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Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.

ABSTRACT: Sleep breathing disorder (SBD) may be an important factor in age-related cognitive decline. In a cohort of healthy elderly subjects, we performed an 8-y longitudinal study to assess whether changes in cognitive function occur in untreated elderly patients with SBD and without dementia and the factors implicated in these changes.A population-based longitudinal study.Clinical research settings.A total of 559 participants of the PROOF study aged 67 y at the study entry and free from neurological disorders were examined.N/A.Abnormal breathing events were defined by an apnea-hypopnea index (AHI) > 15. The raw cognitive data and averaged Z-scores for the attentional, executive, and memory functions were collected at the baseline and follow-up. At baseline, AHI > 15 was found in 54% of subjects with 18% having an AHI > 30. At follow-up, the presence of abnormal breathing events was associated with a slight but significant decline in the attentional domain (P = 0.01), which was more evident in the subjects with an AHI > 30 (P = 0.004). No significant changes over time were observed in the executive and memory functions. Several indices of chronic hypoxemia, defined either as a cumulative peripheral oxygen saturation (SpO2) < 90% or a minimal SpO2, accounted for portions of the variance in the decline in attention. All observed effects were small, accounting for 4-7% of variance in multivariate models.In healthy elderly subjects, various components of sleep breathing disorder at baseline were associated with small changes in selected cognitive functions specific to the attention domain after controlling for multiple comorbidities, such as sleepiness, hypertension, diabetes, anxiety, and depression.ClinicalTrials.gov identifiers NCT 00759304 and NCT 00766584.

SUBMITTER: Martin MS

PROVIDER: S-EPMC4288598 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.

Martin Magali Saint MS Sforza Emilia E Roche Frédéric F Barthélémy Jean Claude JC Thomas-Anterion Catherine C

Sleep 20150201 2

<h4>Study objectives</h4>Sleep breathing disorder (SBD) may be an important factor in age-related cognitive decline. In a cohort of healthy elderly subjects, we performed an 8-y longitudinal study to assess whether changes in cognitive function occur in untreated elderly patients with SBD and without dementia and the factors implicated in these changes.<h4>Design</h4>A population-based longitudinal study.<h4>Setting</h4>Clinical research settings.<h4>Participants</h4>A total of 559 participants ...[more]

PMID: 25325480

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Project description:Importance:Evidence shows that sleep dysfunction and ?-amyloid (A?) deposition work synergistically to impair brain function in individuals with normal cognition, increasing the risk of developing dementia later in life. However, whether A? continues to play an integral role in sleep dysfunction after the onset of cognitive decline in individuals with dementia is unclear. Objective:To determine whether A? deposition in the brain is associated with subjective measures of sleep quality and cognition in elderly individuals with cognitive disorders. Design, Setting, and Participants:A nested survey study was conducted at the Cognitive Disorders and Comprehensive Alzheimer Disease Center of Thomas Jefferson University Hospital in Philadelphia, Pennsylvania. Participants included patients aged 65 years and older with cognitive disorders verified by neuropsychological testing. Eligible participants were identified from a referral center-based sample of patients who underwent fluorine 18-labeled florbetaben positron emission tomography imaging at Thomas Jefferson University Hospital as part of the multicenter Imaging Dementia-Evidence for Amyloid Scanning study. Data collection and analysis occurred between November 2018 and March 2019. Main Outcomes and Measures:Sleep quality was measured via responses to sleep questionnaires, A? deposition was measured via fluorine 18-labeled florbetaben positron emission tomography, and cognition was measured via Mini-Mental State Examination (MMSE) performance. Results:Of the 67 eligible participants, 52 (77.6%) gave informed consent to participate in the study. Of the 52 enrolled participants (mean [SD] age, 76.6 [7.4] years), 27 (51.9%) were women. Daytime sleepiness was associated with A? deposition in the brainstem (B?=?0.0063; 95% CI, 0.001 to 0.012; P?=?.02), but not MMSE performance (B?=?-0.01; 95% CI, -0.39 to 0.37; P?=?.96). The number of nocturnal awakenings was associated with A? deposition in the precuneus (B?=?0.11; 95% CI, 0.06 to 0.17; P?<?.001) and poor MMSE performance (B?=?-2.13; 95% CI, -3.13 to -1.13; P?<?.001). Mediation analysis demonstrated an indirect association between A? deposition and poor MMSE performance that relied on nocturnal awakenings as an intermediary (B?=?-3.99; 95% CI, -7.88 to -0.83; P?=?.01). Conclusions and Relevance:Nighttime sleep disruption may mediate the association between A? and cognitive impairment, suggesting that there is an underlying sleep-dependent mechanism that links A? burden in the brain to cognitive decline. Further elucidation of this mechanism may improve understanding of disease processes associated with A? accumulation.

Dataset Information

Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.

Publications

Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.

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