Dataset Information

Association of ?-Amyloid Burden With Sleep Dysfunction and Cognitive Impairment in Elderly Individuals With Cognitive Disorders.

ABSTRACT: 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?

SUBMITTER: You JC

PROVIDER: S-EPMC6806437 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Association of β-Amyloid Burden With Sleep Dysfunction and Cognitive Impairment in Elderly Individuals With Cognitive Disorders.

You Jason C JC Jones Erica E Cross Devon E DE Lyon Abigail C AC Kang Hyunseung H Newberg Andrew B AB Lippa Carol F CF

JAMA network open 20191002 10

<h4>Importance</h4>Evidence shows that sleep dysfunction and β-amyloid (Aβ) deposition work synergistically to impair brain function in individuals with normal cognition, increasing the risk of developing dementia later in life. However, whether Aβ continues to play an integral role in sleep dysfunction after the onset of cognitive decline in individuals with dementia is unclear.<h4>Objective</h4>To determine whether Aβ deposition in the brain is associated with subjective measures of sleep qual ...[more]

PMID: 31617927

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Project description:Importance:Identifying asymptomatic individuals at high risk of impending cognitive decline because of Alzheimer disease is crucial for successful prevention of dementia. Vascular risk and ?-amyloid (A?) pathology commonly co-occur in older adults and are significant causes of cognitive impairment. Objective:To determine whether vascular risk and A? burden act additively or synergistically to promote cognitive decline in clinically normal older adults; and, secondarily, to evaluate the unique influence of vascular risk on prospective cognitive decline beyond that of commonly used imaging biomarkers, including A? burden, hippocampal volume, fludeoxyglucose F18-labeled (FDG) positron emission tomography (PET), and white matter hyperintensities, a marker of cerebrovascular disease. Design, Setting, and Participants:In this longitudinal observational study, we examined clinically normal older adults from the Harvard Aging Brain Study. Participants were required to have baseline imaging data (FDG-PET, A?-PET, and magnetic resonance imaging), baseline medical data to quantify vascular risk, and at least 1 follow-up neuropsychological visit. Data collection began in 2010 and is ongoing. Data analysis was performed on data collected between 2010 and 2017. Main Outcomes and Measures:Vascular risk was quantified using the Framingham Heart Study general cardiovascular disease (FHS-CVD) risk score. We measured A? burden with Pittsburgh Compound-B PET. Cognition was measured annually with the Preclinical Alzheimer Cognitive Composite. Models were corrected for baseline age, sex, years of education, and apolipoprotein E ?4 status. Results:Of the 223 participants, 130 (58.3%) were women. The mean (SD) age was 73.7 (6.0) years, and the mean (SD) follow-up time was 3.7 (1.2) years. Faster cognitive decline was associated with both a higher FHS-CVD risk score (??=?-0.064; 95% CI, -0.094 to -0.033; P?<?.001) and higher A? burden (??=?-0.058; 95% CI, -0.079 to -0.037; P?<?.001). The interaction of the FHS-CVD risk score and A? burden with time was significant (??=?-0.040, 95% CI, -0.062 to -0.018; P?<?.001), suggesting a synergistic effect. The FHS-CVD risk score remained robustly associated with prospective cognitive decline (??=?-0.055; 95% CI, -0.086 to -0.024; P?<?.001), even after adjustment for A? burden, hippocampal volume, FDG-PET uptake, and white matter hyperintensities. Conclusions and Relevance:In this study, vascular risk was associated with prospective cognitive decline in clinically normal older adults, both alone and synergistically with A? burden. Vascular risk may complement imaging biomarkers in assessing risk of prospective cognitive decline in preclinical Alzheimer disease.

Dataset Information

Association of ?-Amyloid Burden With Sleep Dysfunction and Cognitive Impairment in Elderly Individuals With Cognitive Disorders.

Publications

Association of β-Amyloid Burden With Sleep Dysfunction and Cognitive Impairment in Elderly Individuals With Cognitive Disorders.

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