"Nightmares" can predict dementia! The Lancet sub-issue: The male association is more significant!

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Recently, the Lancet sub-journal eClinicalMedicine published a blockbuster study that provides us with the latest insights
.

Studies have shown that frequent nightmares (≥ 1 time a week) may be associated
with the onset of dementia years or even decades later.

Specifically, middle-aged people (aged 35 to 64) who had weekly nightmares were 4 times more likely to experience cognitive decline over the next 10 years than ordinary people of the same age; Older adults (≥ 65 years old) who have weekly nightmares are twice as likely to be subsequently diagnosed with dementia as
ordinary people of the same age.

Interestingly, studies have found that the association between frequent nightmares and the risk of dementia is significantly stronger
in men.

Older men with weekly nightmares are about 5 times more likely to develop dementia than the average older man; However, older women with weekly nightmares have a 1.
4 times higher
risk of developing dementia than the average older woman.

The paper emphasizes that the current large-scale, prospective analysis "confirms for the first time that nightmares are associated with the risk of dementia and cognitive decline in healthy adults
.
"

Screenshot source: eClinicalMedicine

In recent years, more and more clinical experts have begun to pay attention to the link
between nightmares and the clinical prognosis of patients with certain types of diseases, such as Parkinson's disease.

The results of three different important studies suggest that Parkinson's disease people with higher nightmare frequency will experience faster cognitive decline, and over time, this part of the population will have a significantly higher
risk of developing dementia.

This begs the question: For the average adult who does not have Parkinson's disease, are nightmares also associated with accelerated cognitive decline and the risk of dementia?

The prospective study, which included three population cohort data from the American Midlife Study (MIDUS), the Osteoporotic Fracture Study in Men (MrOS), and the Osteoporotic Fracture Study (SOF), explored whether higher nightmare frequencies in the middle-aged and older population (without cognitive impairment or Parkinson's disease) were associated with faster cognitive decline and whether the risk of developing dementia increased over time
.

• Middle-aged cohorts: The middle-aged cohort data for the current analysis came from the MIDUS study
  .
  
  The MIDUS study was launched in 1995 and enrolled more than 7,000 American adult subjects
  .
  
  The screening criteria for participants in the MIDUS study in this analysis included the inclusion period from January 2004 to September 2009.
  The age is middle-aged (i.
  e.
  35 to 64 years); At baseline, there is no cognitive impairment or Parkinson's disease
  .
  
  Based on these criteria, a total of 605 adult subjects in the MIDUS study were screened in this analysis
  .
  

  
  

• Elderly female cohorts: The data for the elderly female cohort for the current analysis came from the SOF study
  .
  
  The SOF study enrolled a total of 10,366 women aged ≥ 65 from four clinical medical centers in the
  United States.
  
  This analysis included participants recruited in the SOF study between January 2002 and April 2004, and a total of 1475 participants eligible for the analysis were screened
  .
  

  
  

• Elderly male cohorts: The elderly female cohort data for the current analysis came from the MrOS study
  .
  
  The MrOS study enrolled a total of 5994 men ≥ 65 years old from six clinical medical centers in the
  United States.
  
  A total of 1125 eligible participants were included in this analysis who were recruited between December 2003 and March 2005 and between November 2009 and March 2012 in the MrOS study
  .
  

  
  

Image source: 123RF

Statistics show that the analysis included a total of 605 middle-aged participants (mean age 50.
3 years; 55.
7% female) and 2600 elderly subjects (average age 82.
9 years; 56.
7% female).


In both the middle-aged and elderly cohorts, about 6% of the subjects had nightmares ≥ once a week (middle-aged cohorts: 6.
0%; Elderly cohorts: 6.
9%)
.

It is worth noting that compared with middle-aged men, middle-aged women are more likely to have frequent nightmares; In contrast, older men are more likely to have frequent nightmares
than older women.

People with nightmares are not only more likely to have depression, anxiety, and sleep problems, but also generally self-assessed health
than those who reported not having nightmares in the past month at baseline.

The analysis data showed that a total of 90 subjects (14.
9%) of the 13-year follow-up cohort met the criteria for cognitive decline in the middle-aged cohort
.

Model analysis after fully adjusting for correlation showed a linear and statistically significant association between more frequent nightmares and the risk of cognitive decline (trend analysis P-value = 0.
016).


Subjects who had nightmares ≥ once a week were 4 times more likely to experience cognitive decline than those who reported not having nightmares in the past month at baseline (aOR = 3.
99; 95% CI: 1.
07 to 14.
85; P = 0.
039).

In the elderly cohort, a total of 235 (9.
0%) participants were diagnosed with dementia
during the 7-year follow-up period.

Model analysis after fully adjusting for relevant factors showed a linear and statistically significant association between more frequent nightmares and the risk of dementia (trend analysis P-value < 0.
001).


Participants who had nightmares ≥ once a week had a 2.
2-fold risk of developing dementia compared to those who reported not having nightmares in the past month at baseline (aOR = 2.
21; 95% CI: 1.
35-3.
62; P=0.
002).

In addition, further sex-based analysis showed a more statistically significant association between nightmare frequency, cognitive decline, and risk of dementia in men
.

For example, older men with weekly nightmares were about 5 times more likely to develop dementia than the average older man (aOR = 4.
67; 95% CI: 2.
16-10.
11; P< 0.
001); However, older women with weekly nightmares had only 1.
4 times higher risk of developing dementia than the average older woman (aOR = 1.
41; 95% CI: 0.
70-2.
83; P=0.
158).

Overall, the results of the current analysis suggest that frequent nightmares may be useful in predicting cognitive decline and the development
of all-cause dementia in the middle-aged and older population.

Considering that the current number of indicators that can effectively identify the risk of dementia in middle-aged people is extremely limited, the results of the current study are of great significance
.

In the future, we may be able to effectively screen people at high risk for dementia through the physiological phenomenon of nightmares and develop reasonable strategies to slow down the eventual onset
of the disease.