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Xiang W, Shen Y, Chen S, Tan H, Cao Q, Xu L. Causal relationship between sleep disorders and the risk of Alzheimer's disease: A Mendelian randomization study. Sleep Med 2024; 120:34-43. [PMID: 38865787 DOI: 10.1016/j.sleep.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Epidemiological studies have shown that sleep disorders are risk factors for Alzheimer's disease (AD), but the causal relationship between sleep disorders and AD risk is unknown. We aim to assess the potential genetic causal association between sleep characteristics and AD, which may contribute to early identification and prediction of risk factors for AD. METHODS Seven sleep-related traits and the outcome phenotype AD were selected from published genome-wide association studies (GWASs). These sleep-related characteristics and instrumental variables (IVs) for AD were extracted. Two-sample and multivariate Mendelian randomization (MR) analyses were performed to assess the causal relationships between sleep characteristics and AD. The inverse variance weighted (IVW), weighted median (WME), weighted mode (WM), MR-Egger regression (MR-Egger) and simple mode (SM) models were used to evaluate causality. The existence of pleiotropy was detected and corrected by MR-Egger regression, MR pleiotropy residuals and outliers. RESULTS A two-sample MR study revealed a positive causal association between sleep duration and the onset of AD (OR = 1.002, 95 % CI: 1.000-1.004), and the risk of AD increased with increasing sleep duration. The MR-Egger regression method and MR-PRESSO were used to identify and correct pleiotropy, indicating that there was no horizontal pleiotropy. Heterogeneity was evaluated by Cochran's Q, which indicated no heterogeneity. In a multivariate MR study with seven sleep characteristics corrected for each other, we found that sleep duration remained causally associated with AD (OR = 1.004, 95 % CI: 1.000-1.007). Moreover, we found that after mutual correction, daytime napping had a causal relationship with the onset of AD, and daytime napping may reduce the risk of AD (OR = 0.995, 95 % CI: 0.991-1.000). CONCLUSION This study is helpful for the early identification and prediction of risk factors for AD, long sleep durations are a risk factor for AD, and daytime napping can reduce the risk of AD.
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Affiliation(s)
- Wenwen Xiang
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Yu Shen
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Shenjian Chen
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Huadong Tan
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, China Three Gorges University, Yichang, China
| | - Qian Cao
- Department of Neurology, Saarland University, Homburg, Germany
| | - Lijun Xu
- Department of Neurology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
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Kim RT, Zhou L, Li Y, Krieger AC, Nordvig AS, Butler T, de Leon MJ, Chiang GC. Impaired sleep is associated with tau deposition on 18F-flortaucipir PET and accelerated cognitive decline, accounting for medications that affect sleep. J Neurol Sci 2024; 458:122927. [PMID: 38341949 PMCID: PMC10947806 DOI: 10.1016/j.jns.2024.122927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/06/2024] [Accepted: 02/06/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Impaired sleep is commonly associated with Alzheimer's disease (AD), although the underlying mechanisms remain unclear. Furthermore, the moderating effects of sleep-affecting medications, which have been linked to AD pathology, are incompletely characterized. Using data from the Alzheimer's Disease Neuroimaging Initiative, we investigated whether a medical history of impaired sleep, informant-reported nighttime behaviors, and sleep-affecting medications are associated with beta-amyloid and tau deposition on PET and cognitive change, cross-sectionally and longitudinally. METHODS We included 964 subjects with 18F-florbetapir PET scans. Measures of sleep impairment and medication use were obtained from medical histories and the Neuropsychiatric Inventory Questionnaire. Multivariate models, adjusted for covariates, were used to assess associations among sleep-related features, beta-amyloid and tau, and cognition. Cortical tau deposition, categorized by Braak stage, was assessed using the standardized uptake value peak alignment (SUVP) method on 18F-flortaucipir PET. RESULTS Medical history of sleep impairment was associated with greater baseline tau in the meta-temporal, Braak 1, and Braak 4 regions (p = 0.04, p < 0.001, p = 0.025, respectively). Abnormal nighttime behaviors were also associated with greater baseline tau in the meta-temporal region (p = 0.024), and greater cognitive impairment, cross-sectionally (p = 0.007) and longitudinally (p < 0.001). Impaired sleep was not associated with baseline beta-amyloid (p > 0.05). Short-term use of selective serotonin reuptake inhibitors and benzodiazepines slightly weakened the sleep-tau relationship. CONCLUSIONS Sleep impairment was associated with tauopathy and cognitive decline, which could be linked to increased tau secretion from neuronal hyperactivity. Clinically, our results help identify high-risk individuals who could benefit from sleep-related interventions aimed to delay cognitive decline and AD.
