The Role of Cognitive Impairment,Physical Disability,and Chronic Conditions in the Association of Sleep Duration With All-Cause Mortality Among Very Old Adults |
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| Affiliation: | 1. School of Public Health, Tianjin Medical University, Tianjin, China;2. Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden;3. Department of Biostatistics, School of Public Health, Yale University, New Haven, CT;1. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain;2. Department of Psychology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA;3. ICREA, Pg. Lluis Companys 23, Barcelona, Spain;1. Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, Kumamoto, Japan;2. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama, Japan;3. Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kumamoto, Japan;4. Department of Nutritional Management, Kumamoto Rehabilitation Hospital, Kumamoto, Japan;5. Department of Dental Office, Kumamoto Rehabilitation Hospital, Kumamoto, Japan;1. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong;2. Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong;3. Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong |
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| Abstract: | ObjectiveThis study aimed to examine the relationship between sleep duration and all-cause mortality, and to assess the role of cognitive impairment, physical disability, and chronic conditions on this association among very old adults.DesignA prospective cohort study.Setting and ParticipantsWithin the Chinese Longitudinal Healthy Longevity Surveys, 17,637 oldest-old aged 80-105 years were followed up to 10 years (2005- 2014).MeasuresData on sleep duration at baseline were based on self-report and were categorized as short (<7 hour), moderate (7-9 hours), and long sleep (>9 hours). Information on cognitive function using the Mini-Mental State Examination (MMSE), physical disability using Activities of Daily Living (ADL), and chronic conditions including diabetes, heart disease, stroke, asthma, and cancer were collected at baseline based on a structured questionnaire. Information about vital status was ascertained and confirmed by a close family member or village doctor of the participant during the follow-up. Data were analyzed using Cox proportional hazards models, with adjustment for potential confounders.ResultsDuring the follow-up of 10 years, 11,067 (62.7%) participants died. The multivariate-adjusted hazard ratios (HRs) with 95% confidence interval (CI) for mortality were 1.03 (0.98-1.09) for short sleep and 1.13 (1.08-1.18) for long sleep compared with moderate sleep duration. In stratified analysis by cognitive impairment, physical disability, and chronic conditions, the risk of morality was present only among people with MMSE scores ≤24 but did not differ much when stratified by physical disability and chronic conditions. There was a statistically significant interaction between long sleep and cognitive impairment on mortality (P for interaction = .002).Conclusions and ImplicationsLong sleep duration is associated with higher risk of mortality in very old adults independently of health conditions. Cognitive impairment may enhance this association. These findings suggest that health practitioners and families should be aware of the potential adverse prognosis associated with long sleep. |
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| Keywords: | Sleep duration cognitive impairment all-cause mortality oldest-old |
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