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medRxiv PreprintsInternational8 November 2026

Repeated sleep-medication reporting patterns and cognitive change in HRS and SHARE

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Background: Self-reported sleep-medication use has been inconsistently linked to cognitive decline, largely because sleep disturbances, affective symptoms, and treatment transitions co-evolve over time. Moreover, whether repeated sleep-medication reports across consecutive survey waves follow a monotonic dose-response gradient with subsequent cognitive aging remains unclear. We evaluated baseline, two-wave, and three-wave longitudinal patterns of sleep-medication reporting in relation to cognitive trajectories across two large aging cohorts in the United States and Europe. Methods: We analyzed
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