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Affiliation(s)
- Ryan T Kim
- From the Department of Stem Cell and Regenerative Biology, Harvard University, Bauer-Sherman Fairchild Complex 7 Divinity Avenue, Cambridge, MA 02138, United States of America.
| | - Liangdong Zhou
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Yi Li
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Ana C Krieger
- From the Departments of Medicine and Neurology, Division of Sleep Neurology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 425 E 61st St., 5th Floor, New York, NY 10065, United States of America.
| | - Anna S Nordvig
- From the Department of Neurology, Alzheimer's Disease and Memory Disorders Program, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 428 East 72(nd) Street Suite 500, New York, NY 10021, United States of America.
| | - Tracy Butler
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Mony J de Leon
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America.
| | - Gloria C Chiang
- From the Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 407 E 61(st) Street, New York, NY 10065, United States of America; From the Department of Radiology, Division of Neuroradiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 525 East 68th Street, Starr Pavilion, Box 141, New York, NY 10065, United States of America.
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Wei J, Wang M, Guo Y, Liu Y, Dong X. Sleep structure assessed by objective measurement in patients with mild cognitive impairment: A meta-analysis. Sleep Med 2024; 113:397-405. [PMID: 38134714 DOI: 10.1016/j.sleep.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES A meta-analysis was used to explore the characteristic changes in objective sleep structure of patients with mild cognitive impairment (MCI) compared with cognitively healthy older adults. MATERIALS AND METHODS PubMed, EMBAS, Cochrane Library, Scopus, and Web of Science were searched until November 2023. A literature quality evaluation was performed according to the Newcastle-Ottawa Scale, and a meta-analysis was performed by RevMan 5.3 software. RESULTS Fifteen studies with 771 participants were finally included. Compared with normal control groups, patients with MCI had a decreased total sleep time by 34.44 min, reduction in sleep efficiency by 7.96 %, increased waking after sleep onset by 19.61 min, and increased sleep latency by 6.97 min. Ten included studies showed that the patients with MCI had increased N1 sleep by 2.72 % and decreased N3 sleep by 0.78 %; however, there was no significant difference between the MCI and control groups in percentage of N2 sleep. Moreover, Twelve included studies reported the MCI groups had shorter REM sleep of 2.69 %. CONCLUSION Our results provide evidence of abnormal sleep architecture in patients with MCI. As a "plastic state," abnormal sleep architecture may be a promising therapeutic target for slowing cognitive decline and dementia prevention.
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Affiliation(s)
- Jianing Wei
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Min Wang
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuanli Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaofang Dong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
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Kamal F, Morrison C, Dadar M. Investigating the relationship between sleep disturbances and white matter hyperintensities in older adults on the Alzheimer's disease spectrum. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12553. [PMID: 38476639 PMCID: PMC10927930 DOI: 10.1002/dad2.12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/15/2023] [Accepted: 01/19/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION While studies report that sleep disturbance can have negative effects on brain vasculature, its impact on cerebrovascular diseases such as white matter hyperintensities (WMHs) in beta-amyloid-positive older adults remains unexplored. METHODS Sleep disturbance, WMH burden, and cognition in normal controls (NCs), and individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD), were examined at baseline and longitudinally. A total of 912 amyloid-positive participants were included (198 NC, 504 MCI, and 210 AD). RESULTS Individuals with AD reported more sleep disturbances than NC and MCI participants. Those with sleep disturbances had more WMHs than those without sleep disturbances in the AD group. Mediation analysis revealed an effect of regional WMH burden on the relationship between sleep disturbance and future cognition. DISCUSSION These results suggest that WMH burden and sleep disturbance increase from aging to AD. Sleep disturbance decreases cognition through increases in WMH burden. Improved sleep could mitigate the impact of WMH accumulation and cognitive decline.
