Sonia Ancoli-israel
University of California, San Diego, Psychiatry, Faculty Member
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Research Interests: Medicine, Independent Living, Humans, Anoxia, United States, and 15 moreSleep disorders, Male, The, Actigraphy, Polysomnography, Aged, Odds ratio, Geriatric Assessment, Cross Sectional Studies, Cohort Studies, Frail elderly, Sleep Disturbance, Pittsburgh Sleep Quality Index, Medical and Health Sciences, and Sleep initiation and maintenance disorders
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95%CI: 1.14, 2.72, p1⁄4 0.02) compared to OSA-/Ab+ subjects. Being OSA+/Abdid not reveal significant differences in time-to-progression from MCI to AD when compared to OSA-/Absubjects (aHR) 1⁄4 1.17, 95% CI: 0.86, 1.48, p 1⁄4 0.07).... more
95%CI: 1.14, 2.72, p1⁄4 0.02) compared to OSA-/Ab+ subjects. Being OSA+/Abdid not reveal significant differences in time-to-progression from MCI to AD when compared to OSA-/Absubjects (aHR) 1⁄4 1.17, 95% CI: 0.86, 1.48, p 1⁄4 0.07). Conclusions:Among MCI patients, brain amyloid levels may modify the relationship between OSA and AD. Furthermore OSA+ subjects maybe more physiologically susceptible to Ab load at certain threshold levels.
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Older adults frequently experience difficulties with sleep that can be caused by specific sleep disorders (such as sleep-disordered breathing or periodic limb movements in sleep) and circadian rhythm disturbances. These all can be... more
Older adults frequently experience difficulties with sleep that can be caused by specific sleep disorders (such as sleep-disordered breathing or periodic limb movements in sleep) and circadian rhythm disturbances. These all can be effectively treated. Medical illnesses and medications also can have a negative affect on sleep and effective management of these can significantly improve sleep in older adults. Sleep in institutionalized older adults is even more disturbed than sleep of community-dwelling older people and special considerations can be made to improve the quality of sleep in institutional settings.
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Objective Older adults are among the most frequent users of emergency departments (EDs). Nonspecific symptoms, such as fatigue and widespread pain, are among the most common symptoms in patients admitted at the ED. Interleukin 6 (IL-6)... more
Objective Older adults are among the most frequent users of emergency departments (EDs). Nonspecific symptoms, such as fatigue and widespread pain, are among the most common symptoms in patients admitted at the ED. Interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) are inflammation biomarkers associated with chronic stress (i.e., dementia caregiving) and nonspecific symptoms. This study aimed to determine whether IL-6 and TNF-α were prospectively associated with ED risk in dementia caregivers (CGs). Methods Participants were 85 dementia CGs, who reported during three assessments (3, 9, and 15 months after enrollment) if they had visited an ED for any reason. Cox proportional hazards models were used to examine the relations between resting circulating levels of IL-6 and TNF-α obtained at enrollment and subsequent risk for an ED visit, adjusting for age, sex, use of ED 1 month before enrollment, physical and mental health well-being, body mass index, and CG demands. Results (lo...
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Research Interests: Geriatrics, Gerontology, Dementia, Adaptation, Aging, and 15 moreClinical research, Elderly People, Female, Caregivers, Health Status, Clinical Sciences, Aged, Family caregivers, Health risk, Clinical management, Cross Sectional Studies, Geriatrics and Gerontology, dementia caregivers, Brain Disorders, and Human Movement and Sports Sciences
ObjectiveTo examine rest–activity circadian rhythm (RAR) and cognitive decline in older men.DesignLongitudinal.SettingOsteoporotic Fractures in Men (MrOS) and ancillary Outcomes of Sleep Disorders in Men (MrOS Sleep)... more
ObjectiveTo examine rest–activity circadian rhythm (RAR) and cognitive decline in older men.DesignLongitudinal.SettingOsteoporotic Fractures in Men (MrOS) and ancillary Outcomes of Sleep Disorders in Men (MrOS Sleep) studies.ParticipantsMrOS and MrOS Sleep participants (N=2,754; mean age 76.0 ± 5.3).MeasurementsThe Modified Mini‐Mental State examination (3MS) was used to assess cognition at baseline (2003–05) and follow‐up examinations (2005–06 and 2007–09). Wrist actigraphy was used to measure 24‐hour activity counts at baseline. RAR variables included amplitude (strength of activity rhythm), mesor (mean activity level), pseudo F‐statistic (overall circadian rhythm robustness), and acrophase (time of daily peak activity).ResultsAfter an average of 3.4 ± 0.5 years, men with lower amplitudes, mesors, and pseudo F‐statistics had greater decline in 3MS performance (amplitude: –0.7 points Q1 vs –0.5 points Q4, p<.001; mesor: –0.5 points Q1 vs –0.2 points Q4, p=.01; pseudo F‐statistic...
