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P1‐398: Structured Clinical Documentation for Patient Care and Practice‐Based Research in MCI and Dementia
Author(s) -
Yucus Chad J.,
Castle James,
Walters Shaun,
Garduno Lisette,
Frigerio Roberta,
Maraganore Demetrius M.
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.1150
Subject(s) - dementia , medicine , biobank , clinical dementia rating , montreal cognitive assessment , depression (economics) , quality of life (healthcare) , gerontology , test (biology) , cognition , medical record , documentation , physical therapy , psychiatry , family medicine , disease , nursing , computer science , programming language , paleontology , genetics , macroeconomics , economics , biology
Background: Sleep Disordered Breathing (SDB) is commonly reported in the elderly, and recent studies in humans describe associations between SDB and Alzheimer’s disease (AD). However, studies are needed that evaluate whether SDB is associated with AD biomarkers. Our objective was to examine whether the presence of SDB is associated with cerebrospinal fluid phosphorylated tau (CSF P-tau), and neuroimaging evidence of hippocampal atrophy and b-amyloid (Ab) deposition in Mild Cognitive Impairment (MCI) subjects from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. Methods: Data used were obtained from the ADNI database (adni.loni.usc.edu). Study participants included a total of 600 MCI subjects who were a subset of the ADNI cohort. SDB was self-reported and participants were labeled SDB+, SDB , and CPAP+ (if they were SDB+, and using “CPAP/BiPAP” treatment). CSF P-tau, hippocampal and Ab-42 volumes were the outcome variables. Multi-level mixed effects linear regression models were used to examine the relationship between SDB and CSF P-tau, hippocampal and Ab-42 volumes. First, we fit a linear regression model for each participant separately at each time point, and second, we regressed unknown time-specific coefficients against time. Our models were adjusted for age, sex, body mass index, APOE e4 status, and history of cardiovascular disease. This approach provided adjusted risk estimates incorporating the effects of time. Results:Relative to SDBparticipants, SDB+ participants had an increased risk of greater b-amyloid burden, (mean cortical DVR; adjusted Relative Risk (aRR) 1⁄4 1.92, 95% confidence interval (CI) 1.16, 4.14, p 1⁄4 0.002 and precuneus DVR (aRR 1⁄4 1.51, 95% CI 1.03, 3.18, p 1⁄4 0.005). SDB was also associated with greater CSF P-Tau burden (aRR 1⁄4 1.58, 95% CI 1.01, 3.15, p 1⁄4 0.003) and Hippocampal volume (aRR 1⁄4 1.88, 95% CI 1.21, 4.15, p 1⁄4 0.003). There was no difference in risk between CPAP+ and SDB participants (aRR1⁄41.08, 95% CI 0.71, 2.15, p 1⁄4 0.003). Conclusions:Among MCI patients in the ADNI cohort, reports of Sleep Disordered Breathing are associated with greater CSF P-Tau, Hippocampal atrophy and b-amyloid burden over time. Further studies with objective measures of SDB are needed to determine whether SDB accelerates Alzheimer disease.