![]() ![]() This study consisted of a nationwide population-based case-control design. In addition, we investigated whether this association was moderated by age. In this study, we investigated whether primary insomnia was associated with an increased risk of dementia using the Taiwan Longitudinal Health Insurance Database (LHID 2000). Therefore, dementia is one of the biggest threats to the health of the Taiwanese population. In 2007, the estimated average life expectancy was 81 and 75 years for women and men, respectively. ![]() The percentage of the Taiwanese population aged 65 and above has increased over the past 27 years from 4.1% in 1980 to 10.2% in 2007. Approximately 1% of the 35 million people worldwide aged 65 to 69 years are affected by this condition, and its prevalence increases with age of the population. Few studies have investigated the relationship between primary insomnia and the prevalence of neurological diseases.ĭementia is a condition involving a significant decrease in cognitive abilities, including memory deficits, mood changes, and problems in communication and reasoning. ![]() Although an association between sleep and neurological disorders is widely acknowledged, most studies of this association have focused on sleep apnea. Primary insomnia is also associated with hypertension, diabetes, myocardial infarction, stroke, and transient ischemic attack. The sleep disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The predominant symptom is difficulty initiating or maintaining sleep, or suffering from nonrestorative sleep, for at least 1 month. Primary insomnia is sleeplessness that is not attributable to a medical, psychiatric, or environmental cause. Difficulty in sleeping significantly interfering with daily functioning is an important factor considered before diagnosing a patient with insomnia. Insomnia is defined as difficulty in initiating sleep, maintaining sleep, and/or struggling with frequent early morning awakenings. Taiwanese patients with primary insomnia, especially those under 40, had a higher risk of developing dementia than those without primary insomnia. We also found a higher risk of dementia in younger patients. After adjusting for select comorbidities, primary insomnia remained a significant predisposing factor for developing dementia, and was associated with a 2.14-fold (95% confidence interval, 2.01–2.29) increase in dementia risk. The primary insomnia cohort had a higher prevalence of diabetes, dyslipidemia, hypertension, coronary heart disease, chronic liver disease, and chronic kidney disease at baseline. We used a Cox proportional hazards model to assess the primary insomnia on the risk of developing dementia after adjusting for sociodemographic characteristics and comorbidities. We excluded patients under 20 and those with depression, post-traumatic stress disorder, and/or sleep disorders caused by organic lesion(s), drugs, or alcohol. We included 51,734 patients who were diagnosed with primary insomnia from 2002 to 2004 as the test group and 258,715 nonprimary insomnia participants aged 20 years or older as the reference group. This case-control study involved a subset of Taiwan’s National Health Insurance Research Database of reimbursement claims. To investigate the association between primary insomnia and dementia using a Taiwanese population-based database. ![]()
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