Research Interests: Geriatrics, Aging, Medicine, Independent Living, Humans, and 15 moreInternal Medicine, Clinical research, Circadian Rhythm, Male, Men, Actigraphy, Aged, Longitudinal Studies, Odds ratio, Cognitive Decline, Neurosciences, Confidence Interval, confounding, Cognitive dysfunction, and Medical and Health Sciences
Research Interests: Psychology, Depression, Electroencephalography, Medicine, Mood, and 15 moreBiological Sciences, Sleep Apnea, Humans, Obstructive sleep apnea, Female, Male, Sleep, Electromyography, Body Mass Index, Polysomnography, Middle Aged, Severity of Illness Index, Psychology and Cognitive Sciences, Respiratory disturbance index (RDI), and Medical and Health Sciences
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Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in... more
Objectives To evaluate whether objectively measured sleep characteristics are associated with mortality risk independent of inflammatory burden and comorbidity. Methods The Osteoporotic Fractures in Men Sleep Study (conducted in 2003–2005) included community-dwelling older men (n = 2531; average [standard deviation {SD}] age = 76.3 (5.5) years). Sleep measures from in-home polysomnography and wrist actigraphy and assessments of serum inflammatory markers levels (C-reactive protein, interleukin-6, tumor necrosis factor α, tumor necrosis factor α soluble receptor II, and interferon-γ) were obtained. Vital status was ascertained over an average (SD) follow-up of 7.4 (1.9 SD) years. Results Three of the seven main sleep measures examined were independently associated with greater inflammatory burden. Mortality risk associated with prolonged (≥10% total sleep time) blood oxygen desaturation and short (<5 hours) sleep duration was attenuated to nonsignificance after adjusting for infla...
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It is well known that patients with psychiatric disorders complain of sleep difficulties and, in fact, these complaints are confirmed by objective studies.1 Patients with schizophrenia and patients with mood disorders tend to have... more
It is well known that patients with psychiatric disorders complain of sleep difficulties and, in fact, these complaints are confirmed by objective studies.1 Patients with schizophrenia and patients with mood disorders tend to have extremely disturbed sleep and complain of excessive daytime sleepiness, insomnia, or both. There is some evidence that patients with schizophrenia may have circadian rhythm disturbances and/or blunted circadian sleep/wake patterns.2-4 It is known that light exposure is a strong synchronizer of the sleep/wake system and that exposure to bright light tends to decrease with advancing age5 In addition to its direct effect on the circadian system, light exposure has also been implicated as a treatment for some mood disorders.
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The stress associated with providing care for a spouse diagnosed with Alzheimer's disease can have adverse effects on cardiovascular health. One potential explanation is that chronic caregiving stress may contribute to the development... more
The stress associated with providing care for a spouse diagnosed with Alzheimer's disease can have adverse effects on cardiovascular health. One potential explanation is that chronic caregiving stress may contribute to the development of atherosclerosis. The purpose of this study was to determine whether the duration that one has provided care is associated with the degree of atherosclerotic burden, as measured by carotid artery intima-media thickness (IMT). One hundred and ten Alzheimer caregivers [mean age 74 ± 8 (SD) years, 69% female] underwent in-home assessment of carotid artery IMT via B-mode ultrasonography. Data regarding medical history, blood pressure, and multiple indicators of caregiving stress were also collected. Multiple regression indicated that duration of care was positively associated with IMT measured in the internal/bifurcation segments of the carotid artery (β = 0.202, p = 0.044) independent of risk factors such as age, gender, body mass index, smoking his...