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Affiliation(s)
- Farooq Kamal
- Department of PsychiatryMcGill UniversityMontrealQuebecCanada
- Douglas Mental Health University InstituteMontrealQuebecCanada
| | | | - Mahsa Dadar
- Department of PsychiatryMcGill UniversityMontrealQuebecCanada
- Douglas Mental Health University InstituteMontrealQuebecCanada
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Wang Q, Xu S, Liu F, Liu Y, Chen K, Huang L, Xu F, Liu Y. Causal relationship between sleep traits and cognitive impairment: A Mendelian randomization study. J Evid Based Med 2023; 16:485-494. [PMID: 38108111 DOI: 10.1111/jebm.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Observational studies had demonstrated a link between sleep disturbances and cognitive decline. Here, we aimed to investigate the causal association between genetically predicted sleep traits and cognitive impairment using Mendelian randomization (MR). METHODS Using strict criteria, we selected genetic variants from European ancestry Genome-wide association studies (GWAS) from the Sleep Disorders Knowledge Portal and UK Biobank as instrumental variables for several sleep traits, including insomnia, sleep duration, daytime sleepiness, daytime napping, and chronotype. Summary statistics related to cognitive impairment were derived from five different GWAS, including the Social Science Genetic Association Consortium. The role of self-reported sleep trait phenotypes in the etiology of cognitive impairment was explored using inverse-variance weighted (IVW) tests, MR-Egger tests, and weighted medians, and sensitivity analyses were conducted to ensure robustness. RESULTS In the main IVW analysis, sleep duration (reaction time: β = -0.05, 95% CI -0.07 to -0.04, p = 1.93×10-12 ), daytime sleepiness (average cortical thickness: β = -0.12, 95% CI -0.22 to -0.02, p = 0.023), and daytime napping (fluid intelligence: β = -0.47, 95% CI -0.87 to -0.07, p = 0.021; hippocampal volume in Alzheimer's disease: β = -0.99, 95% CI -1.64 to -0.35, p = 0.002) were significantly negatively correlated with cognitive performance. However, any effects of insomnia and chronotype on cognitive impairment were not determined. CONCLUSIONS Our findings highlighted that focusing on sleep behaviors or distinct sleep patterns-particularly sleep duration, daytime sleepiness, and daytime napping, was a promising approach for preventing cognitive impairment. This study also shed light on risk factors for and potential early markers of cognitive impairment risk factors.
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Affiliation(s)
- Qing Wang
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shihan Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fenglan Liu
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yanfei Liu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Keji Chen
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Luqi Huang
- China Evidence-based Medicine Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengqin Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Liu
- National Clinical Research Center for Traditional Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Kim H, Zhu X, Zhao Y, Bell SA, Gehrman PR, Cohen D, Devanand DP, Goldberg TE, Lee S. Resting-state functional connectivity changes in older adults with sleep disturbance and the role of amyloid burden. Mol Psychiatry 2023; 28:4399-4406. [PMID: 37596355 PMCID: PMC10842478 DOI: 10.1038/s41380-023-02214-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/19/2023] [Accepted: 08/02/2023] [Indexed: 08/20/2023]
Abstract
Sleep and related disorders could lead to changes in various brain networks, but little is known about the role of amyloid β (Aβ) burden-a key Alzheimer's disease (AD) biomarker-in the relationship between sleep disturbance and altered resting state functional connectivity (rsFC) in older adults. This cross-sectional study examined the association between sleep disturbance, Aβ burden, and rsFC using a large-scale dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Sample included 489 individuals (53.6% cognitively normal, 32.5% mild cognitive impairment, and 13.9% AD) who had completed sleep measures (Neuropsychiatric Inventory), PET Aβ data, and resting-state fMRI scans at baseline. Within and between rsFC of the Salience (SN), the Default Mode (DMN) and the Frontal Parietal network (FPN) were compared between participants with sleep disturbance versus without sleep disturbance. The interaction between Aβ positivity and sleep disturbance was evaluated using the linear regressions, controlling for age, diagnosis status, gender, sedatives and hypnotics use, and hypertension. Although no significant main effect of sleep disturbance was found on rsFC, a significant interaction term emerged between sleep disturbance and Aβ burden on rsFC of SN (β = 0.11, P = 0.006). Specifically, sleep disturbance was associated with SN hyperconnectivity, only with the presence of Aβ burden. Sleep disturbance may lead to altered connectivity in the SN when Aβ is accumulated in the brain. Individuals with AD pathology may be at increased risk for sleep-related aberrant rsFC; therefore, identifying and treating sleep problems in these individuals may help prevent further disease progression.
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Affiliation(s)
- Hyun Kim
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA.
