{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:19:57Z","timestamp":1788445197187,"version":"build-2803163510"},"reference-count":66,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004472","name":"Riksbankens Jubileumsfond","doi-asserted-by":"publisher","award":["P21-0173"],"award-info":[{"award-number":["P21-0173"]}],"id":[{"id":"10.13039\/501100004472","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2020-02325"],"award-info":[{"award-number":["2020-02325"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010663","name":"H2020 European Research Council","doi-asserted-by":"publisher","award":["804371"],"award-info":[{"award-number":["804371"]}],"id":[{"id":"10.13039\/100010663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018713","name":"Center for Innovative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Rut & Arvid Wolff Memorial Foundation"},{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Several modifiable factors affect Alzheimer\u2019s disease (AD) risk. However, evidence on how these factors interact remains scarce, limiting our understanding of their role in AD development. This study aims to assess interactions between chronic stress exposure and insomnia in relation to AD biomarkers beta-amyloid (A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      ), total tau, and phosphorylated tau.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present study included 124 memory clinic patients without dementia from the Cortisol and Stress in Alzheimer\u2019s disease (Co-STAR) cohort study. Insomnia symptoms, stressful life events (SLEs) and current perceived stress were self-reported via questionnaires, while AD biomarkers were assessed from the cerebrospinal fluid (CSF). Cross-sectional interactions between stress and insomnia in relation to AD biomarkers were examined using linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Insomnia and SLEs interacted in relation to A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      . Greater stressor exposure was associated with reduced CSF A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      levels, reflecting greater brain amyloid accumulation, only in those with moderate-to-high insomnia scores. No interactions were found for total or phosphorylated tau.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that chronic stress and sleep disturbances exhibit an interactive relationship in their associations with AD pathology, and highlights the need for further research into interactive effects of multiple modifiable risk factors in the development of AD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-14102-7","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:57:17Z","timestamp":1788440237000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Insomnia symptoms and stress exposure interact in relation to Alzheimer\u2019s disease biomarkers"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3132-4847","authenticated-orcid":false,"given":"Jasper","family":"Holleman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingemar","family":"K\u00e5reholt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manasa Shanta","family":"N\u00e4sholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran","family":"Hagman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Asp\u00f6","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miia","family":"Kivipelto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Sindi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"14102_CR1","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.psyneuen.2016.02.021","volume":"68","author":"JG Abell","year":"2016","unstructured":"Abell JG, Shipley MJ, Ferrie JE, Kivim\u00e4ki M, Kumari M (2016) Recurrent short sleep, chronic insomnia symptoms and salivary cortisol: a 10-year follow-up in the Whitehall II