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Research Interests: Psychology, Psychiatry, Medicine, Emotions, Humans, and 15 moreInternal Medicine, cyclic AMP, Female, Male, Caregivers, Aged, Middle Aged, Longitudinal Studies, Longitudinal Study, Age Factors, Alzheimer Disease, Personal autonomy, Isoproterenol, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Medicine, Psychosomatic Medicine, Humans, Epinephrine, Female, and 15 moreMale, Body Mass Index, Risk factors, Caregivers, Norepinephrine, Aged, Arousal, Adult, Risk Factors, Coronary Artery Disease, Alzheimer Disease, Psychological Stress, Psychology and Cognitive Sciences, Medical and Health Sciences, and Carotid artery diseases
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Research Interests: Psychology, Psychometrics, Medicine, Biological Sciences, Humans, and 15 moreInternal Medicine, Placebo, Personality Assessment Inventory, Major Depressive Disorder, Female, Male, Sleep, Middle Aged, Adult, Randomized Controlled Trial, Clinical Psychiatry, Personality Inventory, Antipsychotic agents, Psychology and Cognitive Sciences, and Medical and Health Sciences
Background: Elderly individuals who provide care to a spouse suffering from dementia bear an increased risk of coronary heart disease (CHD). Objective: To test the hypothesis that the Framingham CHD Risk Score would be higher in dementia... more
Background: Elderly individuals who provide care to a spouse suffering from dementia bear an increased risk of coronary heart disease (CHD). Objective: To test the hypothesis that the Framingham CHD Risk Score would be higher in dementia caregivers relative to non-caregiving controls. Methods: We investigated 64 caregivers providing in-home care for their spouse with Alzheimer’s disease and 41 gender-matched non-caregiving controls. All subjects (mean age 70 ± 8 years, 75% women, 93% Caucasian) had a negative history of CHD and cerebrovascular disease. The original Framingham CHD Risk Score was computed adding up categorical scores for age, blood lipids, blood pressure, diabetes, and smoking with adjustment made for sex. Results: The average CHD risk score was higher in caregivers than in controls even when co-varying for socioeconomic status, health habits, medication, and psychological distress (8.0 ± 2.9 vs. 6.3 ± 3.0 points, p = 0.013). The difference showed a medium effect size...
Research Interests: Health Behavior, Gerontology, Dementia, Medicine, Cardiovascular Risk, and 15 moreHome Care, Humans, Internal Medicine, Effect size, Blood Pressure, Cerebrovascular Disease, Female, Male, Caregivers, Aged, Coronary heart disease, Blood Lipids, Control Method, Case Control Studies, and Elderly patient
Background: Providing care to a spouse with Alzheimer’s disease (AD) may contribute to cardiovascular disease (CVD). The acute phase reactant C-reactive protein (CRP) is a well-established biomarker of an increased CVD risk. Objective: To... more
Background: Providing care to a spouse with Alzheimer’s disease (AD) may contribute to cardiovascular disease (CVD). The acute phase reactant C-reactive protein (CRP) is a well-established biomarker of an increased CVD risk. Objective: To investigate the hypothesis that dementia caregiving is associated with elevated circulating levels of CRP and possibly other biomarkers of CVD risk. Methods: We examined 118 elderly spousal Alzheimer caregivers and 51 noncaregiving controls about once a year for up to 3 years. Random regression models with fixed and time-variant effects for a range of covariates known to affect biomarker levels were used to evaluate changes in CRP and in 12 additional measures of inflammation, cellular adhesion, endothelial function, and hemostasis in relation to caregiving status, years of caregiving, and major transitions in the caregiving situation. Results: During the study period, longer duration of caregiving was associated with elevated CRP levels (p = 0.040...
