Are primary care consultations for insomnia associated with subsequent onset of dementia? A matched retrospective case-control study
Richard Hoile, Naji Tabet, Helen Smith, Stephen Bremner, Jackie Cassell, Elizabeth Ford(2017)
Are primary care consultations for insomnia associated with subsequent onset of dementia? A matched retrospective case-control study.
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Insomnia is associated with dementia, but whether insomnia is merely a symptom of dementia, or an early prodrome or causative factor, is unclear. We investigated the association between primary care consultations for insomnia and later development of dementia.
A case-control study, using primary care records for 30418 patients from the UK’s Clinical Practice Research Datalink. Cases (with dementia) and controls (without) were matched 1:1 on year of birth and gender. Primary care insomnia consultations were measured during the period 5-10 years before the index date. Adjusted odds ratios (aOR) for developing dementia were estimated with 95% confidence intervals (CIs) using logistic regression, after controlling for sedative exposure (including antipsychotics, benzodiazepines and z-drugs) and physical and mental health comorbidities.
The adjusted odds ratio (aOR) for dementia was 1.31 (95% CI=1.18-1.45, p<0.01) in those with at least one insomnia consultation 5-10 years prior to index date; and 1.90 (95% CI=1.14-3.17, p=0.01) for those with more than 5 consultations. There was a significant but weak association between dementia and benzodiazepine/z-drug use (aOR 1.01, 95% CI=1.00-1.01, p<0.01).
This case-control study provides evidence of an association between insomnia consultations and onset of dementia 5-10 years later. It may be possible to incorporate insomnia into future screening and predictive tools for dementia, especially those used in primary care.
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- Richard Hoile
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