study. Psychoneuroendocrinology 68:91\u201399","journal-title":"Psychoneuroendocrinology"},{"key":"14102_CR2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.psyneuen.2017.05.018","volume":"83","author":"EK Adam","year":"2017","unstructured":"Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE (2017) Diurnal cortisol slopes and mental and physical health outcomes: a systematic review and meta-analysis. Psychoneuroendocrinology 83:25\u201341","journal-title":"Psychoneuroendocrinology"},{"key":"14102_CR3","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jpsychires.2016.02.021","volume":"77","author":"KMd Almondes","year":"2016","unstructured":"Almondes KMd, Costa MV, Malloy-Diniz LF, Diniz BS (2016) Insomnia and risk of dementia in older adults: systematic review and meta-analysis. J Psychiatr Res 77:109\u2013115","journal-title":"J Psychiatr Res"},{"key":"14102_CR4","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1177\/00221465211055993","volume":"63","author":"LR Anderson","year":"2022","unstructured":"Anderson LR, Monden CWS, Bukodi E (2022) Stressful life events, differential vulnerability, and depressive symptoms: critique and new evidence. J Health Soc Behav 63:283\u2013300","journal-title":"J Health Soc Behav"},{"key":"14102_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2023.111899","volume":"217","author":"K Astara","year":"2024","unstructured":"Astara K, Tsimpolis A, Kalafatakis K, Vavougios GD, Xiromerisiou G, Dardiotis E, Christodoulou NG, Samara MT, Lappas AS (2024) Sleep disorders and Alzheimer\u2019s disease pathophysiology: the role of the Glymphatic System. A scoping review. Mech Ageing Dev 217:111899","journal-title":"Mech Ageing Dev"},{"key":"14102_CR6","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s13041-024-01118-1","volume":"17","author":"A Azargoonjahromi","year":"2024","unstructured":"Azargoonjahromi A (2024) The duality of amyloid-\u03b2: its role in normal and Alzheimer\u2019s disease states. Mol Brain 17:44","journal-title":"Mol Brain"},{"key":"14102_CR7","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1038\/nn.4112","volume":"18","author":"TL Bale","year":"2015","unstructured":"Bale TL, Epperson CN (2015) Sex differences and stress across the lifespan. Nat Neurosci 18:1413","journal-title":"Nat Neurosci"},{"key":"14102_CR8","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.neubiorev.2017.01.032","volume":"75","author":"YP Bao","year":"2017","unstructured":"Bao YP, Han Y, Ma J, Wang RJ, Shi L, Wang TY, He J, Yue JL, Shi J, Tang XD, Lu L (2017) Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: meta-analysis and systematic review. Neurosci Biobehav Rev 75:257\u2013273","journal-title":"Neurosci Biobehav Rev"},{"key":"14102_CR9","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s41782-026-00342-0","volume":"10","author":"M Bhatia","year":"2026","unstructured":"Bhatia M, Allers E, Bernardo D, Chinvarun Y, Das S, Lee H-C, Lim S-C, Malik K, Ng CG (2026) Unmet needs in the management of insomnia in older adults and the role of lemborexant: a real-world perspective. Sleep Vigil 10:81\u201397","journal-title":"Sleep Vigil"},{"key":"14102_CR10","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/S0361-9230(03)00086-8","volume":"61","author":"K Blennow","year":"2003","unstructured":"Blennow K, Vanmechelen E (2003) CSF markers for pathogenic processes in Alzheimer\u2019s disease: diagnostic implications and use in clinical neurochemistry. Brain Res Bull 61:235\u2013242","journal-title":"Brain Res Bull"},{"key":"14102_CR11","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1111\/joim.12816","volume":"284","author":"K Blennow","year":"2018","unstructured":"Blennow K, Zetterberg H (2018) Biomarkers for Alzheimer\u2019s disease: current status and prospects for the future. J Intern Med 284:643\u2013663","journal-title":"J Intern