Research Interests: Gerontology, Dementia, Cytokines, Inflammation, Cardiovascular disease, and 15 moreHumans, Internal Medicine, Female, Disease, Caregivers, Aged, C reactive protein, Endothelial Function, Longitudinal Studies, Biomarker, Cardiovascular Diseases, Biological markers, Alzheimer Disease, Case Control Studies, and acute phase
Purpose: The circulating soluble form of intercellular adhesion molecule-1 (sICAM-1) and vascular endothelial growth factor (VEGF) are elevated in women with breast cancer and associated with tumor progression and poor prognosis. This... more
Purpose: The circulating soluble form of intercellular adhesion molecule-1 (sICAM-1) and vascular endothelial growth factor (VEGF) are elevated in women with breast cancer and associated with tumor progression and poor prognosis. This study examined the effects of anthracycline-based chemotherapy on plasma sICAM-1 and VEGF, as well as soluble P-selectin, von Willebrand factor, and interleukin-6 levels. Experimental Design: Twenty-six women diagnosed with stage I–IIIA breast cancer (mean age, 48.4 ± 10.4 years; range, 34–79 years) were studied before (week 1) and at weeks 2 and 3 of cycles 1 and 4 of chemotherapy. Results: The initial effect of chemotherapy was to reduce sICAM-1 levels; compared with pretreatment, sICAM-1 levels were decreased at week 2 of both cycles (P values < 0.01). sICAM-1 levels were elevated, however, at the start of cycle 4 as compared with pretreatment (P < 0.01). Chemotherapy led to an increase in sICAM-1 levels in node-positive but not node-negative ...
Research Interests: Endocrinology, Breast Cancer, Treatment, Chemotherapy, Medicine, and 15 moreHumans, Internal Medicine, Female, Vascular endothelium, Aged, Middle Aged, Adult, Time Factors, Prognosis, Disease Progression, Anthracyclines, Vascular Endothelial Growth Factor, Interleukin, Breast Neoplasms, and Neoplasm metastasis
PURPOSE The purpose of the study is to investigate the cross-sectional and prospective relation between workplace secondhand smoke (SHS) exposure and respiratory symptoms. METHODS Cross-sectional data for workplace SHS exposure and... more
PURPOSE The purpose of the study is to investigate the cross-sectional and prospective relation between workplace secondhand smoke (SHS) exposure and respiratory symptoms. METHODS Cross-sectional data for workplace SHS exposure and respiratory symptoms were collected by using random digit dialing from 7336 never-smoking Hong Kong workers 15 years or older in 1997 to 1998. In the 2000 to 2001 follow-up, 2213 workers who remained never smoking, had the same SHS exposure status, worked at the same job for at least 2 years, and were not exposed to SHS at home at follow-up were included for prospective analysis. RESULTS Cross-sectionally, SHS was associated significantly with frequent colds, cough and phlegm, throat problems, and the presence of any respiratory symptoms with adjusted odds ratios of 1.89 (95% confidence interval [CI], 1.66-2.15), 1.65 (95% CI, 1.35-2.02), 1.88 (95% CI, 1.63-2.15), and 1.96 (95% CI, 1.75-2.20) at baseline, each having significant linear associations with duration of exposure. SHS was not associated with rhinitis. Prospectively, consistent SHS exposure increased the risk for cough and phlegm and any respiratory symptoms by 48% (12% to 97%) and 54% (13% to 109%), respectively. CONCLUSIONS This first non-Western population-based prospective study shows that workplace SHS exposure is associated significantly with frequent respiratory symptoms, both cross-sectionally and prospectively, thus providing strong evidence that the association is causal.
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Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. Once thought to emerge primarily in people with late‐stage disease, these symptoms are currently known to manifest commonly in very early... more
Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. Once thought to emerge primarily in people with late‐stage disease, these symptoms are currently known to manifest commonly in very early disease and in prodromal phases, such as mild cognitive impairment. Despite decades of research, reliable treatments for dementia‐associated NPS have not been found, and those that are in widespread use present notable risks for people using these medications. An Alzheimer's Association Research Roundtable was convened in the spring of 2010 to review what is known about NPS in Alzheimer's disease, to discuss classification and underlying neuropathogenesis and vulnerabilities, and to formulate recommendations for new approaches to tailored therapeutics.
