{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:09:09Z","timestamp":1793106549367,"version":"4.5.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec id=\"ab-noi230078-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Slow-wave sleep (SWS) supports the aging brain in many ways, including facilitating the glymphatic clearance of proteins that aggregate in Alzheimer disease. However, the role of SWS in the development of dementia remains equivocal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether SWS loss with aging is associated with the risk of incident dementia and examine whether Alzheimer disease genetic risk or hippocampal volumes suggestive of early neurodegeneration were associated with SWS loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This prospective cohort study included participants in the Framingham Heart Study who completed 2 overnight polysomnography (PSG) studies in the time periods 1995 to 1998 and 2001 to 2003. Additional criteria for individuals in this study sample were an age of 60 years or older and no dementia at the time of the second overnight PSG. Data analysis was performed from January 2020 to August 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Changes in SWS percentage measured across repeated overnight sleep studies over a mean of 5.2 years apart (range, 4.8-7.1 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-8\">\n                    <jats:title>Main Outcome<\/jats:title>\n                    <jats:p>Risk of incident all-cause dementia adjudicated over 17 years of follow-up from the second PSG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From the 868 Framingham Heart Study participants who returned for a second PSG, this cohort included 346 participants with a mean age of 69 years (range, 60-87 years); 179 (52%) were female. Aging was associated with SWS loss across repeated overnight sleep studies (mean [SD] change, \u22120.6 [1.5%] per year;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Over the next 17 years of follow-up, there were 52 cases of incident dementia. In Cox regression models adjusted for age, sex, cohort, positivity for at least 1\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele, smoking status, sleeping medication use, antidepressant use, and anxiolytic use, each percentage decrease in SWS per year was associated with a 27% increase in the risk of dementia (hazard ratio, 1.27; 95% CI, 1.06-1.54;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01). SWS loss with aging was accelerated in the presence of Alzheimer disease genetic risk (ie,\n                      <jats:italic>APOE<\/jats:italic>\n                      \u03b54 allele) but not hippocampal volumes measured proximal to the first PSG.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230078-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study found that slow-wave sleep percentage declined with aging and Alzheimer disease genetic risk, with greater reductions associated with the risk of incident dementia. These findings suggest that SWS loss may be a modifiable dementia risk factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.3889","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T11:44:32Z","timestamp":1698666272000},"page":"1326","source":"Crossref","is-referenced-by-count":108,"title":["Association Between Slow-Wave Sleep Loss and Incident Dementia"],"prefix":"10.1001","volume":"80","author":[{"given":"Jayandra J.","family":"Himali","sequence":"first","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Glenn Biggs Institute for Alzheimer\u2019s & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas"},{"name":"Department of Population Health Sciences, University of Texas Health Science Center, San Antonio"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Boston University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andree-Ann","family":"Baril","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Douglas Mental Health University Institute, Verdun, Quebec, Canada"},{"name":"Department of Psychiatry, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina G.","family":"Cavuoto","sequence":"additional","affiliation":[{"name":"Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Yiallourou","sequence":"additional","affiliation":[{"name":"Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal D.","family":"Wiedner","sequence":"additional","affiliation":[{"name":"Glenn Biggs Institute for Alzheimer\u2019s & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dibya","family":"Himali","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Boston University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"DeCarli","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa S.","family":"Beiser","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts"},{"name":"Boston