Med"},{"key":"14102_CR12","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.tins.2024.08.015","volume":"47","author":"MR Burke","year":"2024","unstructured":"Burke MR, Sotiropoulos I, Waites CL (2024) The multiple roles of chronic stress and glucocorticoids in Alzheimer\u2019s disease pathogenesis. Trends Neurosci 47:933\u2013948","journal-title":"Trends Neurosci"},{"key":"14102_CR13","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19148457","author":"M Casagrande","year":"2022","unstructured":"Casagrande M, Forte G, Favieri F, Corbo I (2022) Sleep quality and aging: a systematic review on healthy older people, mild cognitive impairment and Alzheimer\u2019s disease. Int J Environ Res Public Health. https:\/\/doi.org\/10.3390\/ijerph19148457","journal-title":"Int J Environ Res Public Health"},{"key":"14102_CR14","doi-asserted-by":"publisher","DOI":"10.1002\/alz.71342","volume":"22","author":"C Cavaill\u00e8s","year":"2026","unstructured":"Cavaill\u00e8s C, Carnethon MR, Knutson KL, Thomas SJ, Yaffe K (2026) Midlife sleep characteristics and Alzheimer\u2019s disease biomarkers 20 years later. Alzheimers Dement 22:e71342","journal-title":"Alzheimers Dement"},{"key":"14102_CR15","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70096","volume":"21","author":"CL Chen","year":"2025","unstructured":"Chen CL, Zhang MY, Wang ZL, Deng JH, Bao YP, Shi J, Lu L, Shi L (2025) Associations among sleep quality, sleep duration, and Alzheimer\u2019s disease biomarkers: a systematic review and meta-analysis. Alzheimers Dement 21:e70096","journal-title":"Alzheimers Dement"},{"key":"14102_CR16","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3233\/JAD-170032","volume":"61","author":"D-W Chen","year":"2018","unstructured":"Chen D-W, Wang J, Zhang L-L, Wang Y-J, Gao C-Y (2018) Cerebrospinal fluid amyloid-\u03b2 levels are increased in patients with insomnia. J Alzheimers Dis 61:645\u2013651","journal-title":"J Alzheimers Dis"},{"key":"14102_CR17","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3233\/JAD-170032","volume":"61","author":"D-W Chen","year":"2017","unstructured":"Chen D-W, Wang J, Zhang L-L, Wang Y-J, Gao C-Y (2017) Cerebrospinal fluid amyloid-\u03b2 levels are increased in patients with insomnia. J Alzheimers Dis 61:645\u2013651","journal-title":"J Alzheimers Dis"},{"key":"14102_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2022.101650","volume":"64","author":"DS Christensen","year":"2022","unstructured":"Christensen DS, Zachariae R, Amidi A, Wu LM (2022) Sleep and allostatic load: a systematic review and meta-analysis. Sleep Med Rev 64:101650","journal-title":"Sleep Med Rev"},{"key":"14102_CR19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241188","volume":"16","author":"K Deater-Deckard","year":"2021","unstructured":"Deater-Deckard K, Chary M, McQuillan ME, Staples AD, Bates JE (2021) Mothers\u2019 sleep deficits and cognitive performance: moderation by stress and age. PLoS ONE 16:e0241188","journal-title":"PLoS ONE"},{"key":"14102_CR20","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.yfrne.2018.03.001","volume":"49","author":"ES Epel","year":"2018","unstructured":"Epel ES, Crosswell AD, Mayer SE, Prather AA, Slavich GM, Puterman E, Mendes WB (2018) More than a feeling: a unified view of stress measurement for population science. Front Neuroendocrinol 49:146\u2013169","journal-title":"Front Neuroendocrinol"},{"key":"14102_CR21","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1007\/s00702-019-01988-z","volume":"126","author":"CM Escher","year":"2019","unstructured":"Escher CM, Sannemann L, Jessen F (2019) Stress and Alzheimer\u2019s disease. J Neural Transm (Vienna) 126:1155\u20131161","journal-title":"J Neural Transm (Vienna)"},{"key":"14102_CR22","first-page":"177","volume":"17","author":"A Gaur","year":"2022","unstructured":"Gaur A, Kaliappan A, Balan Y, Sakthivadivel V, Medala