Insomnia complaints correlated with higher risk of cognitive impairment in older adults following stroke: a National Representative Comparison Study

Wei Liang; Dean Wu; Yeu-Hui Chuang; Yen-Chun Fan; Hsiao-Yean Chiu

doi:10.1007/s41105-023-00477-x

Insomnia complaints correlated with higher risk of cognitive impairment in older adults following stroke: a National Representative Comparison Study

Sleep Biol Rhythms. 2023 Jul 18;22(1):41-47. doi: 10.1007/s41105-023-00477-x. eCollection 2024 Jan.

Authors

Wei Liang¹, Dean Wu^{2

3

4}, Yeu-Hui Chuang^{1

5

6}, Yen-Chun Fan⁷, Hsiao-Yean Chiu^{1

4

8

9}

Affiliations

¹ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
² Department of Neurology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
³ Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Research Center of Sleep Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁶ Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁷ School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
⁸ Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
⁹ Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.

PMID: 38476858
PMCID: PMC10899963 (available on 2024-07-18)
DOI: 10.1007/s41105-023-00477-x

Abstract

Although associations among insomnia, cognitive impairment, and stroke have been demonstrated, whether insomnia increases the risk of cognitive impairment after stroke remains unclear. The aim of this study was to examine whether insomnia complaints moderated the association between stroke and cognitive impairment in older adults. This study was a secondary data analysis that used data from the National Health Interview Survey 2009. A total of 447 older adults with a mean age of 74.63 years (50.1% men) were included. Self-reported insomnia and stroke occurrence were determined using a questionnaire. Cognitive impairment was assessed using the Mini-Mental State Examination. We used multivariate logistic regression to analyze the association between insomnia complaints and cognitive impairment. Participants were categorized into four groups: those with stroke and insomnia (58), those with stroke without insomnia (91), those without stroke with insomnia (116), and those without stroke or insomnia (182). The prevalence of insomnia complaints was 38.9%, and the frequency of poststroke cognitive impairment was 50.3%. After controlling for potential confounders, participants with stroke (with or without insomnia) had a significantly higher risk of cognitive impairment than those without stroke or insomnia (adjusted odds ratios: 4.16 and 2.91, 95% confidence intervals: 1.91-9.07 and 1.56-5.43, respectively). Stroke with or without insomnia complaints was associated with a higher risk of cognitive impairment relative to older adults without stroke or insomnia. The risk of cognitive impairment was the highest among participants with both stroke and insomnia.

Keywords: Cognitive impairment; Insomnia; Older adults; Stroke.

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