Sleep disturbances and the speed of multimorbidity development in old age: results from a longitudinal population-based
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RESEARCH ARTICLE
Open Access
Sleep disturbances and the speed of multimorbidity development in old age: results from a longitudinal populationbased study Shireen Sindi1,2*†, Laura Monica Pérez3,4†, Davide L. Vetrano3,5, Federico Triolo3, Ingemar Kåreholt3,6, Linnea Sjöberg3, Alexander Darin-Mattsson3, Miia Kivipelto1,2,7,8,9, Marco Inzitari4,10† and Amaia Calderón-Larrañaga3†
Abstract Background: Sleep disturbances are prevalent among older adults and are associated with various individual diseases. The aim of this study was to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults. Methods: Data were gathered from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study of subjects aged 60+ (N = 3363). The study included a subsample (n = 1189) without multimorbidity at baseline (< 2 chronic diseases). Baseline sleep disturbances were derived from the Comprehensive Psychiatric Rating Scale and categorized as none, mild, and moderate–severe. The number of chronic conditions throughout the 9-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic disease accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. We repeated the analyses including only cardiovascular, neuropsychiatric, or musculoskeletal diseases as the outcome. Results: Moderate–severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year = 0.142, p = 0.008), regardless of potential confounders. Significant positive associations were also found between moderate–severe sleep disturbances and neuropsychiatric (ß/year = 0.041, p = 0.016) and musculoskeletal (ß/year = 0.038, p = 0.025) disease accumulation, but not with cardiovascular diseases. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded. (Continued on next page)
* Correspondence: [email protected] † Shireen Sindi and Laura M Pérez contributed equally as first authors. † Marco Inzitari and Amaia Calderón-Larrañaga contributed equally as last authors. 1 Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden 2 Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Cr
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