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Division of Anxiety, Mood, Eating, and Related Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Yiming Zhao
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sophie A Bell
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Daniel Cohen
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA
| | - D P Devanand
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Terry E Goldberg
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA
- Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Area Brain Aging and Mental Health, New York State Psychiatric Institute, New York, NY, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
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Kamal F, Morrison C, Dadar M. Investigating the relationship between sleep disturbances and white matter hyperintensities in older adults on the Alzheimer's disease spectrum. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.13.23288544. [PMID: 37131746 PMCID: PMC10153314 DOI: 10.1101/2023.04.13.23288544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background While studies report that sleep disturbance can have negative effects on brain vasculature, its impact on cerebrovascular disease such as white matter hyperintensities (WMHs) in beta-amyloid positive older adults remains unexplored. Methods Linear regressions, mixed effects models, and mediation analysis examined the crosssectional and longitudinal associations between sleep disturbance, cognition, and WMH burden, and cognition in normal controls (NCs), mild cognitive impairment (MCI), and Alzheimer's disease (AD) at baseline and longitudinally. Results People with AD reported more sleep disturbance than NC and MCI. AD with sleep disturbance had more WMHs than AD without sleep disturbances. Mediation analysis revealed an effect of regional WMH burden on the relationship between sleep disturbance and future cognition. Conclusion These results suggest that WMH burden and sleep disturbance increases from aging to AD. Sleep disturbance decreases cognition through increases in WMH burden. Improved sleep could mitigate the impact of WMH accumulation and cognitive decline.
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Affiliation(s)
- Farooq Kamal
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, H4H 1R3, Canada
| | - Cassandra Morrison
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 2B4, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, H3A 2B4, Canada
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, H4H 1R3, Canada
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Kim H, Zhu X, Zhao Y, Bell S, Gehrman P, Cohen D, Devanand D, Goldberg T, Lee S. Resting-State Functional Connectivity Changes in Older Adults with Sleep Disturbance and the Role of Amyloid Burden. RESEARCH SQUARE 2023:rs.3.rs-2547880. [PMID: 36798352 PMCID: PMC9934741 DOI: 10.21203/rs.3.rs-2547880/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Sleep and related disorders could lead to changes in various brain networks, but little is known about the role of amyloid β (Aβ) burden-a key Alzheimer's disease (AD) biomarker-in the relationship between sleep disturbance and altered resting state functional connectivity (rsFC) in older adults. This cross-sectional study examined the association between sleep disturbance, Aβ burden, and rsFC using a large-scale dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Sample included 489 individuals (53.6% cognitively normal, 32.5% mild cognitive impairment, and 13.9% AD) who had completed sleep measures (Neuropsychiatric Inventory), PET Aβ data, and resting-state fMRI scans at baseline. Within and between rsFC of the Salience (SN), the Default Mode (DMN) and the Frontal Parietal network (FPN) were compared between participants with sleep disturbance versus without sleep disturbance. The interaction between Aβ positivity and sleep disturbance was evaluated using linear regressions, controlling for age, diagnosis status, gender, sedatives and hypnotics use, and hypertension. Although no significant main effect of sleep disturbance was found on rsFC, a significant interaction term emerged between sleep disturbance and Aβ burden on rsFC of SN (β=0.11, P=0.006). Specifically, sleep disturbance was associated with SN hyperconnectivity, only with the presence of Aβ burden. Sleep disturbance may lead to altered connectivity in the SN when Aβ is accumulated in the brain. Individuals with AD pathology may be at increased risk for sleep-related aberrant rsFC; therefore, identifying and treating sleep problems in these individuals may help prevent further disease progression.