K, Umesh M (2022) Sleep and Alzheimer: the link Maedica (Bucur) 17:177\u2013185","journal-title":"Sleep and Alzheimer: the link Maedica (Bucur)"},{"key":"14102_CR23","doi-asserted-by":"publisher","first-page":"9047","DOI":"10.1523\/JNEUROSCI.2797-06.2006","volume":"26","author":"KN Green","year":"2006","unstructured":"Green KN, Billings LM, Roozendaal B, McGaugh JL, LaFerla FM (2006) Glucocorticoids increase amyloid-\u03b2 and tau pathology in a mouse model of Alzheimer\u2019s disease. J Neurosci 26:9047","journal-title":"J Neurosci"},{"key":"14102_CR24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2022-000344","volume":"4","author":"J Holleman","year":"2022","unstructured":"Holleman J, Adagunodo S, K\u00e5reholt I, Hagman G, Asp\u00f6 M, Udeh-Momoh CT, Solomon A, Kivipelto M, Sindi S (2022) Cortisol, cognition and Alzheimer\u2019s disease biomarkers among memory clinic patients. BMJ Neurol Open 4:e000344","journal-title":"BMJ Neurol Open"},{"key":"14102_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2023.105316","volume":"119","author":"J Holleman","year":"2024","unstructured":"Holleman J, K\u00e5reholt I, Asp\u00f6 M, Hagman G, Udeh-Momoh CT, Kivipelto M, Solomon A, Sindi S (2024) Life-course stress, cognition, and diurnal cortisol in memory clinic patients without dementia. Arch Gerontol Geriatr 119:105316","journal-title":"Arch Gerontol Geriatr"},{"key":"14102_CR26","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1080\/13607863.2021.1875190","volume":"26","author":"Y Inoue","year":"2022","unstructured":"Inoue Y, Stickley A, Yazawa A, Aida J, Koyanagi A, Kondo N (2022) Childhood adversities, late-life stressors and the onset of depressive symptoms in community-dwelling older adults. Aging Ment Health 26:828\u2013833","journal-title":"Aging Ment Health"},{"key":"14102_CR27","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.jalz.2018.02.018","volume":"14","author":"CR Jack Jr.","year":"2018","unstructured":"Jack CR Jr., Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, Holtzman DM, Jagust W, Jessen F, Karlawish J, Liu E, Molinuevo JL, Montine T, Phelps C, Rankin KP, Rowe RA, Scheltens P, Siemers E, Snyder HM, Rowe CC, Sperling R, Elliott C, Masliah E, Ryan L, Silverberg N, Contributors (2018) NIA-AA research framework: toward a biological definition of Alzheimer\u2019s disease. Alzheimers Dement 14:535\u2013562","journal-title":"Alzheimers Dement"},{"key":"14102_CR28","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.jalz.2014.01.001","volume":"10","author":"F Jessen","year":"2014","unstructured":"Jessen F, Amariglio RE, van Boxtel M, Breteler M, Ceccaldi M, Ch\u00e9telat G, Dubois B, Dufouil C, Ellis KA, van der Flier WM, Glodzik L, van Harten AC, de Leon MJ, McHugh P, Mielke MM, Molinuevo JL, Mosconi L, Osorio RS, Perrotin A, Petersen RC, Rabin LA, Rami L, Reisberg B, Rentz DM, Sachdev PS, de la Sayette V, Saykin AJ, Scheltens P, Shulman MB, Slavin MJ, Sperling RA, Stewart R, Uspenskaya O, Vellas B, Visser PJ, Wagner M, Subjective Cognitive Decline Initiative Working G (2014) A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer\u2019s disease. Alzheimers Dement 10:844\u2013852","journal-title":"Alzheimers Dement"},{"key":"14102_CR29","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.neubiorev.2009.10.002","volume":"35","author":"RP Juster","year":"2010","unstructured":"Juster RP, McEwen BS, Lupien SJ (2010) Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev 35:2\u201316","journal-title":"Neurosci Biobehav Rev"},{"key":"14102_CR30","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1159\/000492177","volume":"65","author":"A Koyanagi","year":"2019","unstructured":"Koyanagi A, Oh H, Vancampfort D, Carvalho AF, Veronese N, Stubbs B, Lara E (2019) Perceived stress and mild cognitive impairment among 32,715 community-dwelling older adults across six