Premium
[P3–192]: EFFECT OF OBSTRUCTIVE SLEEP APNEA (OSA) ON RATE OF CHANGE OF AD BIOMARKERS IN COGNITIVELY NORMAL, MCI AND AD ELDERLY: FINDINGS FROM THE ALZHEIMER's DISEASE NEUROIMAGING INITIATIVE (ADNI) COHORT
Author(s) -
Bubu Omonigho Michael,
Sharma Ram A.,
UmasaborBubu Ogie Queen,
Mukhtar Fahad,
Azizi Seixas,
deLeon Mony,
JeanLouis Girardin,
Osorio Ricardo S.
Publication year - 2017
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.2017.06.1404
Subject(s) - obstructive sleep apnea , medicine , alzheimer's disease neuroimaging initiative , cohort , cardiology , neuroimaging , cerebrospinal fluid , cognitive decline , alzheimer's disease , disease , dementia , psychiatry
Background: Evidence from numerous research implicates disturbed sleep or lack of sleep as one of the risk factors for Alzheimer’s disease (AD) and in a recent meta-analysis, we confirmed the association providing an “average” magnitude of effect. However, the extent of the risk of the association of disturbed sleep with AD biomarkers remains uncertain. We conducted further subgroup meta-analyses to quantify the effect of disturbed sleep on cognitive impairment; preclinical AD and symptomatic AD respectively. Methods:PubMed, Embase, Web of Science, and the Cochrane library were used to identify original published literature for this review. Sleep problems and/or disorders were the risk factor of interest in this meta-analysis, and grouped as sleep quality, sleep duration, circadian rhythm abnormalities, insomnia, and obstructive sleep apnea (OSA) for sub-group analyses. Our target variables included the use of cognitive tests assessing cognitive impairment; the use of AD biomarkers or abnormal proteins assessing preclinical AD; and the use of ICD9/DSMIV diagnoses of symptomatic AD. Effect estimates of individual studies were pooled and relative risks (RR) and 95% confidence intervals (CI) were calculated using random effects models. Meta-regression analyses examining the effect of potential influencing factors was also conducted. Results:Twentyseven observational studies (n 1⁄4 69,216 participants) that provided 52 RR estimates were included in the meta-analysis. Subgroup meta-analytic findings showed a RR increase inverse to diagnostic confidence (e.g., 1.60, 1.70 and 3.80 for AD, Cognitive Impairment and preclinical AD, P-value <.001 for all). Relative risk for AD and/or cognitive decline was (RR: 2.37, 1.86, 1.62, 1.38 and 1.38, p<.001 for all) for OSA, sleep quantity, sleep quality, insomnia, and circadian rhythm abnormalities respectively. Meta-regression results suggested that sample size might have significantly influenced the effect size such that larger sample size studies tended to result in smaller risk and vice versa. Conclusions:Our findings suggest that disturbed sleep had a four-fold association with AD biomarkers. OSA also appeared to be a strong risk factor for AD. Since changes in AD biomarkers are predictive of persons that ultimately develop AD, these results highlight potential mechanistic relationships that are vital for potential prevention of AD.