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To examine sex-specific associations of sleep duration and napping self-reported at mean age of 69 years (range: 53–81) with risk of incident dementia 24 years later at age 90 +. Analytic sample included individuals from a population-based study who reported sleep and napping once in the 1980s and 24 years later (range: 16–38) joinedThe 90+ Studyand were evaluated in-person. Those without dementia at baseline ofThe 90+ Studywere prospectively followed. Hazard ratios [HR] and 95% confidence intervals [CI] of dementia risk were estimated by Cox regression. Of 574 participants 71% were women, mean age at start of dementia follow-up withThe 90+ Studywas 93 years (range: 90–102). After 3.3 years (range: 0.4–13.8) of follow-up 47% developed dementia. Higher risk of dementia at age 90+ was seen in women with &lt;6 hours of self-reported sleep per night (adjusted HR = 2.00; 95% CI = 1.15–3.50;  p  = .01) compared with 8 hours. Lower risk of dementia at 90+ was seen in men with short-to-moderate (&lt;60 minutes) self-reported naps compared with no naps (HR = 0.33; 95% CI = 0.18–0.63;  p  &lt; .01). Sleep and nap 24 years earlier are important risk factors for dementia after age 90.

Self-reported sleep in relation to risk of dementia a quarter of a century later at age 90+: The 90+ Study