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Association of sleep duration with Alzheimer's disease and cognition.

July 8, 2026pubmed logopapers

Authors

Anagnostakis F,O'Toole CK,Erus G,Srinivasan D,Cui Y,Kokkorakis M,Ma X,Reitz C,Brickman AM,Kontos D,Gupta A,Payabvash S,Konofagou EE,McIlvain G,Cheng F,Baldwin MR,Shou H,Davatzikos C,Resnick S,Wen J

Affiliations (13)

  • Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Laboratory of AI and Biomedical Science (LABS), Columbia University, New York, New York, USA.
  • Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
  • Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA.
  • Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, New York, USA.
  • Department of Radiology, Columbia University, New York, New York, USA.
  • Center for Innovation in Imaging Biomarkers and Integrated Diagnostics (CIMBID), Department of Radiology, Columbia University, New York, New York, USA.
  • Department of Biomedical Engineering, Columbia University, New York, New York, USA.
  • Cleveland Clinic Genome Center, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University, New York, New York, USA.
  • Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
  • New York Genome Center (NYGC), New York Genome Center (Independent Consortium), New York, New York, USA.
  • Department of Computer Science, Columbia University, New York, New York, USA.

Abstract

The association of sleep duration with Alzheimer's disease (AD) - related brain atrophy and cognition remains unclear. Among 38,816 participants in the UK Biobank, we examined the association between sleep duration and a validated machine-learning-derived magnetic resonance imaging (MRI) signature of AD-related atrophy (Spatial Pattern of Abnormality for Recognition of Early AD [SPARE-AD]) and three cognitive test scores using generalized additive models. Independently, electronic health records (EHR) from TriNetX were used to examine the 10-year AD risk associated with insomnia and hypersomnia. Sleep duration exhibited a U-shaped association with SPARE-AD (p = 0.001), Trail Making Tests A and B, and the Digit Symbol Substitution Test (all p < 0.001). Short (5-6 hours) and long (9-10 hours) sleep duration were associated with poorer cognitive performance. Both insomnia and hypersomnia showed a high risk for Alzheimer's disease. This study demonstrates a U-shaped association between sleep duration and AD-like atrophy and cognition. These findings show that excessive or insufficient sleep is linked to worse brain health.

Topics

Sleep DurationAlzheimer DiseaseCognitionJournal Article

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