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Affiliation(s)
| | - Xi Zhu
- Columbia University Medical Center
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Gallagher VT, Reilly SE, Williams IC, Mattos M, Manning C. Patterns of sleep disturbances across stages of cognitive decline. Int J Geriatr Psychiatry 2023; 38:e5865. [PMID: 36578203 PMCID: PMC10107468 DOI: 10.1002/gps.5865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate insomnia symptoms and excessive sleep/sluggishness across stages of cognitive decline (cognitively normal [CN], Cognitively Impairment, Not Demented [CIND], dementia) in a large, racially/ethnically diverse sample of older adults (70+) in the US. We also examined whether sleep disturbances at baseline predicted conversion to CIND or dementia at follow-up. METHODS In this secondary analysis of the Aging, Demographics, and Memory Study (ADAMS) supplement of the Health Retirement Study, we analyzed patterns of informant-reported insomnia and excessive sleep symptoms among three groups of older adults (n = 846): CN, CIND, and dementia. RESULTS CIND adults were significantly more likely to have informant-reported insomnia symptoms than those in the CN group (p = 0.013). This was driven by a significant race/ethnicity-by-insomnia interaction with diagnostic status (p = 0.029), such that CIND Black and Hispanic older adults had increased insomnia symptom rates compared to CN, whereas White adults had similar insomnia symptoms across diagnostic status. Across all racial/ethnic groups, the prevalence of excessive sleep symptoms increased stepwise from CN to CIND to dementia (p < 0.001). Overall, insomnia symptoms at baseline predicted conversion from CN to CIND (p < 0.001, OR = 0.288; 95% CI: 0.143-0.580) at 4-year (approximate) follow-up; there was no relationship between baseline insomnia or excessive sleep/sluggishness symptoms and conversion from CIND to dementia. DISCUSSION/CONCLUSION This study provides evidence for the increased risk of insomnia symptoms among Hispanic and Black older adults with CIND, and indicates that insomnia symptoms may be associated with increased risk for development of cognitive impairment.
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Affiliation(s)
| | - Shannon E. Reilly
- Department of NeurologyUniversity of Virginia HealthCharlottesvilleVirginiaUSA
| | | | - Meghan Mattos
- School of NursingUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Carol Manning
- Department of NeurologyUniversity of Virginia HealthCharlottesvilleVirginiaUSA
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Casagrande M, Forte G, Favieri F, Corbo I. Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148457. [PMID: 35886309 PMCID: PMC9325170 DOI: 10.3390/ijerph19148457] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 02/01/2023]
Abstract
Aging is characterized by changes in the structure and quality of sleep. When the alterations in sleep become substantial, they can generate or accelerate cognitive decline, even in the absence of overt pathology. In fact, impaired sleep represents one of the earliest symptoms of Alzheimer’s disease (AD). This systematic review aimed to analyze the studies on sleep quality in aging, also considering mild cognitive impairment (MCI) and AD. The review process was conducted according to the PRISMA statement. A total of 71 studies were included, and the whole sample had a mean age that ranged from 58.3 to 93.7 years (62.8–93.7 healthy participants and 61.8–86.7 pathological populations). Of these selected studies, 33 adopt subjective measurements, 31 adopt objective measures, and 10 studies used both. Pathological aging showed a worse impoverishment of sleep than older adults, in both subjective and objective measurements. The most common aspect compromised in AD and MCI were REM sleep, sleep efficiency, sleep latency, and sleep duration. These results underline that sleep alterations are associated with cognitive impairment. In conclusion, the frequency and severity of sleep disturbance appear to follow the evolution of cognitive impairment. The overall results of objective measures seem more consistent than those highlighted by subjective measurements.
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Affiliation(s)
- Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Correspondence: (M.C.); (I.C.)
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Roma, Italy;
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
| | - Francesca Favieri
- Body and Action Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy;
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
| | - Ilaria Corbo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Roma, Italy
- Correspondence: (M.C.); (I.C.)
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Kim H, Levine A, Cohen D, Gehrman P, Zhu X, Devanand DP, Lee S, Goldberg TE. The Role of Amyloid, Tau, and APOE Genotype on the Relationship Between Informant-Reported Sleep Disturbance and Alzheimer’s Disease Risks. J Alzheimers Dis 2022; 87:1567-1580. [DOI: 10.3233/jad-215417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The association between sleep and Alzheimer’s disease (AD) biomarkers are well-established, but little is known about how they interact to change the course of AD. Objective: To determine the potential interaction between sleep disturbance and Aβ, tau, and APOE4 on brain atrophy and cognitive decline. Methods: Sample included 351 participants (mean age 72.01 ± 6.67, 50.4%female) who were followed for approximately 5 years as part of the Alzheimer’s Disease Neuroimaging Initiative. Informant-reported sleep disturbance (IRSD) was measured using the Neuropsychiatric Inventory (NPI). Changes in magnetic resonance imaging (MRI)-measured AD signature brain regions and cognitive performance and IRSD’s interaction with cerebrospinal fluid amyloid-β (Aβ42) and p-Tau depositions and APOE4 status were examined using the linear mixed models. Results: Baseline IRSD was not significantly associated with the rate of atrophy after adjusting for covariates (age, sex, education, total NPI severity score, and sleep medications). However, there was a significant interaction between IRSD and AD biomarkers on faster atrophy rates in multiple brain regions, including the cortical and middle temporal volumes. Post-hoc analyses indicated that Aβ and p-Tau/Aβ predicted a faster decline in these regions/domains in IRSD, compared with biomarker-negative individuals with IRSD (ps≤0.001). There was a significant IRSD*APOE4 interaction for brain atrophy rate (ps≤0.02) but not for cognition. Conclusion: IRSD may increase the future risk of AD by contributing to faster brain atrophy and cognitive decline when combined with the presence of AD biomarkers and APOE4. Early intervention for sleep disturbance could help reduce the risk of developing AD.
