RT Journal Article
SR Electronic
T1 Sleep-disordered breathing advances cognitive decline in the elderly
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1964
OP 1971
DO 10.1212/WNL.0000000000001566
VO 84
IS 19
A1 Ricardo S. Osorio
A1 Tyler Gumb
A1 Elizabeth Pirraglia
A1 Andrew W. Varga
A1 Shou-en Lu
A1 Jason Lim
A1 Margaret E. Wohlleber
A1 Emma L. Ducca
A1 Viachaslau Koushyk
A1 Lidia Glodzik
A1 Lisa Mosconi
A1 Indu Ayappa
A1 David M. Rapoport
A1 Mony J. de Leon
A1 For the Alzheimer's Disease Neuroimaging Initiative
YR 2015
UL http://n.neurology.org/content/84/19/1964.abstract
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