low- and middle-income countries. Gerontology 65:155\u2013163","journal-title":"Gerontology"},{"key":"14102_CR31","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1002\/nur.22278","volume":"46","author":"WC Kuo","year":"2023","unstructured":"Kuo WC, Ersig AL, Kunkul F, Brown RL, Oakley LD (2023) Linking chronic stress to insomnia symptoms in older adults: the role of stress co-occurrence during the pandemic. Res Nurs Health 46:68\u201379","journal-title":"Res Nurs Health"},{"key":"14102_CR32","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1038\/s41582-020-00435-y","volume":"17","author":"F Leng","year":"2021","unstructured":"Leng F, Edison P (2021) Neuroinflammation and microglial activation in Alzheimer disease: where do we go from here? Nat Rev Neurol 17:157\u2013172","journal-title":"Nat Rev Neurol"},{"key":"14102_CR33","doi-asserted-by":"publisher","first-page":"759","DOI":"10.3233\/JAD-191317","volume":"74","author":"P Liu","year":"2020","unstructured":"Liu P, Zhao B, Wei M, Li Y, Liu J, Ma L, Shang S, Huo K, Wang J, Li R, Qu Q (2020) Activation of inflammation is associated with amyloid-\u03b2 accumulation induced by chronic sleep restriction in rats. J Alzheimers Dis 74:759\u2013773","journal-title":"J Alzheimers Dis"},{"key":"14102_CR34","doi-asserted-by":"publisher","first-page":"glag081","DOI":"10.1093\/gerona\/glag081","volume":"81","author":"S Liu","year":"2026","unstructured":"Liu S, Huang J, Calderon R, Spira AP, McPhillips MV, Gooneratne N, Gill J, Li J (2026) Sleep architecture and self-reported sleep quality are associated with Alzheimer\u2019s disease biomarkers in older adults without dementia. J Gerontol A Biol Sci Med Sci 81:glag081","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"14102_CR35","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","volume":"404","author":"G Livingston","year":"2024","unstructured":"Livingston G, Huntley J, Liu KY, Costafreda SG, Selb\u00e6k G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivim\u00e4ki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N (2024) Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 404:572\u2013628","journal-title":"Lancet"},{"key":"14102_CR36","first-page":"14","volume":"35","author":"MM Mielke","year":"2018","unstructured":"Mielke MM (2018) Sex and gender differences in Alzheimer\u2019s disease dementia. Psychiatr Times 35:14\u201317","journal-title":"Psychiatr Times"},{"key":"14102_CR37","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s11920-017-0835-1","volume":"19","author":"BS Mohlenhoff","year":"2017","unstructured":"Mohlenhoff BS, O\u2019Donovan A, Weiner MW, Neylan TC (2017) Dementia risk in posttraumatic stress disorder: the relevance of sleep-related abnormalities in brain structure, amyloid, and inflammation. Curr Psychiatry Rep 19:89","journal-title":"Curr Psychiatry Rep"},{"key":"14102_CR38","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-56071-9","volume":"14","author":"L Mosconi","year":"2024","unstructured":"Mosconi L, Williams S, Carlton C, Zarate C, Boneu C, Fauci F, Ajila T, Nerattini M, Jett S, Andy C, Battista M, Pahlajani S, Osborne J, Brinton RD, Dyke JP (2024) Sex-specific associations of serum cortisol with brain biomarkers of Alzheimer\u2019s risk. Sci Rep 14:5519","journal-title":"Sci Rep"},{"key":"14102_CR39","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.3233\/JAD-220924","volume":"91","author":"J Nicolazzo","year":"2023","unstructured":"Nicolazzo J, Cavuoto M, Rowsthorn E, Cribb L, Bransby L, Gibson M, Wall P, Velakoulis D, Eratne D, Buckley R, Yassi N, Yiallourou S, Brodtmann A, Hamilton GS, Naughton MT, Lim YY, Pase MP (2023) Insomnia symptoms and biomarkers of Alzheimer\u2019s disease in the community. J Alzheimers Dis 91:1423\u20131434","journal-title":"J Alzheimers Dis"},{"key":"14102_CR40","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1111\/sjop.12071","volume":"54","author":"M