University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Seshadri","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Glenn Biggs Institute for Alzheimer\u2019s & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Pase","sequence":"additional","affiliation":[{"name":"Framingham Heart Study, Framingham, Massachusetts"},{"name":"Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia"},{"name":"Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"5955","key":"noi230078r1","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1126\/science.1180962","article-title":"Amyloid-beta dynamics are regulated by orexin and the sleep-wake cycle.","volume":"326","author":"Kang","year":"2009","journal-title":"Science"},{"issue":"6429","key":"noi230078r2","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1126\/science.aav2546","article-title":"The sleep-wake cycle regulates brain interstitial fluid tau in mice and CSF tau in humans.","volume":"363","author":"Holth","year":"2019","journal-title":"Science"},{"issue":"6156","key":"noi230078r3","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1126\/science.1241224","article-title":"Sleep drives metabolite clearance from the adult brain.","volume":"342","author":"Xie","year":"2013","journal-title":"Science"},{"issue":"8","key":"noi230078r4","doi-asserted-by":"publisher","first-page":"2104","DOI":"10.1093\/brain\/awx148","article-title":"Slow wave sleep disruption increases cerebrospinal fluid amyloid-\u00df levels.","volume":"140","author":"Ju","year":"2017","journal-title":"Brain"},{"issue":"6","key":"noi230078r5","doi-asserted-by":"publisher","first-page":"1800","DOI":"10.1093\/ije\/dyv337","article-title":"Cohort profile: the Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology.","volume":"44","author":"Tsao","year":"2015","journal-title":"Int J Epidemiol"},{"issue":"12","key":"noi230078r6","first-page":"1077","article-title":"The Sleep Heart Health Study: design, rationale, and methods.","volume":"20","author":"Quan","year":"1997","journal-title":"Sleep"},{"issue":"7","key":"noi230078r7","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1093\/sleep\/21.7.749","article-title":"Reliability of scoring respiratory disturbance indices and sleep staging.","volume":"21","author":"Whitney","year":"1998","journal-title":"Sleep"},{"issue":"7","key":"noi230078r8","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1093\/sleep\/21.7.759","article-title":"Methods for obtaining and analyzing unattended polysomnography data for a multicenter study.","volume":"21","author":"Redline","year":"1998","journal-title":"Sleep"},{"issue":"6","key":"noi230078r10","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1056\/NEJMoa1504327","article-title":"Incidence of dementia over three decades in the Framingham Heart Study.","volume":"374","author":"Satizabal","year":"2016","journal-title":"N Engl J Med"},{"issue":"10","key":"noi230078r12","doi-asserted-by":"publisher","first-page":"2787","DOI":"10.1161\/STROKEAHA.113.000947","article-title":"Brain imaging and cognitive predictors of stroke and Alzheimer disease in the Framingham Heart Study.","volume":"44","author":"Weinstein","year":"2013","journal-title":"Stroke"},{"issue":"10","key":"noi230078r13","doi-asserted-by":"publisher","first-page":"e1341","DOI":"10.1212\/WNL.0000000000010306","article-title":"Cardiovascular health, genetic risk, and risk of dementia in the Framingham Heart Study.","volume":"95","author":"Peloso","year":"2020","journal-title":"Neurology"},{"issue":"5","key":"noi230078r14","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1016\/S1474-4422(18)30053-X","article-title":"The effect of APOE and other common genetic variants on the onset of Alzheimer\u2019s disease and dementia: a community-based cohort study.","volume":"17","author":"van der Lee","year":"2018","journal-title":"Lancet Neurol"},{"issue":"6","key":"noi230078r15","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1093\/gerona\/glw130","article-title":"Physical activity, brain volume, and dementia risk: the Framingham Study.","volume":"72","author":"Tan","year":"2017","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"12","key":"noi230078r16","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1161\/CIRCULATIONAHA.115.021275","article-title":"Revised Framingham Stroke Risk Profile to reflect temporal trends.","volume":"135","author":"Dufouil","year":"2017","journal-title":"Circulation"},{"issue":"1","key":"noi230078r17","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/psyg.2015.15.issue-1","article-title":"Sleep disturbances and dementia.","volume":"15","author":"Cipriani","year":"2015","journal-title":"Psychogeriatrics"},{"issue":"1","key":"noi230078r18","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1515\/2161-962X.1014","article-title":"Imputation strategies for the estimation of natural direct and indirect