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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Sleep Fragmentation and the Risk of Incident Alzheimer's Disease and Cognitive Decline in Older Persons</title><author><name sortKey="Lim, Andrew S P" sort="Lim, Andrew S P" uniqKey="Lim A" first="Andrew S. P." last="Lim">Andrew S. P. Lim</name><affiliation><nlm:aff id="aff1">Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Kowgier, Matthew" sort="Kowgier, Matthew" uniqKey="Kowgier M" first="Matthew" last="Kowgier">Matthew Kowgier</name><affiliation><nlm:aff id="aff2">Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research, University of Toronto, Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Yu, Lei" sort="Yu, Lei" uniqKey="Yu L" first="Lei" last="Yu">Lei Yu</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author><author><name sortKey="Buchman, Aron S" sort="Buchman, Aron S" uniqKey="Buchman A" first="Aron S." last="Buchman">Aron S. Buchman</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author><author><name sortKey="Bennett, David A" sort="Bennett, David A" uniqKey="Bennett D" first="David A." last="Bennett">David A. Bennett</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23814339</idno><idno type="pmc">3669060</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669060</idno><idno type="RBID">PMC:3669060</idno><idno type="doi">10.5665/sleep.2802</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">000683</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000683</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Sleep Fragmentation and the Risk of Incident Alzheimer's Disease and Cognitive Decline in Older Persons</title><author><name sortKey="Lim, Andrew S P" sort="Lim, Andrew S P" uniqKey="Lim A" first="Andrew S. P." last="Lim">Andrew S. P. Lim</name><affiliation><nlm:aff id="aff1">Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Kowgier, Matthew" sort="Kowgier, Matthew" uniqKey="Kowgier M" first="Matthew" last="Kowgier">Matthew Kowgier</name><affiliation><nlm:aff id="aff2">Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research, University of Toronto, Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Yu, Lei" sort="Yu, Lei" uniqKey="Yu L" first="Lei" last="Yu">Lei Yu</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author><author><name sortKey="Buchman, Aron S" sort="Buchman, Aron S" uniqKey="Buchman A" first="Aron S." last="Buchman">Aron S. Buchman</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author><author><name sortKey="Bennett, David A" sort="Bennett, David A" uniqKey="Bennett D" first="David A." last="Bennett">David A. Bennett</name><affiliation><nlm:aff id="aff3">Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</nlm:aff></affiliation><affiliation><nlm:aff id="aff4">Department of Neurological Sciences, Rush University, Chicago, IL</nlm:aff></affiliation></author></analytic><series><title level="j">Sleep</title><idno type="ISSN">0161-8105</idno><idno type="eISSN">1550-9109</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective:</title><p>Cross-sectional studies suggest that sleep fragmentation is associated with cognitive performance in older adults. We tested the hypothesis that sleep fragmentation is associated with incident Alzheimer's disease (AD) and the rate of cognitive decline in older adults.</p></sec><sec><title>Design:</title><p>Prospective cohort study.</p></sec><sec><title>Setting:</title><p>Community-based</p></sec><sec><title>Participants:</title><p>737 community dwelling older adults without dementia.</p></sec><sec><title>Measurements and Results:</title><p>Sleep fragmentation was quantified from up to 10 consecutive days of actigraphy. Subjects underwent annual evaluation for AD with 19 neuropsychological tests. Over a follow-up period of up to 6 years (mean 3.3 years), 97 individuals developed AD. In a Cox proportional hazards model controlling for age, sex, and education, a higher level of sleep fragmentation was associated with an increased risk of AD (HR = 1.22, 95%CI 1.03-1.44, P = 0.02 per 1SD increase in sleep fragmentation). An individual with high sleep fragmentation (90<sup>th</sup> percentile) had a 1.5-fold risk of developing AD as compared with someone with low sleep fragmentation (10<sup>th</sup> percentile). The association of sleep fragmentation with incident AD did not vary along demographic lines and was unchanged after controlling for potential confounders including total daily rest time, chronic medical conditions, and the use of common medications which can affect sleep. In a linear mixed effect analysis, a 0.01 unit increase in sleep fragmentation was associated with a 22% increase in the annual rate of cognitive decline relative to the average rate of decline in the cohort (Estimate = -0.016, SE = 0.007, P = 0.03).</p></sec><sec><title>Conclusions:</title><p>Sleep fragmentation in older adults is associated with incident AD and the rate of cognitive decline.</p></sec><sec><title>Citation:</title><p>Lim ASP; Kowgier M; Yu L; Buchman AS; Bennett DA. Sleep fragmentation and the risk of incident alzheimer's disease and cognitive decline in older persons. <italic>SLEEP</italic> 2013;36(7):1027-1032.