Research Interests: Cognitive Science, Dementia, Magnetic Resonance Imaging, Biological Sciences, Brain Mapping, and 15 moreHumans, Aggression, Default Mode Network, Female, Disease, Depressive Disorder, Apathy, Clinical Sciences, Aged, Cognitive impairment, Human Brain Mapping, Elsevier, Alzheimer Disease, Logistic Models, and Behavioral symptoms
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PurposeThe goal of this study was to examine whether daily increased morning light exposure would maintain or improve sleep and the circadian pattern of relatively more activity in the day and less during the night in women undergoing... more
PurposeThe goal of this study was to examine whether daily increased morning light exposure would maintain or improve sleep and the circadian pattern of relatively more activity in the day and less during the night in women undergoing chemotherapy for breast cancer.Patients and MethodsParticipants were 39 women with newly diagnosed breast cancer, randomized to either 30-mins of daily morning bright white light (BWL) or dim red light (DRL). Sleep/wake was measured objectively for 72-h with wrist actigraphy and subjectively with the Pittsburgh Sleep Quality Index (PSQI) prior to and during chemotherapy cycles 1 and 4. The study was registered with the National Institutes of Health ClinicalTrials.gov (Clinical Trials number: NCT00478257).ResultsResults from actigraphy suggested that compared to the DRL group, women in the BWL group had longer night-time sleep, fewer sleep disturbances during the night, and had fewer and shorter daytime naps at the end of cycle 4 of chemotherapy as well...
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Research Interests: Psychology, Medicine, Biological Sciences, Humans, Epinephrine, and 15 moreFemale, Male, Sleep, Risk factors, Caregivers, Norepinephrine, Polysomnography, Aged, Cardiovascular Diseases, Risk Factors, Cross Sectional Studies, Alzheimer Disease, Catecholamines, Psychology and Cognitive Sciences, and Medical and Health Sciences
Spousal caregivers of Alzheimer's disease patients are at increased risk for cardiovascular disease, possibly via sympathetic response to stressors and subsequent catecholamine surge. Personal mastery (i.e., belief that one can manage... more
Spousal caregivers of Alzheimer's disease patients are at increased risk for cardiovascular disease, possibly via sympathetic response to stressors and subsequent catecholamine surge. Personal mastery (i.e., belief that one can manage life's obstacles) may decrease psychological and physiological response to stressors. This study examines the relationship between mastery and sympathetic arousal in elderly caregivers, as measured by norepinephrine (NE) reactivity to an acute psychological stressor. Cross-sectional. Data were collected by a research nurse in each caregiver's home. Sixty-nine elderly spousal Alzheimer caregivers (mean age: 72.8 years) who were not taking beta-blocking medication. After assessment for mastery and objective caregiving stressors, caregivers underwent an experimental speech task designed to induce sympathetic arousal. Mastery was assessed using Pearlin's Personal Mastery scale and Alzheimer patient functioning was assessed using the Clinica...
