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  • 1. Tan, Xiao
    et al.
    Lebedeva, Aleksandra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Stockholm, Sweden.
    Wang, Hui-Xin
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Sleep Mediates the Association Between Stress at Work and Incident Dementia: Study From the Survey of Health, Ageing and Retirement in Europe2023In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 78, no 3, p. 447-453Article in journal (Refereed)
    Abstract [en]

    Background: Both psychosocial stress at work and sleep disturbance may predispose impaired cognitive function and dementia in later life. However, whether sleep plays a mediating role for the link between stress at work and subsequent dementia has yet to be investigated.

    Methods: Data from the Survey of Health, Ageing and Retirement in Europe were used for the study. A cohort of 7 799 dementia-free individuals (aged 71.1 ± 0.2 years) were followed up for a median of 4.1 years for incident dementia. Job demand and control were estimated using questions derived from the Karasek’s Job Content Questionnaire. Sleep disturbance was ascertained by a question in the EURO-Depression scale. Cox proportional hazard models adjusted for age, sex, education, cognitive test score, and other potential covariates were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of dementia in relation to different job strain levels.

    Results: An interaction between job demand and sleep disturbance regarding the risk of dementia was detected. Data suggested a protective role of high-level job demand for dementia in individuals with sleep disturbance (HR [95% CI]: 0.69 [0.47, 1.00]) compared with low job demand. A 4-category job strain model based on the combination of job demand and job control levels suggested that among individuals with sleep disturbance, passive job (low demand, low control) was associated with a higher risk of dementia (1.54 [1.01, 2.34]), compared to active job (high demand, high control).

    Conclusion: The link between work-related stress and risk of dementia is limited to individuals suffering sleep disturbance.

  • 2. Tan, Xiao
    et al.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Sweden.
    Lagerros, Ylva Trolle
    Åkerstedt, Anna Miley
    Bellocco, Rino
    Adami, Hans-Olov
    Ye, Weimin
    Pei, Jin-Jing
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Wang, Hui-Xin
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Interactive association between insomnia symptoms and sleep duration for the risk of dementia: a prospective study in the Swedish National March Cohort2023In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 52, no 9, article id afad163Article in journal (Refereed)
    Abstract [en]

    Objective: Given the importance of sleep in maintaining neurocognitive health, both sleep duration and quality might be component causes of dementia. However, the possible role of insomnia symptoms as risk factors for dementia remain uncertain. Methods: We prospectively studied 22,078 participants in the Swedish National March Cohort who were free from dementia and stroke at baseline. Occurrence of dementia was documented by national registers during a median follow-up period of 19.2 years. Insomnia symptoms and sleep duration were ascertained by Karolinska Sleep Questionnaire. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: Compared to participants without insomnia at baseline, those who reported any insomnia symptom experienced a greater incidence of dementia during follow-up (HR 1.08, 95% CI: 1.03, 1.35). Difficulty initiating sleep versus non insomnia (HR 1.24, 95% CI: 1.02, 1.52), but not difficulty maintaining sleep or early morning awakening was associated with an increased risk of dementia. Short sleep duration was associated with increased risk of dementia (6 h vs. 8 h, HR 1.29, 95% CI: 1.11-1.51; 5 h vs. 8 h, HR 1.26, 95% CI: 1.00-1.57). Stratified analyses suggested that insomnia symptoms increased the risk of dementia only amongst participants with =7 h sleep (vs. non-insomnia HR 1.24, 95% CI: 1.00-1.54, P=0.05), but not amongst short sleepers (<7 h). Short sleep duration also did not further inflate the risk of dementia amongst insomniacs. Conclusion: Insomnia and short sleep duration increase the risk of dementia amongst middle-aged to older adults.

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