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67/100

✓ Peer-reviewed alzhub usefulness score 67 out of 100. Prevention and risk

Topic: Risk, prevention and care in population studies

Importance Slow-wave sleep (SWS) supports the aging brain in many ways, including facilitating the glymphatic clearance of proteins that aggregate in Alzheimer disease. However, the role of SWS in the development of dementia remains equivocal. Objective To determine whether SWS loss with aging is associated with the risk of incident dementia and examine whether Alzheimer disease genetic risk or hippocampal volumes suggestive of early neurodegeneration were associated with SWS loss. Design, setting, and participants This prospective cohort study included participants in the Framingham Heart Study who completed 2 overnight polysomnography (PSG) studies in the time periods 1995 to 1998 and 2001 to 2003. Additional criteria for individuals in this study sample were an age of 60 years or older and no dementia at the time of the second overnight PSG. Data analysis was performed from January 2020 to August 2023. Exposure Changes in SWS percentage measured across repeated overnight sleep studies over a mean of 5.2 years apart (range, 4.8-7.1 years). Main outcome Risk of incident all-cause dementia adjudicated over 17 years of follow-up from the second PSG. Results From the 868 Framingham Heart Study participants who returned for a second PSG, this cohort included 346 participants with a mean age of 69 years (range, 60-87 years); 179 (52%) were female. Aging was associated with SWS loss across repeated overnight sleep studies (mean [SD] change, -0.6 [1.5%] per year; P Conclusions and relevance This cohort study found that slow-wave sleep percentage declined with aging and Alzheimer disease genetic risk, with greater reductions associated with the risk of incident dementia. These findings suggest that SWS loss may be a modifiable dementia risk factor.

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APA 7th

Himali, J. J., Baril, A. A., Cavuoto, M. G., Yiallourou, S., Wiedner, C. D., Himali, D., et al. (2023). Association Between Slow-Wave Sleep Loss and Incident Dementia. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2023.3889

Vancouver

Himali JJ, Baril AA, Cavuoto MG, Yiallourou S, Wiedner CD, Himali D, et al. Association Between Slow-Wave Sleep Loss and Incident Dementia. JAMA Neurology. 2023. doi:10.1001/jamaneurol.2023.3889. PMID: 37902739.

BibTeX

@article{himali2023-37902739,
  author  = {Himali, J. J. and Baril, A. A. and Cavuoto, M. G. and Yiallourou, S. and Wiedner, C. D. and Himali, D. and others},
  title   = {{Association Between Slow-Wave Sleep Loss and Incident Dementia}},
  journal = {JAMA Neurology},
  year    = {2023},
  doi     = {10.1001/jamaneurol.2023.3889},
  pmid    = {37902739},
  url     = {https://doi.org/10.1001/jamaneurol.2023.3889}
}

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Key findings

Objective To determine whether SWS loss with aging is associated with the risk of incident dementia and examine whether Alzheimer disease genetic risk or hippocampal volumes suggestive of early neurodegeneration were associated with SWS loss.
Results From the 868 Framingham Heart Study participants who returned for a second PSG, this cohort included 346 participants with a mean age of 69 years (range, 60-87 years); 179 (52%) were female.
Aging was associated with SWS loss across repeated overnight sleep studies (mean [SD] change, -0.6 [1.5%] per year; P < .001).
These findings suggest that SWS loss may be a modifiable dementia risk factor.

Why it matters

This prospective cohort study of 346 Framingham Heart Study participants found that slow-wave sleep loss with aging was associated with the risk of incident dementia. It suggests that slow-wave sleep loss may be a marker of dementia risk, but it does not show that improving sleep prevents or treats dementia.

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Study details

Study designcohort
Participants346
Effect sizeHR 1.27 (95% CI 1.06-1.54) per 1%/year loss of slow-wave sleep
Evidence strengthEarly

Limitations

Small sample with few dementia cases; two sleep studies only; sleep loss could be an early consequence of neurodegeneration rather than a cause.

How this study scored 67/100

Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 66 of the 98 points we could judge it on, which is 67 out of 100.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA Neurology)
Journal's citation record	2 / 4	JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	2 / 5	Rated “early” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2023 — within 6 year(s) of the newest study here
Sample size	2 / 4	346 participants
Effect reported	3 / 3	Effect reported with a statistic (interval, p-value, ratio or similar)
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	4 / 7	Cited 98 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	19.6 citations a year over 5 year(s) since 2023
Impact for its field and year	4 / 6	Cited 17.7× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 4 other studies in this library
Still being cited	3 / 4	Cited 96 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Matthew Paul Pase: h-index 49 (OpenAlex, whole career)
Institution's track record	3 / 3	Harvard University: institution h-index 3,235 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 9 institution(s) in 3 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 37902739)
Free to read	— / 2	Access not recorded — left out of this score
Points	66 / 98	Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 66 of the 98 points we could judge it on is 67 out of 100.
Total	67 / 100	—

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