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Affiliation(s)
- Hyun Kim
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Divisionof Geriatric Psychiatry, New York State Psychiatric Institute, NewYork, NY, USA
| | - Alina Levine
- Division of Mental Health DataScience, New York State Psychiatric Institute, New York, NY, USA
| | - Daniel Cohen
- Divisionof Geriatric Psychiatry, New York State Psychiatric Institute, NewYork, NY, USA
| | - Philip Gehrman
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- Mental Illness Research, Education, and Clinical Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Divisionof Geriatric Psychiatry, New York State Psychiatric Institute, NewYork, NY, USA
| | - Davangere P. Devanand
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Divisionof Geriatric Psychiatry, New York State Psychiatric Institute, NewYork, NY, USA
- Department ofNeurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Seonjoo Lee
- Division of Mental Health DataScience, New York State Psychiatric Institute, New York, NY, USA
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Terry E. Goldberg
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Divisionof Geriatric Psychiatry, New York State Psychiatric Institute, NewYork, NY, USA
- Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA
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12
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Kent BA, Feldman HH, Nygaard HB. Sleep and its regulation: An emerging pathogenic and treatment frontier in Alzheimer's disease. Prog Neurobiol 2021; 197:101902. [PMID: 32877742 PMCID: PMC7855222 DOI: 10.1016/j.pneurobio.2020.101902] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/19/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
A majority of patients with Alzheimer's disease (AD) experience some form of sleep disruption, including nocturnal sleep fragmentation, increased daytime napping, decreased slow-wave sleep (SWS, stage N3), and decreased rapid-eye-movement sleep (REM). Clinical studies are investigating whether such sleep disturbances are a consequence of the underlying disease, and whether they also contribute to the clinical and pathological manifestations of AD. Emerging research has provided a direct link between several of these sleep disruptions and AD pathophysiology, suggesting that treating sleep disorders in this population may target basic mechanisms of the disease. Here, we provide a comprehensive review of sleep disturbances associated with the spectrum of AD, ranging from the preclinical stages through dementia. We discuss how sleep interacts with AD pathophysiology and, critically, whether sleep impairments can be targeted to modify the disease course in a subgroup of affected AD patients. Ultimately, larger studies that fully utilize new diagnostic and experimental tools will be required to better define the most relevant sleep disturbance to target in AD, the interventions that best modulate this target symptom, and whether successful early intervention can modify AD risk and prevent dementia.
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Affiliation(s)
- Brianne A Kent
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, USA; Division of Neurology, University of British Columbia, Vancouver, Canada.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurosciences, University of California, San Diego, La Jolla, USA
| | - Haakon B Nygaard
- Division of Neurology, University of British Columbia, Vancouver, Canada
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13
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Pini L, Wennberg A, Mitolo M, Meneghello F, Burgio F, Semenza C, Venneri A, Mantini D, Vallesi A. Quality of sleep predicts increased frontoparietal network connectivity in patients with mild cognitive impairment. Neurobiol Aging 2020; 95:205-213. [DOI: 10.1016/j.neurobiolaging.2020.07.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/13/2020] [Accepted: 07/25/2020] [Indexed: 11/27/2022]
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14
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Hudon C, Escudier F, De Roy J, Croteau J, Cross N, Dang-Vu TT, Zomahoun HTV, Grenier S, Gagnon JF, Parent A, Bruneau MA, Belleville S. Behavioral and Psychological Symptoms that Predict Cognitive Decline or Impairment in Cognitively Normal Middle-Aged or Older Adults: a Meta-Analysis. Neuropsychol Rev 2020; 30:558-579. [PMID: 32394109 DOI: 10.1007/s11065-020-09437-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.