effects.","volume":"1","author":"Vansteelandt","year":"2012","journal-title":"Epidemiol Methods"},{"issue":"7","key":"noi230078r19","doi-asserted-by":"publisher","first-page":"e2325152","DOI":"10.1001\/jamanetworkopen.2023.25152","article-title":"Sleep architecture, obstructive sleep apnea, and cognitive function in adults.","volume":"6","author":"Pase","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"6","key":"noi230078r20","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/S2213-2600(19)30057-8","article-title":"Normal polysomnography parameters in healthy adults: a systematic review and meta-analysis.","volume":"7","author":"Boulos","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"32","key":"noi230078r21","doi-asserted-by":"publisher","first-page":"6315","DOI":"10.1523\/JNEUROSCI.0503-19.2019","article-title":"Sleep as a potential biomarker of tau and \u00df-amyloid burden in the human brain.","volume":"39","author":"Winer","year":"2019","journal-title":"J Neurosci"},{"key":"noi230078r22","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.78191","article-title":"Timely coupling of sleep spindles and slow waves linked to early amyloid-\u00df burden and predicts memory decline.","volume":"11","author":"Chylinski","year":"2022","journal-title":"Elife"},{"issue":"7","key":"noi230078r23","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1038\/nn.4035","article-title":"\u00df-Amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation.","volume":"18","author":"Mander","year":"2015","journal-title":"Nat Neurosci"},{"issue":"5","key":"noi230078r24","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1002\/ana.v93.5","article-title":"Rapid eye movement sleep, neurodegeneration, and amyloid deposition in aging.","volume":"93","author":"Andr\u00e9","year":"2023","journal-title":"Ann Neurol"},{"issue":"12","key":"noi230078r25","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1212\/WNL.0000000000004373","article-title":"Sleep architecture and the risk of incident dementia in the community.","volume":"89","author":"Pase","year":"2017","journal-title":"Neurology"},{"issue":"3","key":"noi230078r26","doi-asserted-by":"publisher","first-page":"411","DOI":"10.5665\/sleep.4500","article-title":"Relationships between sleep stages and changes in cognitive function in older men: the MrOS Sleep Study.","volume":"38","author":"Song","year":"2015","journal-title":"Sleep"},{"issue":"1","key":"noi230078r27","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsx179","article-title":"Slow-wave sleep is associated with incident hypertension: the Sleep Heart Health Study.","volume":"41","author":"Javaheri","year":"2018","journal-title":"Sleep"},{"issue":"11","key":"noi230078r28","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1093\/sleep\/32.11.1507","article-title":"Lack of association of the APOE epsilon 4 allele with the risk of obstructive sleep apnea: meta-analysis and meta-regression.","volume":"32","author":"Thakre","year":"2009","journal-title":"Sleep"},{"issue":"1","key":"noi230078r29","doi-asserted-by":"publisher","first-page":"e0191281","DOI":"10.1371\/journal.pone.0191281","article-title":"APOEe4 and slow wave sleep in older adults.","volume":"13","author":"Tranah","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"noi230078r30","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13195-022-00992-y","article-title":"APOE e4, Alzheimer\u2019s disease neuropathology and sleep disturbance, in individuals with and without dementia.","volume":"14","author":"Blackman","year":"2022","journal-title":"Alzheimers Res Ther"},{"issue":"5","key":"noi230078r31","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1016\/j.neuron.2017.11.013","article-title":"ApoE4 accelerates early seeding of amyloid pathology.","volume":"96","author":"Liu","year":"2017","journal-title":"Neuron"},{"issue":"11","key":"noi230078r32","doi-asserted-by":"publisher","DOI":"10.2196\/16273","article-title":"Accuracy of wristband Fitbit models in assessing sleep: systematic review and meta-analysis.","volume":"21","author":"Haghayegh","year":"2019","journal-title":"J Med Internet Res"},{"key":"noi230078r9","author":"Rechtschaffen","year":"1968"},{"key":"noi230078r11","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2000","edition":"4th ed, text re"}],"container-title":["JAMA Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/articlepdf\/2810957\/jamaneurology_himali_2023_oi_230078_1702053725.13395.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T11:26:29Z","timestamp":1702293989000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/fullarticle\/2810957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":32,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaneurol.2023.3889","relation":{},"ISSN":["2168-6149"],"issn-type":[{"value":"2168-6149","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,1]]}}}