gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

08. - 11.09.2019, Dortmund

Associations between Sleep Characteristics and Mild Cognitive Impairment in The Heinz Nixdorf Recall Cohort Study

Meeting Abstract

  • Christian Brachem - Nutritional Epidemiology, Department of Nutrition and Food Science, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
  • Angela Winkler - Department of Neurology, University Hospital of Essen, University of Duisburg-Essen,, Essen, Germany
  • Sarah Tebrügge - Department of Neurology, University Hospital of Essen, University of Duisburg-Essen,, Essen, Germany
  • Christian Weimar - Klinik für Neurologie; Universitätsklinikum Essen; Universität Duisburg-Essen, Essen, Germany
  • Karl-Heinz Jöckel - Universitätsklinikum Essen, Essen, Germany
  • Raimund Erbel - Institut für Medizinische Informatik, Biometrie und Epidemiologie; Universitätsklinikum Essen; Universität Duisburg-Essen, Essen, Germany
  • Susanne Moebus - Institut für Medizinische Informatik, Biometrie und Epidemiologie; Universitätsklinikum Essen, Essen, Germany
  • Andreas Stang - Universitätsklinikum Essen, Essen, Germany
  • Nico Dragano - Institut für Medizinische Soziologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  • Martha Jokisch - Department of Neurology, University Hospital of Essen, University of Duisburg-Essen,, Essen, Germany
  • Bernd Kowall - Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 64. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (GMDS). Dortmund, 08.-11.09.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocAbstr. 193

doi: 10.3205/19gmds106, urn:nbn:de:0183-19gmds1060

Published: September 6, 2019

© 2019 Brachem et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Introduction: Poor sleep is known to be associated with prevalence of mild cognitive impairment (MCI) and dementia. However, these associations are largely based on cross-sectional studies. This study presents longitudinal associations between self-reported sleep characteristics (sleep quality, sleep disturbances, total and nocturnal sleep duration) and incident MCI.

Methods: Participants were selected as complete cases (N = 1890) from the first and second follow-up of the Heinz Nixdorf Recall study, a population-based cohort study in Germany (age at first follow-up 50 to 80 years, without history of cancer, stroke or cardiovascular diseases at baseline, mean duration of follow-up 5.2 years). Additionally, we performed multiple imputation on the extensive dataset and compared complete case and imputation results. MCI was assessed with extensive cognitive test during at both examinations, sleep characteristic were measured at the first examination using standardised questionnaires. Estimates of relative risks (RR) with 95% confidence intervals (CI) were obtained from a log-linear model with a Poisson working likelihood and robust standard errors (unadjusted and adjusted for sociodemographic and cardiovascular risk factors). We examined how different definitions of nocturnal sleep duration affected the results.

Results: We found that the risk of MCI is associated with poor sleep quality (Pittsburgh Sleep Quality Index > 5) (RR = 1.49, 95% CI: 1.21 to 1.82, fully adjusted, multiple imputation) and sleep disturbances (e.g. difficulties initiating sleep (almost nightly versus never) RR = 1.43 (1.06 to 1.93)). When nocturnal sleep duration did not explicitly exclude time awake in bed, we found a U-shaped association between sleep duration and MCI risk. When nocturnal sleep duration explicitly excluded time awake, MCI risk was only increased for short sleep (≤ 5 hours) (RR = 1.24 (0.93 to 1.66), reference 7 to < 8 hours).

Conclusion: We found positive associations between poor sleep and risk for MCI. In assessment of sleep duration, explicit exclusion of time awake in bed strongly affected associations with incident MCI.

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.


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