Nordin","year":"2013","unstructured":"Nordin M, Nordin S (2013) Psychometric evaluation and normative data of the Swedish version of the 10-item perceived stress scale. Scand J Psychol 54:502\u2013507","journal-title":"Scand J Psychol"},{"key":"14102_CR41","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1111\/sbr.12024","volume":"11","author":"M Nordin","year":"2013","unstructured":"Nordin M, \u00c5kerstedt T, Nordin S (2013) Psychometric evaluation and normative data for the Karolinska Sleep Questionnaire. Sleep Biol Rhythms 11:216\u2013226","journal-title":"Sleep Biol Rhythms"},{"key":"14102_CR42","first-page":"206","volume":"30","author":"PA Osterrieth","year":"1944","unstructured":"Osterrieth PA (1944) Le test de copie d\u2019une figure complexe; contribution a l\u2019etude de la perrception et de la memoire. [Test of copying a complex figure; contribution to the study of perception and memory.]. Archives de Psychologie 30:206\u2013356","journal-title":"Archives de Psychologie"},{"key":"14102_CR43","doi-asserted-by":"publisher","first-page":"892754","DOI":"10.3389\/fnagi.2022.892754","volume":"14","author":"S Ouanes","year":"2022","unstructured":"Ouanes S, Clark C, Richiardi J, Mar\u00e9chal B, Lewczuk P, Kornhuber J, Kirschbaum C, Popp J (2022) Cerebrospinal Fluid cortisol and Dehydroepiandrosterone Sulfate, Alzheimer\u2019s disease pathology, and cognitive decline. Front Aging Neurosci 14:892754","journal-title":"Front Aging Neurosci"},{"key":"14102_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60030474","author":"E Paj\u0117dien\u0117","year":"2024","unstructured":"Paj\u0117dien\u0117 E, Urbonavi\u010di\u016bt\u0117 V, Ramanauskait\u0117 V, Strazdauskas L, Stefani A (2024) Sex differences in insomnia and circadian rhythm disorders: a systematic review. Medicina (Kaunas). https:\/\/doi.org\/10.3390\/medicina60030474","journal-title":"Medicina (Kaunas)"},{"key":"14102_CR45","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1002\/ana.26881","volume":"95","author":"E Palpatzis","year":"2024","unstructured":"Palpatzis E, Akinci M, Aguilar-Dominguez P, Garcia-Prat M, Blennow K, Zetterberg H, Carboni M, Kollmorgen G, Wild N, Fauria K, Falcon C, Gispert JD, Su\u00e1rez-Calvet M, Grau-Rivera O, S\u00e1nchez-Benavides G, Arenaza-Urquijo EM, for the As, (2024) Lifetime Stressful Events Associated with Alzheimer\u2019s Pathologies, Neuroinflammation and Brain Structure in a Risk Enriched Cohort. Ann Neurol 95:1058\u20131068","journal-title":"Ann Neurol"},{"key":"14102_CR46","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.5664\/jcsm.7172","volume":"14","author":"D Patel","year":"2018","unstructured":"Patel D, Steinberg J, Patel P (2018) Insomnia in the elderly: a review. J Clin Sleep Med 14:1017\u20131024","journal-title":"J Clin Sleep Med"},{"key":"14102_CR47","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1037\/hea0000629","volume":"37","author":"JR Piazza","year":"2018","unstructured":"Piazza JR, Dmitrieva NO, Charles ST, Almeida DM, Orona GA (2018) Diurnal cortisol profiles, inflammation, and functional limitations in aging: findings from the MIDUS study. Health Psychol 37:839\u2013849","journal-title":"Health Psychol"},{"key":"14102_CR48","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1093\/sleep\/30.8.955","volume":"30","author":"D Riemann","year":"2007","unstructured":"Riemann D, Voderholzer U, Spiegelhalder K, Hornyak M, Buysse DJ, Nissen C, Hennig J, Perlis ML, van Elst LT, Feige B (2007) Chronic insomnia and MRI-measured hippocampal volumes: a pilot study. Sleep 30:955\u2013958","journal-title":"Sleep"},{"key":"14102_CR49","doi-asserted-by":"publisher","first-page":"e2102","DOI":"10.1212\/WNL.0000000000201043","volume":"99","author":"A Rosenberg","year":"2022","unstructured":"Rosenberg A, \u00d6hlund-Wistbacka U, Hall