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Affiliation(s)
- Carol Hudon
- École de psychologie, Université Laval, 2601, ch. de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada. .,CERVO Brain Research Centre, Québec, QC, Canada.
| | - Frédérique Escudier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jessie De Roy
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | - Jordie Croteau
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Nathan Cross
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | | | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
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15
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Kemp EC, Ebner MK, Ramanan S, Godek TA, Pugh EA, Bartlett HH, McDonald JW, Mecca MC, van Dyck CH, Mecca AP. Statin Use and Risk of Cognitive Decline in the ADNI Cohort. Am J Geriatr Psychiatry 2020; 28:507-517. [PMID: 31806426 PMCID: PMC7170771 DOI: 10.1016/j.jagp.2019.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/02/2019] [Accepted: 11/05/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To investigate associations between statin use and cognitive change, as well as diagnostic conversion, in individuals with cognitively normal (CN) status, mild cognitive impairment (MCI), and dementia due to Alzheimer disease (AD-dementia). METHODS A multicenter cohort study with 1629 adults 48 to 91 years old with CN status, early MCI (EMCI), late MCI (LMCI), or AD-dementia at baseline followed prospectively for 24 months. Statin use was assessed at baseline, and cognition was measured over time with a composite memory score, a composite executive function score, and a global cognition score (Alzheimer's Disease Assessment Scale). Conversion to a more impaired diagnostic category was determined by clinician assessment. Repeated measures linear mixed-effects models were used to evaluate associations between statin use and change in cognition over time. Cox proportional hazards models were used to evaluate associations between statin use and time to diagnostic conversion. All models were stratified by baseline diagnostic group. RESULTS Statin use was not associated with change in cognitive measures for CN, LMCI, or AD-dementia participants. Among EMCI participants, statin use was associated with a significantly slower rate of decline on the memory composite, but no other cognitive measure. Statin use was not associated with time to conversion for any diagnostic group. CONCLUSIONS This study did not support an association between statin use and diagnostic conversion but suggested a possible association between statin use and cognitive change in EMCI. Additional randomized clinical trials of statins may be warranted in the prodromal EMCI stage of AD.
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Affiliation(s)
- Emily C. Kemp
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Corresponding Author: Emily C. Kemp, B.S., One Church Street, 8th Floor, New Haven, CT 06510, (203) 764-8100 (phone), (203) 764-8111 (fax),
| | - Megan K. Ebner
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Srinath Ramanan
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Tyler A. Godek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Erika A. Pugh
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Hugh H. Bartlett
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Julia W. McDonald
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marcia C. Mecca
- Veterans Affairs Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06517, USA,Department of Internal Medicine, Geriatrics Section, and the Program on Aging, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher H. van Dyck
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA,Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Adam P. Mecca
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06510, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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16
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Sleep Quality and Health-Related Quality of Life in Older People With Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer Disease. J Nerv Ment Dis 2020; 208:387-396. [PMID: 31977718 DOI: 10.1097/nmd.0000000000001137] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We aimed to investigate sleep quality and health-related quality of life (HRQOL) in older adults with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer disease (AD). A total of 221 participants were divided into the following five groups: normal controls (NCs), SCD without memory concerns (SCD-0), SCD with memory concerns (SCD-1), MCI, and AD according to their cognitive status. Compared with NC, individuals with SCD-0, SCD-1, MCI, and AD had more sleep problems and reduced HRQOL. Participants with poor sleep quality had an increased risk of cognitive impairment compared with participants with good sleep quality. Within all five subgroups, individuals with poor sleep quality reported more difficulties in HRQOL than individuals with good sleep quality. Future studies employing a longitudinal design, larger samples, and objective evaluation tools are needed.
