The Relationship Between Insomnia And Insomnia Types And Cognitive Impairment In Older Adults

Background: Although insomnia is a risk factor for cognitive dysfunction,the bidirectional relationship between insomnia symptoms and cognitive impairment at the population level remains unclear.Objective: To understand the prevalence of insomnia,insomnia symptoms and cognitive dysfunction among the older adults aged 65 and above in urban and rural areas and explore the bidirectional association between mild cognitive impairment and dementia and insomnia and its symptoms in China.Methods: Data from the China Multicenter Dementia Survey(CMDS)were used in this study.Insomnia was screened by the Chinese version of the Athens Insomnia Scale(AIS).Consensus mild cognitive impairment and dementia were diagnosed based on the 2018 Chinese Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Disorders criteria.Multivariate logistic regression model was used to analyze the relationship between insomnia and insomnia symptoms and cognitive impairment.Results: We included 10 829 participants aged 72.47 ± 5.91 years.The average educational level is 6.02 ± 4.70 years.The prevalence of insomnia was 32.1%(95% CI:31.2% ～ 33.0%),mild cognitive impairment was 32.0%(95% CI: 31.1% ～ 32.9%)and dementia was 8.0%(95% CI: 7.5% ～ 8.5%).Controlling for risk factors,insomnia was associated with an increased risk of mild cognitive impairment,as was MCI,but the association between insomnia and dementia was not significant.Stratified analyses by insomnia symptom type revealed bidirectional interactions between difficulty falling asleep and mild cognitive impairment,and more daytime sleeping and dementia.Conclusions: These findings revealed that insomnia and cognitive impairment reciprocally potentiate each other,reinforcing the value of insomnia and cognitive impairment management in community-dwelling older adults to prevent both.