Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.

<h4>Background</h4>The evidence on the relationship between insomnia and risk of dementia, Alzheimer's disease (AD), and Vascular dementia (VD) is not consistent. We conducted this meta-analysis to examine the evidence for the risk of developing dementia, AD, or VD in patients with...

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Main Authors: Mingxian Meng, Xiaoming Shen, Yanming Xie, Rui Lan, Shirui Zhu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0318814
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author Mingxian Meng
Xiaoming Shen
Yanming Xie
Rui Lan
Shirui Zhu
author_facet Mingxian Meng
Xiaoming Shen
Yanming Xie
Rui Lan
Shirui Zhu
author_sort Mingxian Meng
collection DOAJ
description <h4>Background</h4>The evidence on the relationship between insomnia and risk of dementia, Alzheimer's disease (AD), and Vascular dementia (VD) is not consistent. We conducted this meta-analysis to examine the evidence for the risk of developing dementia, AD, or VD in patients with all subtypes of insomnia.<h4>Methods</h4>A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted using the following search strings: 'Insomnia OR Sleep initiation and Maintenance disorders OR Early morning awakening' AND 'Dementia OR Alzheimer's Disease OR Vascular Dementia' AND 'Risk'. Data extraction was done independently by two researchers. Pooled odds ratio (OR) accompanied by 95% confidence interval (CI) were calculated using either a random-effects model or a fixed-effects model. Sensitivity analyses were performed to assess the robustness of the findings. The potential for publication bias was evaluated through Egger's test and Begg's test.<h4>Results</h4>This meta-analysis included 16 studies with a combined sample size of over 9 million individuals. Pooled analyses revealed a significant association between insomnia and dementia risk (OR = 1.36; 95% CI: 1.01-1.84), with increased risks for AD (OR = 1.52; 95% CI: 1.19-1.93) and VD (OR = 2.10; 95% CI = 2.06-2.14). Subgroup analyses showed no evidence of associations between initial insomnia (OR = 1.01; 95% CI = 0.71-1.31), sleep-maintenance insomnia (OR = 0.88; 95% CI = 0.66-1.17), and early morning awakening (OR = 0.94; 95% CI = 0.83-1.07) with dementia risk. Insomnia patients from Europe (OR = 1.24; 95% CI = 1.14-1.35), Asia (OR = 2.19; 95% CI = 2.06-2.32), and the Americas (OR = 1.05; 95% CI =  1.04-1.07) had varying risks of dementia. Subgroups with less than five years of follow-up (OR = 2.16; 95% CI = 1.81-2.60) exhibited higher dementia risks in insomnia patients, while those with more than five years of follow-up (OR = 1.17; 95% CI = 1.03-1.33) showed a lower risk.<h4>Conclusion</h4>Our meta-analysis reveals that insomnia is linked to the risk of dementia, AD, and VD. These findings suggest that insomnia may significantly contribute to the risk of all-cause dementia, highlighting the importance of early intervention and management of insomnia. Despite our efforts to minimize and explore the sources of heterogeneity, it still remained, and therefore our results should be interpreted with caution.
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spelling doaj-art-1482567c1e6d4778aeb7935c1fd2ded32025-08-20T02:46:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01204e031881410.1371/journal.pone.0318814Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.Mingxian MengXiaoming ShenYanming XieRui LanShirui Zhu<h4>Background</h4>The evidence on the relationship between insomnia and risk of dementia, Alzheimer's disease (AD), and Vascular dementia (VD) is not consistent. We conducted this meta-analysis to examine the evidence for the risk of developing dementia, AD, or VD in patients with all subtypes of insomnia.<h4>Methods</h4>A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted using the following search strings: 'Insomnia OR Sleep initiation and Maintenance disorders OR Early morning awakening' AND 'Dementia OR Alzheimer's Disease OR Vascular Dementia' AND 'Risk'. Data extraction was done independently by two researchers. Pooled odds ratio (OR) accompanied by 95% confidence interval (CI) were calculated using either a random-effects model or a fixed-effects model. Sensitivity analyses were performed to assess the robustness of the findings. The potential for publication bias was evaluated through Egger's test and Begg's test.<h4>Results</h4>This meta-analysis included 16 studies with a combined sample size of over 9 million individuals. Pooled analyses revealed a significant association between insomnia and dementia risk (OR = 1.36; 95% CI: 1.01-1.84), with increased risks for AD (OR = 1.52; 95% CI: 1.19-1.93) and VD (OR = 2.10; 95% CI = 2.06-2.14). Subgroup analyses showed no evidence of associations between initial insomnia (OR = 1.01; 95% CI = 0.71-1.31), sleep-maintenance insomnia (OR = 0.88; 95% CI = 0.66-1.17), and early morning awakening (OR = 0.94; 95% CI = 0.83-1.07) with dementia risk. Insomnia patients from Europe (OR = 1.24; 95% CI = 1.14-1.35), Asia (OR = 2.19; 95% CI = 2.06-2.32), and the Americas (OR = 1.05; 95% CI =  1.04-1.07) had varying risks of dementia. Subgroups with less than five years of follow-up (OR = 2.16; 95% CI = 1.81-2.60) exhibited higher dementia risks in insomnia patients, while those with more than five years of follow-up (OR = 1.17; 95% CI = 1.03-1.33) showed a lower risk.<h4>Conclusion</h4>Our meta-analysis reveals that insomnia is linked to the risk of dementia, AD, and VD. These findings suggest that insomnia may significantly contribute to the risk of all-cause dementia, highlighting the importance of early intervention and management of insomnia. Despite our efforts to minimize and explore the sources of heterogeneity, it still remained, and therefore our results should be interpreted with caution.https://doi.org/10.1371/journal.pone.0318814
spellingShingle Mingxian Meng
Xiaoming Shen
Yanming Xie
Rui Lan
Shirui Zhu
Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
PLoS ONE
title Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
title_full Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
title_fullStr Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
title_full_unstemmed Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
title_short Insomnia and risk of all-cause dementia: A systematic review and meta-analysis.
title_sort insomnia and risk of all cause dementia a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0318814
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AT yanmingxie insomniaandriskofallcausedementiaasystematicreviewandmetaanalysis
AT ruilan insomniaandriskofallcausedementiaasystematicreviewandmetaanalysis
AT shiruizhu insomniaandriskofallcausedementiaasystematicreviewandmetaanalysis