245386
VL - 6
SP - 71
EP - 78
JO - Sleep Health
JF - Sleep Health
SN - 2352-7218
IS - 1
ER -