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Sleep</journal-id><journal-id journal-id-type="iso-abbrev">Sleep</journal-id><journal-id journal-id-type="publisher-id">Sleep</journal-id><journal-title-group><journal-title>Sleep</journal-title></journal-title-group><issn pub-type="ppub">0161-8105</issn><issn pub-type="epub">1550-9109</issn><publisher><publisher-name>Associated Professional Sleep Societies, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23814339</article-id><article-id pub-id-type="pmc">3669060</article-id><article-id pub-id-type="doi">10.5665/sleep.2802</article-id><article-categories><subj-group subj-group-type="heading"><subject>Sleep Fragmentation and Risk of Alzheimer Disease and Cognitive Decline</subject></subj-group></article-categories><title-group><article-title>Sleep Fragmentation and the Risk of Incident Alzheimer's Disease and Cognitive Decline in Older Persons</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lim</surname><given-names>Andrew S. P.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Kowgier</surname><given-names>Matthew</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Yu</surname><given-names>Lei</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Buchman</surname><given-names>Aron S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bennett</surname><given-names>David A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><aff id="aff1"><label>1</label>Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada</aff><aff id="aff2"><label>2</label>Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research, University of Toronto, Toronto, ON, Canada</aff><aff id="aff3"><label>3</label>Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL</aff><aff id="aff4"><label>4</label>Department of Neurological Sciences, Rush University, Chicago, IL</aff></contrib-group><author-notes><corresp id="cor1">Address correspondence to: Andrew S. P. Lim, MD, <addr-line>Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave – M1-600, Toronto, ON, Canada M4N 3M5</addr-line><phone>(647) 970-4060</phone><fax>(416) 480-4674</fax><email>andrew.lim@utoronto.ca</email></corresp></author-notes><pub-date pub-type="epub"><day>1</day><month>7</month><year>2013</year></pub-date><volume>36</volume><issue>7</issue><fpage>1027</fpage><lpage>1032</lpage><history><date date-type="received"><month>6</month><year>2012</year></date><date date-type="rev-recd"><month>11</month><year>2012</year></date><date date-type="accepted"><month>1</month><year>2013</year></date></history><permissions><copyright-statement>© 2013 Associated Professional Sleep Societies, LLC.</copyright-statement><copyright-year>2013</copyright-year></permissions><abstract><sec><title>Objective:</title><p>Cross-sectional studies suggest that sleep fragmentation is associated with cognitive performance in older adults. We tested the hypothesis that sleep fragmentation is associated with incident Alzheimer's disease (AD) and the rate of cognitive decline in older adults.</p></sec><sec><title>Design:</title><p>Prospective cohort study.</p></sec><sec><title>Setting:</title><p>Community-based</p></sec><sec><title>Participants:</title><p>737 community dwelling older adults without dementia.</p></sec><sec><title>Measurements and Results:</title><p>Sleep fragmentation was quantified from up to 10 consecutive days of actigraphy. Subjects underwent annual evaluation for AD with 19 neuropsychological tests. Over a follow-up period of up to 6 years (mean 3.3 years), 97 individuals developed AD. In a Cox proportional hazards model controlling for age, sex, and education, a higher level of sleep fragmentation was associated with an increased risk of AD (HR = 1.22, 95%CI 1.03-1.44, P = 0.02 per 1SD increase in sleep fragmentation). An individual with high sleep fragmentation (90<sup>th</sup> percentile) had a 1.5-fold risk of developing AD as compared with someone with low sleep fragmentation (10<sup>th</sup> percentile). The association of sleep fragmentation with incident AD did not vary along demographic lines and was unchanged after controlling for potential confounders including total daily rest time, chronic medical conditions, and the use of common medications which can affect sleep. In a linear mixed effect analysis, a 0.01 unit increase in sleep fragmentation was associated with a 22% increase in the annual rate of cognitive decline relative to the average rate of decline in the cohort (Estimate = -0.016, SE = 0.007, P = 0.03).</p></sec><sec><title>Conclusions:</title><p>Sleep fragmentation in older adults is associated with incident AD and the rate of cognitive decline.</p></sec><sec><title>Citation:</title><p>Lim ASP; Kowgier M; Yu L; Buchman AS; Bennett DA. Sleep fragmentation and the risk of incident alzheimer's disease and cognitive decline in older persons. <italic>SLEEP</italic> 2013;36(7):1027-1032.</p></sec></abstract><kwd-group><kwd>Actigraphy</kwd><kwd>Alzheimer's disease</kwd><kwd>cognitive decline</kwd><kwd>epidemiology</kwd><kwd>sleep fragmentation</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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