‘Nightmare’ Predicts Dementia! “The Lancet” sub-issue: The male correlation is more significant!

▎WuXi AppTec Content Team Editor

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Nightmare is an extremely disturbing, terrifying dream that occurs during sleep. Nightmare is more common in the general population, with approximately 5% of adults having nightmares at least once a week and another 12%-40% having nightmares at least once a month. If other unpleasant dreams (less than nightmares) are counted, the percentage will likely be higher.

It should be pointed out that,Although the biological imagination of nightmares is common in the adult population, so far, the impact of nightmares on human health has been largely still unknown.

Recently, the Lancet subsidiary eClinicalMedicine published a major study that provides us with the latest insights. Research indicates that frequent nightmares (≥1 per week) may be associated with the development of dementia years or even decades later. Specifically, middle-aged people (ages 35-64) who experienced weekly nightmares were as likely to experience cognitive decline over the next 10 years as the average person of the same age< strong>4 times; while weekly nightmares in older adults (≥65 years old) are 2 times as likely for a subsequent diagnosis of dementia. .

Interestingly, the study found that the association between frequent nightmares and dementia risk was significantly stronger in men. Older men with weekly nightmares were 5 times more likely to develop dementia than the average older man; however, older women with weekly nightmares were only at the risk of developing dementia 1.4 times for women. The current large-scale, prospective analysis “is the first to demonstrate that nightmares are associated with the risk of dementia and cognitive decline in healthy adults,” the paper highlights.

Screenshot source: eClinicalMedicine

In recent years, more and more clinical experts have begun to pay attention to the link between nightmares and the clinical prognosis of patients with certain types of diseases, such as Parkinson’s disease. The results of three different important studies in the past suggest that people with Parkinson’s disease with higher frequency of nightmares will have a faster cognitive decline, and the risk of dementia in this group of people will increase significantly over time. high.

This begs the question: Is nightmares also associated with accelerated cognitive decline and risk of dementia in the average adult without Parkinson’s disease?

The current prospective study included the Mid-Life Study in America (MIDUS), Men’s Osteoporotic Fracture Study (MrOS) and the Osteoporotic Fracture Study (SOF) 3 population cohort data to explore whether the higher frequency of nightmares in the middle-aged and older population (without cognitive impairment or Parkinson’s disease) Is associated with faster cognitive decline and whether the risk of dementia increases further over time.

Middle-aged cohort: The middle-aged cohort for the current analysis was derived from the MIDUS study. The MIDUS study, launched in 1995, enrolled more than 7,000 American adult subjects. Screening criteria for participants in the MIDUS study for this analysis included: enrollment from January 2004 to September 2009; middle age (ie, 35 to 64 years); no cognitive impairment at baseline or Parkinson’s Disease. Based on these criteria, a total of 605 adult subjects in the MIDUS study were screened for this analysis.

Older Women’s Cohort: Data from the older women’s cohort for the current analysis were obtained from the SOF study. The SOF study enrolled 10,366 women aged ≥65 years from 4 clinical centers in the United States. This analysis included subjects recruited from January 2002 to April 2004 in the SOF study, and a total of 1475 subjects eligible for analysis were screened.

Older male cohort: Data from the older female cohort for the current analysis were obtained from the MrOS study. The MrOS study enrolled 5994 men ≥65 years old from six clinical centers in the United States. Subjects recruited from December 2003 to March 2005 and from November 2009 to March 2012 in the MrOS study were included in this analysis. A total of 1125 eligible subjects were included in this analysis.

Image source: 123RF

Statistics showed that 605 middle-aged subjects were included in the analysis (mean age 50.3 years; 55.7% female), older subjects There were 2600 subjects (mean age 82.9 years; 56.7% female). About 6% of subjects in both middle-aged and elderly cohortshad nightmares ≥1 time per week (middle-aged cohort: 6.0%; elderly cohort : 6.9%).

It is interesting to note that,middle-aged women are more likely to have frequent nightmares than middle-aged men; in contrast, older men are more likely to have nightmares than older women Frequent nightmares. Compared with people who reported no nightmares in the past month at baseline, people with nightmares were not only more likely to have depression, anxiety, and sleep problems, but also generally had worse self-assessed health.

Analysis data showed that in the middle-aged cohort, a total of 90 subjects (14.9%) met the criteria for cognitive decline during the 13-year follow-up. The results of the model analysis after full adjustment for related factors showed that more frequent nightmares were linearly and statistically significantly associated with the risk of cognitive decline (P for trend = 0.016). Subjects who had nightmares ≥1 per week had a 4-fold higher risk of cognitive decline compared with those who reported no nightmares in the past month at baseline (aOR = 3.99; 95% CI: 1.07-14.85; P=0.039).

In the elderly cohort, a total of 235 (9.0%) subjects were diagnosed with dementia during the 7-year follow-up period. The results of the model analysis after fully adjusting for relevant factors showed a linear and statistically significant association between more frequent nightmares and the risk of dementia (P value for trend analysis

The risk of dementia was 2.2 times higher in subjects with ≥1 nightmare per week compared with those who reported no nightmares in the past month at baseline (aOR = 2.21; 95%CI: 1.35-3.62; P=0.002).

Additionally, further analyses stratified by sex showed that the association between nightmare frequency and cognitive decline and risk of developing dementia was more statistically significant in men significant meaning. For example, older men with weekly nightmares were 5 times more likely to develop dementia than the average older man (aOR = 4.67; 95%CI: 2.16-10.11; P p>

1.4-fold (aOR = 1.41; 95%CI: 0.70-2.83; P=0.158).

Overall, the results of this current analysis suggest that frequent nightmares may be useful in predicting cognitive decline and all-cause dementia in middle-aged and older adults. The results of the current study are extremely significant, considering that there are currently very few indicators that can effectively identify the risk of dementia in the middle-aged population. In the future, we may be able to effectively screen people at high risk of dementia through the physiological phenomenon of nightmares, and develop reasonable strategies to slow the eventual onset of the disease.