{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:11:51Z","timestamp":1792735911432,"version":"4.5.0"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Among older adults, chronic insomnia is a risk factor for cognitive decline. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the initial treatment. We conducted a retrospective cohort study of 84,739 Veterans, using national Veterans Health Administration data, to evaluate the association between CBT-I completion and incident cognitive impairment among older Veterans. Veterans were classified as administration of\n                    <jats:italic toggle=\"yes\">Any CBT-I<\/jats:italic>\n                    versus\n                    <jats:italic toggle=\"yes\">Referral only<\/jats:italic>\n                    using electronic documented notes. Incident cognitive impairment was defined by dementia-related diagnosis codes or an associated medication prescription. Among Veterans not using sedative-hypnotics, there was a decreased incidence of cognitive impairment for Veterans completing\n                    <jats:italic toggle=\"yes\">Any CBT-I<\/jats:italic>\n                    compared to\n                    <jats:italic toggle=\"yes\">Referral only<\/jats:italic>\n                    , RR= 0.87 (95% CI: 0.80\u20130.98). Yet, for Veterans taking sedative-hypnotic medications, there was an increased incidence of cognitive impairment between groups, RR= 1.18 (95% CI: 1.07\u20131.30). CBT-I may offer a protective effect from incident cognitive impairment; however, the presence of sedative-hypnotics reverses this trend.\n                  <\/jats:p>","DOI":"10.1177\/07334648251330666","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T10:35:51Z","timestamp":1743676551000},"page":"156-165","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Cognitive Behavioral Therapy for Insomnia and Incident Cognitive Impairment Among Older Veterans"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1404-5599","authenticated-orcid":false,"given":"Hana","family":"Kusumoto","sequence":"first","affiliation":[{"name":"University of Colorado Anschutz Medical Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Khakharia","sequence":"additional","affiliation":[{"name":"Atlanta VA Healthcare System"},{"name":"Emory University School of Medicine"},{"name":"Department of Veterans Affairs Birmingham\/Atlanta Geriatric Research, Education, and Clinical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam D.","family":"Bramoweth","sequence":"additional","affiliation":[{"name":"VA Pittsburgh Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Phillips","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance H.","family":"Fung","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA"},{"name":"VA Greater Los Angeles Healthcare System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Eisenstein","sequence":"additional","affiliation":[{"name":"Atlanta VA Healthcare System"},{"name":"Emory University School of 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