The Association of Religious Attendance and Neuropsychiatric Symptoms, Cognition, and Sleep Disturbances in Dementia

Abstract Background Neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances are commonly found in dementia and are indicators of dementia progression (Alzheimer’s Association, 2021; Santacruz Escudero, et al., 2019; Tsunoda, et al., 2020). Given the growing number of older adults with dementia and absence of a cure, it is increasingly important to identify protective factors that may slow progression of dementia, particularly since up to 40% of risk factors are modifiable (Livingston et al., 2020). A growing body of literature supports religion and spirituality as modifiable risk factors for mental and physical health, yet few studies have been conducted in older adults with dementia (Koenig et al., 2012; VanderWeele et al., 2017). Method We analyzed data from the Health and Retirement Study in 2000, 2006, and 2008 and sub‐study, Aging Demographics, and Memory Study in 2001‐2003, 2006‐2007, and 2008‐2009 to examine the association of religious attendance with neuropsychiatric symptoms, cognitive function, and sleep disturbances among older adults in the U.S. ( N = 72) age 70 years and older with dementia. A cross‐sectional analysis using Spearman’s partial Rho correlation was utilized to determine associations beyond social interaction. Result Aged 73‐100 years, participants had a mean age of 84.23 (5.73) years, mean cognitive function (Clinical Dementia Rating)(Hughes et al., 1982; Morris, 1993) of 1.17(.53), were 35.5% male, and 64.5% female. Significant associations were found for reported religious attendance and caregiver‐reported NPS using the Neuropsychiatric Inventory (Cummings et al., 1994; Kaufer et al., 1998) (r s (97) = ‐ .124, 95% CI [‐.129, ‐.119], p<.0005), cognitive function as measured by CDR, r s (97) = ‐ .018, 95% CI [‐.023, ‐.013], p<.001), and caregiver reported sleep disturbance captured by 3 yes/no items (Jelicic et al., 2002; Moon et al., 2017), r s (97) = ‐ .275, 95% CI [‐.280, ‐.271], p<.0005). Increased religious attendance was associated with lower NPS, better cognitive function, and fewer sleep disturbances beyond adjusting for social interaction. Conclusion Longitudinal studies and clinical trials in large, diverse samples are warranted to further examine the relationship between religion and spirituality, and dementia progression.