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17
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Shimizu S, Takenoshita N, Inagawa Y, Tsugawa A, Hirose D, Kaneko Y, Ogawa Y, Serisawa S, Sakurai S, Hirao K, Kanetaka H, Kanbayashi T, Imanishi A, Sakurai H, Hanyu H. Positive Association Between Cognitive Function and Cerebrospinal Fluid Orexin A Levels in Alzheimer’s Disease. J Alzheimers Dis 2020; 73:117-123. [DOI: 10.3233/jad-190958] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Soichiro Shimizu
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Naoto Takenoshita
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yuta Inagawa
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Akito Tsugawa
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Hirose
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yoshitsugu Kaneko
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yusuke Ogawa
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shuntaro Serisawa
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shu Sakurai
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kentaro Hirao
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hidekazu Kanetaka
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Takashi Kanbayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Hirofumi Sakurai
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Haruo Hanyu
- Department of Geriatric Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
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18
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Li K, Luo X, Zeng Q, Jiaerken Y, Wang S, Xu X, Xu X, Xu J, Wang C, Zhou J, Huang P, Zhang M. Interactions between sleep disturbances and Alzheimer's disease on brain function: a preliminary study combining the static and dynamic functional MRI. Sci Rep 2019; 9:19064. [PMID: 31836777 PMCID: PMC6911090 DOI: 10.1038/s41598-019-55452-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
Though sleep disturbance constitutes the risk factor for Alzheimer's disease (AD), the underlying mechanism is still unclear. This study aims to explore the interaction between sleep disturbances and AD on brain function. We included 192 normal controls, 111 mild cognitive impairment (MCI), and 30 AD patients, with either poor or normal sleep (PS, NS, respectively). To explore the strength and stability of brain activity, we used static amplitude of low-frequency fluctuation (sALFF) and dynamic ALFF (dALFF) variance. Further, we examined white matter hyperintensities (WMH) and amyloid PET deposition, representing the vascular risk factor and AD-related hallmark, respectively. We observed that sleep disturbance significantly interacted with disease severity, exposing distinct effects on sALFF and dALFF variance. Interestingly, PS groups showed the dALFF variance trajectory of initially increased, then decreased and finally increased along the AD spectrum, while showing the opposite trajectory of sALFF. Further correlation analysis showed that the WMH burden correlates with dALFF variance in PS groups. Conclusively, our study suggested that sleep disturbance interacts with AD severity, expressing as effects of compensatory in MCI and de-compensatory in AD, respectively. Further, vascular impairment might act as important pathogenesis underlying the interaction effect between sleep and AD.
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Affiliation(s)
- Kaicheng Li
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xiao Luo
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Qingze Zeng
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Yerfan Jiaerken
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Shuyue Wang
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xiaopei Xu
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Xiaojun Xu
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Jingjing Xu
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Chao Wang
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Jiong Zhou
- Department of Neurology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Peiyu Huang
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
| | - Minming Zhang
- Department of Radiology, 2nd Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
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19
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Palmer K, Mitolo M, Burgio F, Meneghello F, Venneri A. Sleep Disturbance in Mild Cognitive Impairment and Association With Cognitive Functioning. A Case-Control Study. Front Aging Neurosci 2018; 10:360. [PMID: 30473661 PMCID: PMC6237832 DOI: 10.3389/fnagi.2018.00360] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/22/2018] [Indexed: 12/14/2022] Open
Abstract
Objectives: The aims of the current study are to (1) report the frequency of specific sleep disturbance symptoms in Mild Cognitive Impairment (MCI) and cognitive healthy older persons; (2) examine whether overall poor sleep and specific sleep disturbance symptoms are more common in persons with MCI compared to cognitive healthy older controls and; (3) examine the association between sleep disturbances and performance in general and specific cognitive domains in persons with MCI and separately in cognitive healthy older persons. Methods: Data were collected at the Fondazione Ospedale San Camillo Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Venice, Italy as part of the European VPH-DARE@IT project. We included 69 persons with MCI (mean age 75.7; SD = 7.7) and 72 sex-matched cognitively healthy controls (mean age 71.8; SD = 7.0). Participants underwent extensive neuropsychological assessment and evaluation of subjective sleep performance with the Sleep Continuity in Alzheimer’s Disease Scale(SCADS). Results: A fifth of MCI patients (21.7%, n = 15) had poor sleep compared to 15.3% (n = 11) of cognitively healthy controls. MCI patients had a 3.2 higher odds of having poor sleep compared to cognitively healthy controls after adjustment for age, education, sex, and general cognitive functioning (Odds Ratio (OR) = 3.2; 95% Confidence Interval (CI) = 1.1–9.2). Persons who reported waking up twice or more during the night had higher odds of being MCI compared to those who never wake or wake only once (OR = 2.6; 95% CI = 1.1–6.1). In MCI patients, poor sleep was associated with better general cognitive functioning and short-term working memory, whereas in cognitive healthy older persons poor sleep was associated with impairment in episodic memory performance and executive functioning. Discussion: Our results confirm previous studies showing that sleep disturbances are common in MCI, and this may be due to an ongoing neurodegenerative process rather than a symptom of cognitive impairment. Future research with objective sleep measurements are needed in MCI as well as interventions to improve sleep with the aim of preventing cognitive decline.
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Affiliation(s)
- Katie Palmer
- Fondazione Ospedale San Camillo IRCCS, Venice, Italy
| | | | | | | | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
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