Snoring and risk of dementia: a prospective cohort and Mendelian randomization study.

IF 5.6 2区医学 Q1 Medicine Sleep Pub Date : 2025-01-13 DOI:10.1093/sleep/zsae149

Yaqing Gao, Shea Andrews, Iyas Daghlas, Willa D Brenowitz, Cyrus A Raji, Kristine Yaffe, Yue Leng

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Abstract

Study objectives: The association between snoring, a very common condition that increases with age, and dementia risk is controversial. We aimed to investigate the observational and causal relationship between snoring and dementia, and to elucidate the role of body mass index (BMI).

Methods: Using data from 451 250 participants who were dementia-free at baseline, we examined the association between self-reported snoring and incident dementia using Cox proportional-hazards models. Causal relationship between snoring and Alzheimer's disease (AD) was examined using bidirectional two-sample Mendelian randomization (MR) analysis.

Results: During a median follow-up of 13.6 years, 8325 individuals developed dementia. Snoring was associated with a lower risk of all-cause dementia (hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89 to 0.98) and AD (HR 0.91; 95% CI 0.84 to 0.97). The association was slightly attenuated after adjusting for BMI, and was stronger in older individuals, APOE ε4 allele carriers, and during shorter follow-up periods. MR analyses suggested no causal effect of snoring on AD; however, genetic liability to AD was associated with a lower risk of snoring. Multivariable MR indicated that the effect of AD on snoring was primarily driven by BMI.

Conclusions: The phenotypic association between snoring and lower dementia risk likely stems from reverse causation, with genetic predisposition to AD associated with reduced snoring. This may be driven by weight loss in prodromal AD. Increased attention should be paid to reduced snoring and weight loss in older adults as potential early indicators of dementia risk.

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打鼾与痴呆症风险：前瞻性队列和孟德尔随机研究。

研究目的打鼾是一种随年龄增长而增加的常见疾病，其与痴呆症风险之间的关系存在争议。我们旨在研究打鼾与痴呆之间的观察和因果关系，并阐明体重指数（BMI）的作用：我们使用 451,250 名基线时未患痴呆症的参与者的数据，通过 Cox 比例危险模型研究了自我报告的打鼾与痴呆症之间的关系。采用双向双样本孟德尔随机化（MR）分析法研究了打鼾与阿尔茨海默病（AD）之间的因果关系：结果：在中位 13.6 年的随访期间，共有 8325 人罹患痴呆症。打鼾与较低的全因痴呆风险（危险比 [HR] 0.93；95% 置信区间 [CI] 0.89 至 0.98）和注意力缺失症风险（HR 0.91；95% 置信区间 [CI] 0.84 至 0.97）相关。在调整体重指数（BMI）后，这种关联略有减弱，在年龄较大、APOE ε4等位基因携带者和随访时间较短的个体中，这种关联更强。磁共振分析表明，打鼾对注意力缺失症没有因果关系，但是注意力缺失症的遗传易感性与较低的打鼾风险有关。多变量磁共振分析表明，AD对打鼾的影响主要由体重指数（BMI）驱动：结论：打鼾与痴呆症风险降低之间的表型关联可能源于反向因果关系，即AD遗传易感性与打鼾减少相关。这可能是AD前驱期体重减轻所致。作为痴呆症风险的潜在早期指标，老年人打鼾减少和体重减轻应得到更多关注。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep Medicine-Neurology (clinical)

CiteScore

8.70

自引率

10.70%

发文量

期刊介绍： SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.

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