1
|
Khosroazad S, Gilbert CF, Aronis JB, Daigle KM, Esfahani M, Almaghasilah A, Ahmed FS, Elias MF, Meuser TM, Kaye LW, Singer CM, Abedi A, Hayes MJ. Sleep movements and respiratory coupling as a biobehavioral metric for early Alzheimer's disease in independently dwelling adults. BMC Geriatr 2023; 23:252. [PMID: 37106470 PMCID: PMC10141904 DOI: 10.1186/s12877-023-03983-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Sleep disorder is often the first symptom of age-related cognitive decline associated with Alzheimer's disease (AD) observed in primary care. The relationship between sleep and early AD was examined using a patented sleep mattress designed to record respiration and high frequency movement arousals. A machine learning algorithm was developed to classify sleep features associated with early AD. METHOD Community-dwelling older adults (N = 95; 62-90 years) were recruited in a 3-h catchment area. Study participants were tested on the mattress device in the home bed for 2 days, wore a wrist actigraph for 7 days, and provided sleep diary and sleep disorder self-reports during the 1-week study period. Neurocognitive testing was completed in the home within 30-days of the sleep study. Participant performance on executive and memory tasks, health history and demographics were reviewed by a geriatric clinical team yielding Normal Cognition (n = 45) and amnestic MCI-Consensus (n = 33) groups. A diagnosed MCI group (n = 17) was recruited from a hospital memory clinic following diagnostic series of neuroimaging biomarker assessment and cognitive criteria for AD. RESULTS In cohort analyses, sleep fragmentation and wake after sleep onset duration predicted poorer executive function, particularly memory performance. Group analyses showed increased sleep fragmentation and total sleep time in the diagnosed MCI group compared to the Normal Cognition group. Machine learning algorithm showed that the time latency between movement arousals and coupled respiratory upregulation could be used as a classifier of diagnosed MCI vs. Normal Cognition cases. ROC diagnostics identified MCI with 87% sensitivity; 89% specificity; and 88% positive predictive value. DISCUSSION AD sleep phenotype was detected with a novel sleep biometric, time latency, associated with the tight gap between sleep movements and respiratory coupling, which is proposed as a corollary of sleep quality/loss that affects the autonomic regulation of respiration during sleep. Diagnosed MCI was associated with sleep fragmentation and arousal intrusion.
Collapse
Affiliation(s)
- Somayeh Khosroazad
- Electrical and Computer Engineering, University of Maine, 5708 Barrows Hall, Orono, ME, 04469, USA
- Activas Diagnostics, LLC, 20 Godfrey Dr., Orono, ME, 04473, USA
| | - Christopher F Gilbert
- Activas Diagnostics, LLC, 20 Godfrey Dr., Orono, ME, 04473, USA
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA
| | - Jessica B Aronis
- Activas Diagnostics, LLC, 20 Godfrey Dr., Orono, ME, 04473, USA
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA
| | - Katrina M Daigle
- Psychology Department, Suffolk University, 73 Tremont St., Boston, MA, 02108, USA
| | | | - Ahmed Almaghasilah
- Electrical and Computer Engineering, University of Maine, 5708 Barrows Hall, Orono, ME, 04469, USA
- Graduate School of Biomedical Science & Engineering, University of Maine, 5775 Stodder Hall, Orono, ME, 04469, USA
| | - Fayeza S Ahmed
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA
| | - Merrill F Elias
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA
| | - Thomas M Meuser
- Center for Excellence On Aging, University of New England, 11 Hills Beach Rd., Biddeford, ME, 04005, USA
| | - Leonard W Kaye
- Center On Aging, University of Maine, 327 Camden Hall, Orono, ME, 04469, USA
| | - Clifford M Singer
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA
- Mood and Memory Clinic, Northern Light Health, 269 Stillwater Ave., Bangor, ME, 04402, USA
| | - Ali Abedi
- Electrical and Computer Engineering, University of Maine, 5708 Barrows Hall, Orono, ME, 04469, USA
- Activas Diagnostics, LLC, 20 Godfrey Dr., Orono, ME, 04473, USA
| | - Marie J Hayes
- Activas Diagnostics, LLC, 20 Godfrey Dr., Orono, ME, 04473, USA.
- Psychology Department, University of Maine, 5740 Beryl Warner Williams Hall, Orono, ME, 5740-04469, USA.
- Graduate School of Biomedical Science & Engineering, University of Maine, 5775 Stodder Hall, Orono, ME, 04469, USA.
| |
Collapse
|