A, Bonnard A, Hagman G, Ryd\u00e9n M, Thunborg C, Wiggenraad F, Sandebring-Matton A, Solomon A, Kivipelto M (2022) \u03b2-Amyloid, tau, neurodegeneration classification and eligibility for anti-amyloid treatment in a memory clinic population. Neurology 99:e2102\u2013e2113","journal-title":"Neurology"},{"key":"14102_CR50","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1186\/s12974-020-01960-9","volume":"17","author":"S Sadeghmousavi","year":"2020","unstructured":"Sadeghmousavi S, Eskian M, Rahmani F, Rezaei N (2020) The effect of insomnia on development of Alzheimer\u2019s disease. J Neuroinflammation 17:289","journal-title":"J Neuroinflammation"},{"key":"14102_CR51","doi-asserted-by":"publisher","first-page":"e70179","DOI":"10.1002\/alz.70179","volume":"21","author":"A Salardini","year":"2025","unstructured":"Salardini A, Himali JJ, Abdullah MS, Chaudhari R, Young V, Zilli EM, McGrath ER, Gonzales MM, Thibault EG, Salinas J, Aparicio HJ, Himali D, Ghosh S, Buckley RF, Satizabal CL, Johnson KA, DeCarli C, Fakhri GE, Vasan RS, Seshadri S (2025) Elevated serum cortisol associated with early-detected increase of brain amyloid deposition in Alzheimer\u2019s disease imaging biomarkers among menopausal women: the Framingham heart study. Alzheimers Dement 21:e70179","journal-title":"Alzheimers Dement"},{"key":"14102_CR52","volume-title":"Rey auditory verbal learning test: a handbook","author":"M Schmidt","year":"1996","unstructured":"Schmidt M (1996) Rey auditory verbal learning test: a handbook. Western Psychological Services, Los Angeles"},{"key":"14102_CR53","doi-asserted-by":"publisher","first-page":"383","DOI":"10.31887\/DCNS.2006.8.4\/ssmith","volume":"8","author":"SM Smith","year":"2006","unstructured":"Smith SM, Vale WW (2006) The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues Clin Neurosci 8:383\u2013395","journal-title":"Dialogues Clin Neurosci"},{"key":"14102_CR54","doi-asserted-by":"publisher","first-page":"7840","DOI":"10.1523\/JNEUROSCI.0730-11.2011","volume":"31","author":"I Sotiropoulos","year":"2011","unstructured":"Sotiropoulos I, Catania C, Pinto LG, Silva R, Pollerberg GE, Takashima A, Sousa N, Almeida OF (2011) Stress acts cumulatively to precipitate Alzheimer\u2019s disease-like tau pathology and cognitive deficits. J Neurosci 31:7840\u20137847","journal-title":"J Neurosci"},{"key":"14102_CR55","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.sleep.2018.03.011","volume":"52","author":"Y Sun","year":"2018","unstructured":"Sun Y, Shi L, Bao Y, Shi J, Lu L (2018) The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: evidence from a longitudinal study. Sleep Med 52:221\u2013229","journal-title":"Sleep Med"},{"key":"14102_CR56","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1111\/nan.12203","volume":"41","author":"A Ugarte","year":"2015","unstructured":"Ugarte A, Gil\u2010Bea F, Garc\u00eda\u2010Barroso C, Cedazo\u2010Minguez \u00c1, Ram\u00edrez MJ, Franco R, Garc\u00eda\u2010Osta A, Oyarzabal J, Cuadrado\u2010Tejedor M (2015) Decreased levels of guanosine 3\u2032, 5\u2032\u2010monophosphate (cGMP) in cerebrospinal fluid (CSF) are associated with cognitive decline and amyloid pathology in Alzheimer\u2019s disease. Neuropathol Appl Neurobiol 41:471\u2013482","journal-title":"Neuropathol Appl Neurobiol"},{"key":"14102_CR57","doi-asserted-by":"publisher","first-page":"119","DOI":"10.5582\/bst.2022.01042","volume":"16","author":"C Wang","year":"2022","unstructured":"Wang C, Song P, Niu Y (2022) The management of dementia worldwide: a review on policy practices, clinical guidelines, end-of-life care, and challenge along with aging population. Biosci Trends 16:119\u2013129","journal-title":"Biosci Trends"},{"key":"14102_CR58","volume-title":"Wechsler adult intelligence scale - fourth edition (WAIS-IV)","author":"D Wechsler","year":"2008","unstructured":"Wechsler D (2008) Wechsler adult intelligence scale - fourth edition (WAIS-IV). Pearson, San Antonio, TX"},{"key":"14102_CR59","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1111\/j.1365-2796.2004.01380.x","volume":"256","author":"B Winblad","year":"2004","unstructured":"Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Petersen RC (2004) Mild cognitive impairment\u2013beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 256:240\u2013246","journal-title":"J Intern Med"},{"key":"14102_CR60","unstructured":"World Health Organization (1992) International statistical classification of disease and related health problems - Tenth Revision. In, Geneva"},{"key":"14102_CR61","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.ynstr.2018.03.002","volume":"8","author":"Y Yan","year":"2018","unstructured":"Yan Y, Dominguez S, Fisher DW, Dong H (2018) Sex differences in chronic stress responses and Alzheimer\u2019s disease. Neurobiol Stress 8:120\u2013126","journal-title":"Neurobiol Stress"},{"key":"14102_CR62","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ynstr.2018.02.004","volume":"8","author":"CM Yuede","year":"2018","unstructured":"Yuede CM, Timson BF, Hettinger JC, Yuede KM, Edwards HM, Lawson JE, Zimmerman SD, Cirrito JR (2018) Interactions between stress and physical activity on Alzheimer\u2019s disease pathology. Neurobiol Stress 8:158\u2013171","journal-title":"Neurobiol Stress"},{"key":"14102_CR63","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.3233\/JAD-220664","volume":"89","author":"I Zawar","year":"2022","unstructured":"Zawar I, Mattos MK, Manning C, Quigg M (2022) Sleep disturbances, cognitive status, and biomarkers of dementia. J Alzheimers Dis 89:1367\u20131374","journal-title":"J Alzheimers Dis"},{"key":"14102_CR64","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1038\/s41392-024-01911-3","volume":"9","author":"J Zhang","year":"2024","unstructured":"Zhang J, Zhang Y, Wang J, Xia Y, Chen L (2024) Recent advances in Alzheimer\u2019s disease: mechanisms, clinical trials and new drug development strategies. Signal Transduct Target Ther 9:211","journal-title":"Signal Transduct Target Ther"},{"key":"14102_CR65","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2020.101171","volume":"64","author":"B Zheng","year":"2020","unstructured":"Zheng B, Tal R, Yang Z, Middleton L, Udeh-Momoh C (2020) Cortisol hypersecretion and the risk of Alzheimer\u2019s disease: a systematic review and meta-analysis. Ageing Res Rev 64:101171","journal-title":"Ageing Res Rev"},{"key":"14102_CR66","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2023.105067","volume":"146","author":"L Zhou","year":"2023","unstructured":"Zhou L, Kong J, Li X, Ren Q (2023) Sex differences in the effects of sleep disorders on cognitive dysfunction. Neurosci Biobehav Rev 146:105067","journal-title":"Neurosci Biobehav Rev"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-026-14102-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-026-14102-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-026-14102-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:03:29Z","timestamp":1788444209000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-026-14102-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":66,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["14102"],"URL":"https:\/\/doi.org\/10.1007\/s00415-026-14102-7","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"assertion":[{"value":"5 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All Co-STAR participants provided written informed consent to participate in the study before taking part. This study involves human participants, was approved by Regional Ethical Review Board (Stockholm) 2014\/524-31\/1, and was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval and consent","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"560"}}