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Association Between Circadian Rest-Activity Rhythms and Incident Dementia in Older Adults
Wendy Wang, Amal Asiri Wanigatunga, Lacey Etzkorn, Jill A. Rabinowitz, Priya Palta, James Russell Pike, Ryan James Dougherty, Vadim Zipunnikov et al.. Neurology, 2025-12-29
Topic: Risk, prevention and care in population studies
Of the 2,183 participants (mean ± SD age 79 ± 4.5 years, 58% female, 24% Black), 176 (8%) developed dementia. The median follow-up time was 3 years, and the mean Zio XT Patch wear time was 12 days. After multivariable adjustment, each 1-SD decrement in relative amplitude and 1-SD increment in intradaily variability were associated with 54% (95% CI 32%-78%) and 19% (95% CI 2%-38%) greater risk of dementia, respectively. Amplitude and mesor were associated with elevated dementia risk after multivariable adjustment (hazard ratios per 1-SD decrement: 1.43 [95% CI 1.15-1.78] and 1.33 [95% CI 1.08-1.63], respectively). A later acrophase was associated with 1.45 times (95% CI 1.01-2.07) greater risk of dementia compared with a normal acrophase. Using accelerometer data from a commonly used ambulatory ECG monitor, weaker and more fragmented circadian RARs and later peak activity time were prospectively associated with elevated dementia risk in older Black and White adults. Limitations of our study include the lack of dementia subtype data and objective sleep disorder measurements. Further research to determine whether circadian rhythm interventions can reduce dementia risk is warranted.
Key findings
- Of the 2,183 participants (mean ± SD age 79 ± 4.5 years, 58% female, 24% Black), 176 (8%) developed dementia.
- The median follow-up time was 3 years, and the mean Zio XT Patch wear time was 12 days.
- After multivariable adjustment, each 1-SD decrement in relative amplitude and 1-SD increment in intradaily variability were associated with 54% (95% CI 32%-78%) and 19% (95% CI 2%-38%) greater risk of dementia, respectively.
- Amplitude and mesor were associated with elevated dementia risk after multivariable adjustment (hazard ratios per 1-SD decrement: 1.43 [95% CI 1.15-1.78] and 1.33 [95% CI 1.08-1.63], respectively).
- A later acrophase was associated with 1.45 times (95% CI 1.01-2.07) greater risk of dementia compared with a normal acrophase.
Why it matters
This cohort study found that weaker and more fragmented rest-activity rhythms and later peak activity time were associated with higher dementia risk in older Black and White adults. It did not test whether changing circadian rhythms can reduce dementia risk.
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Study details
- Study designcohort study
- Participants2,183
- Evidence strengthModerate
How this study scored 60/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 58 of the 96 points we could judge it on, which is 60 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,183 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Lin Y. Chen holds only 1 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41461059) |
| Free to read | 2 / 2 | Free to read |
| Points | 58 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 58 of the 96 points we could judge it on is 60 out of 100. |
| Total | 60 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/wnl.0000000000214513
- PubMed: 41461059
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Wang, W., Wanigatunga, A. A., Etzkorn, L., Rabinowitz, J. A., Palta, P., Pike, J. R., et al. (2025). Association Between Circadian Rest-Activity Rhythms and Incident Dementia in Older Adults. Neurology. https://doi.org/10.1212/wnl.0000000000214513
Vancouver
Wang W, Wanigatunga AA, Etzkorn L, Rabinowitz JA, Palta P, Pike JR, et al. Association Between Circadian Rest-Activity Rhythms and Incident Dementia in Older Adults. Neurology. 2025. doi:10.1212/wnl.0000000000214513. PMID: 41461059.
BibTeX
@article{wang2025-41461059,
author = {Wang, Wendy and Wanigatunga, Amal Asiri and Etzkorn, Lacey and Rabinowitz, Jill A. and Palta, Priya and Pike, James Russell and Dougherty, Ryan James and Zipunnikov, Vadim and others},
title = {{Association Between Circadian Rest-Activity Rhythms and Incident Dementia in Older Adults}},
journal = {Neurology},
year = {2025},
doi = {10.1212/wnl.0000000000214513},
pmid = {41461059},
url = {https://doi.org/10.1212/wnl.0000000000214513}
}
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