Research Interests: Psychology, Medicine, Activities of Daily Living, Humans, Coping, and 15 moreFemale, Male, Psychological Intervention, Psychosocial, Caregivers, Norepinephrine, Clinical Sciences, Aged, Middle Aged, Arousal, Questionnaires, Public health systems and services research, Cross Sectional Studies, Alzheimer Disease, and Psychiatric Status Rating Scales
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Research Interests: Demography, Acculturation, Medicine, California, Population, and 15 moreHumans, Female, Male, Mexican Americans, Clinical Sciences, Prevalence, Middle Aged, Questionnaires, Adult, Ethnic Group, Age Factors, Health surveys, European Continental Ancestry Group, Chi Square Distribution, and Logistic Models
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Research Interests: Psychology, Cognition, Medicine, Biological Sciences, Humans, and 15 moreSleep disorders, Male, Sleep, Actigraphy, Aged, Analysis of Variance, Age Factors, Chi Square Distribution, Organic Chemicals, Cognition disorders, Neuropsychological Tests, Psychology and Cognitive Sciences, Epworth sleepiness scale, Pittsburgh Sleep Quality Index, and Medical and Health Sciences
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Research Interests: Medicine, Independent Living, Humans, Anoxia, United States, and 15 moreSleep disorders, Male, The, Actigraphy, Polysomnography, Aged, Odds ratio, Geriatric Assessment, Cross Sectional Studies, Cohort Studies, Frail elderly, Sleep Disturbance, Pittsburgh Sleep Quality Index, Medical and Health Sciences, and Sleep initiation and maintenance disorders
Research Interests: Medicine, Osteoporosis, Sleep Apnea, Humans, Male, and 15 moreRegression Analysis, Snoring, The, Body Mass Index, Hip Fractures, Polysomnography, Aged, Prevalence, Asian Americans, Retrospective Studies, Age Factors, European Continental Ancestry Group, Cross Sectional Studies, Severity of Illness Index, and Medical and Health Sciences
Research Interests: Medicine, Cardiovascular Risk, Humans, Internal Medicine, Female, and 15 moreMale, Incidence, Body Mass Index, Caregivers, Aged, Chronic Stress, Biological markers, Coefficient of Determination, Cross sectional Study, Cross Sectional Studies, Alzheimer Disease, Enzyme Linked Immunosorbent Assay, Interleukin, Medical and Health Sciences, and Apnea hypopnea index
Research Interests: Medicine, Prospective studies, Humans, Female, Confidence intervals, and 15 moreFollow-up studies, The, Body Mass Index, Risk factors, Questionnaires, Older Women, Sleep-Disordered Breathing, Time Factors, Odds ratio, Risk Factors, Plethysmography, Cross Sectional Studies, Cognition disorders, Psychiatric Status Rating Scales, and Medical and Health Sciences
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symptoms burden, women in the highest quartile of cumulative depressive symptom burden had 19% more MMSE errors over time (95% CI1⁄414%,23%) and 19% worse Trails B score (95%CI1⁄416%,22%). Similarly, those with the highest quartile of... more
symptoms burden, women in the highest quartile of cumulative depressive symptom burden had 19% more MMSE errors over time (95% CI1⁄414%,23%) and 19% worse Trails B score (95%CI1⁄416%,22%). Similarly, those with the highest quartile of cumulative depressive symptom burden had worse scores on most of the Year 20 cognitive tests and a two-fold greater likelihood of developing dementia or MCI (OR1⁄42.0; 95% CI1⁄41.38,2.90). Conclusions: Long-term cumulative depressive symptom burden was independently associated with cognitive decline, worse cognitive scores and greater odds of developing dementia orMCI. Cumulative depressive symptom adversities may increase the risk of cognitive decline and late-life dementia/MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.
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Purpose To examine long-term cognitive effects of chemotherapy and identify predictors among women with breast cancer (WBC). Patients and methods Sixty-nine WBC scheduled to receive chemotherapy, and 64 matched-controls with no cancer,... more
Purpose To examine long-term cognitive effects of chemotherapy and identify predictors among women with breast cancer (WBC). Patients and methods Sixty-nine WBC scheduled to receive chemotherapy, and 64 matched-controls with no cancer, participated. Objective and subjective cognition, total sleep time, nap time, circadian activity rhythms (CAR), sleep quality, fatigue, and depression were measured pre-chemotherapy (Baseline), end of cycle 4 (Cycle-4), and one-year post-chemotherapy (1-Year). Results WBC showed no change in objective cognitive measures from Baseline to Cycle-4 but significantly improved from both time points to 1-Year. Matched-controls showed an increase in test performance at all time points. WBC had significantly higher self-reported cognitive dysfunction at Cycle-4 and 1-Year compared to baseline and compared to matched-controls. Worse neuropsychological functioning was predicted by less robust CARs (i.e., inconsistent 24 h pattern), worse sleep quality, longer na...