ArticleSleep2021
Systemic inflammation as a moderator between sleep and incident dementia.
Article in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 30 citations in OpenAlex.
- The association of long-term air pollution with a composite neurodegenerative risk score among Chinese elderly: evidence from the CHARLS.Environmental health : a global access science source · 2026Article
- "Like Taking Part in Star Wars": Qualitative Study Using Thematic Analysis to Explore the Acceptability and Experiences of Older Adults Participating in Remote Longitudinal Sleep and Dementia Research.Journal of medical Internet research · 2026Article
- Systematic Review on the Association Between Sleep and the Risk of Alzheimer's Disease: An Evolutionary Perspective.Evolutionary applications · 2026Review
- Subjective sleep characteristics in non-demented adults: domain-specific associations with multimodal Alzheimer's disease biomarkers.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Sleep Disorders in Neurodegenerative Diseases with Dementia: A Comprehensive Review.Journal of clinical medicine · 2025Review
- Inflammatory Status Modifies the Association Between Glycemic Traits and Cognitive Impairment in Patients With Coronary Artery Disease.Journal of the American Heart Association · 2025Article
- Long sleep duration, cognitive performance, and the moderating role of depression: A cross-sectional analysis in the Framingham Heart Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Individual and integrated indexes of inflammation predicting the risks of mental disorders - statistical analysis and artificial neural network.BMC psychiatry · 2025Article
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- Sleep-related changes in astrocytic biomarkers are modulated byBrain communications · 2025Article
- Sleep efficiency and event-related potentials in patients with depression: the mediating role of serum C-reactive protein.Frontiers in psychiatry · 2025Article
- Insufficient Sleep and Alzheimer's Disease: Potential Approach for Therapeutic Treatment Methods.Brain sciences · 2024Review
- Article
- Editorial: The 3 S's: sex, stress, and sleep as risk factors for dementias.Frontiers in aging neuroscience · 2024Article
- Peripheral immunity and risk of incident brain disorders: a prospective cohort study of 161,968 participants.Translational psychiatry · 2023Article
- Sleep quality mediates the relationship between systemic inflammation and neurocognitive performance.Brain, behavior, & immunity - health · 2023Article
- The Putative Role of Neuroinflammation in the Interaction between Traumatic Brain Injuries, Sleep, Pain and Other Neuropsychiatric Outcomes: A State-of-the-Art Review.Journal of clinical medicine · 2023Review
- Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China.Frontiers in public health · 2023Article
- Sleep disturbance is associated with mild cognitive impairment: a community population-based cross-sectional study.BMC public health · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
STUDY
objectivesTo determine whether C-reactive protein (CRP), a marker of systemic inflammation, moderates the association between sleep and incident dementia.
methodsWe studied Framingham Heart Study participants who completed at baseline a serum CRP assessment and in-home polysomnography to measure sleep duration, sleep efficiency, sleep latency, wake after sleep onset (WASO), number of awakenings, arousal index, and apnea-hypopnea index. Participants were divided into groups according to their CRP level: low (<1 mg/L), average (1-3 mg/L), and high inflammation (>3 mg/L). Surveillance for outcomes (incident all-cause and Alzheimer's disease [AD] dementia) commenced at baseline and continued up to 22.5 years.
resultsIn 291 participants (mean age 67.5 ± 4.9 years, 51.6% men) followed for 13.4 ± 5.4 years, we observed 43 cases of all-cause dementia, 33 of which were clinically consistent with AD. Whereas no direct association between CRP or sleep exposures was observed with incident dementia, CRP levels interacted with nighttime wakefulness when predicting both incident all-cause and AD dementia. In the high CRP group, longer WASO (hazard ratio [HR], 2.89; 95% CI, 1.31-6.34) and more nighttime awakenings (HR, 4.55; 95% CI, 1.19-17.38) were associated with higher risk of incident dementia. In the low CRP group, fewer nighttime awakenings were associated with a higher risk of incident dementia (HR, 0.07; 95% CI, 0.01-0.68).
conclusionsOur findings suggest that inflammation moderates the association between sleep, particularly nighttime wakefulness, and dementia risk. The presence of inflammation may be an important determinant in evaluating how sleep disturbances relate to neurodegeneration.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.