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P1‐271: URINE ALBUMIN‐TO‐CREATININE RATIO TRAJECTORIES IN EARLY ADULTHOOD AND COGNITIVE FUNCTION IN MIDDLE AGE
Author(s) -
Sedaghat Sanaz,
Yaffe Kristine,
Sidney Stephen,
Jacobs David R.,
Sorond Farzaneh,
Carnethon Mercedes,
Launer Lenore J.
Publication year - 2018
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.2018.06.277
Subject(s) - renal function , cognitive decline , cognition , digit symbol substitution test , creatinine , stroop effect , cognitive test , medicine , verbal memory , dementia , effects of sleep deprivation on cognitive performance , verbal learning , trail making test , psychology , audiology , neuropsychology , psychiatry , pathology , disease , alternative medicine , placebo
Background: Recent studies describe associations between Sleep Disordered Breathing (SDB) and brain beta amyloid in cognitive normal individuals. We aimed to evaluate the effect of SDB on time-to-progression from cognitive normal to mild cognitive impairment in amyloid positive versus amyloid negative elderly participants. Methods: Data used for this analysis were obtained from the ADNI database (adni.loni.usc.edu). Study participants included 288 Cognitive Normal (NL) subjects. SDB was self-reported and participants were labeled SDB+, SDB . Brain amyloid was assessed using Florbetapir PET imaging. The primary outcome of the analysis was time-to-progression fromNL toMCI. Data analysis was performed in two phases. First, brain amyloid burden was dichotomized into amyloid positive (n 1⁄4 95) and negative (n 1⁄4 193). SDB status was determined in each group (i.e. Ab+/SDB+ (n 1⁄413) vs. Ab+/SDB(n 1⁄4 92) and Ab-/SDB+ (n 1⁄418) vs. Ab-/ SDB(n 1⁄4 175)). Second, Cox proportional hazards models was used to estimate the effect of SDB and Ab load (i.e. SDB+/Ab+ vs. SDB-/Ab-) on the relative hazard of progression from NL to MCI. Models were adjusted for age, sex, body mass index, APOE e4 status, and history of cardiovascular disease. Results: Over the span of approximately 3 years, SDB+ /Ab+ NL subjects were more likely to progress to MCI when compared to SDB-/ Ab+ NL subjects (49% versus 42%). SDB+/AbNL subjects when compared to SDB-/AbNL subjects did not show significant difference in the progression rate (17% versus 16%). SDB+/Ab+ predicted shorter time-to-progression with adjusted hazard ratio (aHR) 1⁄4 1.16, 95% CI: 1.04, 1.32, p 1⁄4 0.03) compared to SDB-/ Absubjects. Being SDB+/Abdid not reveal significant differences in time-to-progression from NL to MCI when compared to SDB-/Absubjects (aHR) 1⁄4 1.01, 95% CI: 0.76, 1.26, p 1⁄4 0.10). Conclusions: Sleep Disordered Breathing and Brain beta-amyloid both predict time-to-progression from cognitive normal to mild cognitive impairment with brain beta-amyloid modifying the progression risk. Further studies with objective measures of SDB are needed to determine whether SDB severity increases the progression risk in cognitively normal elderly.

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