PT - JOURNAL ARTICLE AU - Ricardo S. Osorio AU - Tyler Gumb AU - Elizabeth Pirraglia AU - Andrew W. Varga AU - Shou-en Lu AU - Jason Lim AU - Margaret E. Wohlleber AU - Emma L. Ducca AU - Viachaslau Koushyk AU - Lidia Glodzik AU - Lisa Mosconi AU - Indu Ayappa AU - David M. Rapoport AU - Mony J. de Leon AU - For the Alzheimer's Disease Neuroimaging Initiative TI - Sleep-disordered breathing advances cognitive decline in the elderly AID - 10.1212/WNL.0000000000001566 DP - 2015 May 12 TA - Neurology PG - 1964--1971 VI - 84 IP - 19 4099 - http://n.neurology.org/content/84/19/1964.short 4100 - http://n.neurology.org/content/84/19/1964.full SO - Neurology2015 May 12; 84 AB - Objective: To examine whether the presence of sleep-disordered breathing (SDB) is associated with an earlier age at mild cognitive impairment (MCI) or Alzheimer disease (AD)-dementia onset in participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. We also examined whether continuous positive airway pressure (CPAP) use is associated with delayed onset of cognitive decline.Methods: From the ADNI cohort, 3 subsets with progressively stringent criteria were created in a step-wise manner. Age at MCI or AD-dementia onset was the main outcome variable. Analyses were performed separately for each subset in untreated SDB+ vs SDB− and untreated SDB+ vs CPAP+ groups. Chi-square and t tests were performed to examine between-group differences. Survival analyses were performed using the Kaplan–Meier method, compared by the log-rank test, and assessed by multivariate Cox regression adjusting for potential confounders.Results: SDB+ patients had a younger age at MCI onset in all subsets (MC1: 72.63 vs 83.67; MC2: 72.15 vs 83.45; MC3: 77.40 vs 89.89; p < 0.01). SDB+ patients had a younger age at AD-dementia onset only in our most conservative subset (AC3: 83.46 vs 88.13; p < 0.05). In a combined outcome analysis, SDB+ patients had a younger age at onset to MCI or AD-dementia in all subsets. In subsets 1 and 2, CPAP use delayed the age at MCI onset (CMC1: 72.63 vs 82.10; CMC2: 72.11 vs 82.10; p < 0.01).Conclusions: Consistent with our hypothesis, the presence of SDB was associated with an earlier age at cognitive decline. Our findings in CPAP+ participants suggest that CPAP treatment of SDB may delay progression of cognitive impairment.AD=Alzheimer disease; ADNI=Alzheimer's Disease Neuroimaging Initiative; BMI=body mass index; CPAP=continuous positive airway pressure; MCI=mild cognitive impairment; NL=cognitively normal; SDB=sleep-disordered breathing