Greater Cognitive Deficits with Sleep-Disordered Breathing Among Individuals with Genetic Susceptibility to Alzheimer Disease: The Multi-Ethnic Study of Atherosclerosis

Details

• Personal Author:
  Charles LE ; Djonlagic I ; Fitzpatrick AL ; Johnson DA ; Lane J ; O'Hara R ; Rapp SR ; Redline S ; Reid M ; Saxena R ; Wang R
• Description:
  Rationale: There are conflicting findings regarding the link between sleep apnea and cognitive dysfunction. Objective: Investigate associations between indicators of sleep-disordered breathing (SDB) and cognitive function in the Multi-Ethnic Study of Atherosclerosis and assess effect modification by the apolipoprotein epsilon-4 (APOE-epsilon4) allele. Methods: A diverse population (N=1,752) underwent Type 2 in-home polysomnography, which included measurement of % sleep time <90% oxyhemoglobin saturation (%Sat<90%) and apnea-hypopnea index (AHI). Epworth Sleepiness Scale score (ESS) and sleep apnea syndrome (SAS; AHI > 5 and ESS> 10) were also analyzed. Cognitive outcomes included the Cognitive Abilities Screening Instrument (CASI); Digit Symbol Coding Test (DSC); and Digit Span Tests (DST) Forward and Backward. Results: Participants were 45.4% male, age 68.1(standard deviation: 9.1) years with a median AHI=9.0 and mean ESS=6.0. Approximately, 9.7% had SAS and 26.8% had at least one copy of the APOepsilon-4 allele. In adjusted analyses, a one standard deviation increase in %Sat<90% and ESS score were associated with a poorer attention and memory assessed by the DST Forward score (β=-0.12 (standard error: 0.06) and β=-0.13 (0.06), respectively; P<0.05). SAS and higher ESS scores were also associated with poorer attention and processing speed as measured by the DSC, β=-0.69 (0.35) and β=-1.42 (0.35), respectively (P<0.05). The presence of APOE-epsilon4 allele modified the associations of %Sat<90% with DST forward and of ESS with DSCT, Pinteraction<0.05. Conclusions: Overnight hypoxemia and sleepiness were associated with cognition. The average effect estimates were small, similar to effects estimated for several other individual dementia risk factors. Associations were strongest in APOE-epsilon4 risk allele carriers. Our results: 1) suggest that SDB be considered among a group of modifiable dementia risk factors; and 2) highlight the potential vulnerability of APOE-epsilon4 risk allele carriers with SDB. [Description provided by NIOSH]
• Subjects:
  Genetics Lung Lung Diseases Nervous System Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Apolipoprotein E-4 Author Keywords: Sleep Apnea Cognition Cognitive Function Genes Genetic Predisposition Hypoxemia Hypoxia Oxygen Deprivation Population Based Studies Sleep Apnea Sleepiness

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• ISSN:
  2329-6933
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Massachusetts ; North Carolina ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 9 ; Washington ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  14
• Issue:
  11
• NIOSHTIC Number:
  nn:20050114
• Citation:
  Ann Am Thorac Soc 2017 Nov; 14(11):1697-1705
• Contact Point Address:
  Dayna A Johnson, Harvard Medical School, Sleep Medicine, 221 Longwood Ave. BLI 225, Boston, Massachusetts, 02115 United States
• Email:
  djohnson@research.bwh.harvard.edu
• Federal Fiscal Year:
  2018
• Peer Reviewed:
  True
• Source Full Name:
  Annals of the American Thoracic Society
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ed77b46991b0c409dc6c34df5361ab300fd4ef507a86eee6eb2e76559ddc750e81c962dc39d961e8215832882555fb8066a1ef3143cc98c1a0bac2ddfe91b9ef
• Download URL:
  https://stacks.cdc.gov/view/cdc/210603/cdc_210603_DS1.pdf
• File Type:
  [PDF - 544.75 KB ]