Objective short sleep duration increases the risk of all-cause mortality associated with possible vascular cognitive impairment

Objectives: Cognitive impairment is a leading cause of disability worldwide, and cardiometabolic conditions are key contributors to its development. Short sleep is also a potential contributor to brain health; however, its role in predicting mortality remains poorly understood. We investigated whether objective short sleep duration increases the risk of all cause mortality associated with coexisting cognitive impairment and cardiometabolic conditions, i.e., possible vascular cognitive impairment (VCI). Design: This is a longitudinal study. Setting: This is a population-based, in-lab study. Participants: A total of 1,524 adults (aged 48.9 +/- 13.4 years, 53.4% women) from the Penn State Adult Cohort were included in the study. Measurements: All-cause mortality was estimated after 19.1 +/- 5.1 years of follow-up. Neuropsycholog cal testing was performed to ascertain cognitive impairment Clinical history and physical examination were performed to ascertain stage 2 hyperiension, type 2 diabeles, heart disease, and stroke. Possible VCI was defined as the presence of any of these cardiometabolic conditions and cognitive impairment In-lab, 8 hour polysomnography (PSG) was performed to ascertain shod sleep duration (i.e., <6 hours). Results: Multivariable-adjustecl Cox proportional-hazard models showed that lhe risk of all-cause modality associated with cardiometabolic conditions (n=864) and possible VCI (n=122) was significantly increased in those who slept <6 hours at baseline (hazards ratio [HR] =1.79, 95%, confidence interval [CI]=128-251 and HR = 4.01, 95% CI = 2.66-6.05, respectively), while it was negligible in those who slept >= 6 hours (HR = 1,44,95% CI = 0.99-2.09 and HR = 141, 95% CI = 0.70-233, respectively). Conclusions: Objective short sleep duration predicts the mortality prognosis of adults with possible VCI. Sleep duration and cognition should be objectively evaluated in patients presenting with a cluster of cardiometabolic conditions and sleep and cognitive complaints. Short sleep is a useful risk factor in the prediction of adverse cardiometabolic and brain health outcomes. (C) 2019 National Sleep foundation. Published by Elsevier Inc All rights reserved.