Interactive Associations of Neuropsychiatry Inventory-Questionnaire Assessed Sleep Disturbance and Vascular Risk on Alzheimer's Disease Stage Progression in Clinically Normal Older Adults

• Type of Material: Article
• Authors: Omonigho M Bubu, NYU; Ellita T Williams, NYU; Ogie Q Umasabor-Bubu, State University New York (SUNY); Sonya S Kaur, University of Miami; Arlener D Turner, University of Miami; Judite Blanc, University of Miami; Jaime Ramos Cejudo, NYU; Anna E Mullins, Icahn School of Medicine at Mount Sinai; Ankit Parekh, Icahn School of Medicine at Mount Sinai; Korey Kam, Icahn School of Medicine at Mount Sinai; Zainab T Osakwe, Adelphi University; Ann W Nguyen, Case Western Reserve University; Antoine Trammell, Emory University; Alfred K Mbah, University of South Florida; Mony de Leon, Weill Cornell Medicine; David M Rapoport, Icahn School of Medicine at Mount Sinai; Indu Ayappa, Icahn School of Medicine at Mount Sinai; Gbenga Ogedegbe, NYU; Girardin Jean-Louis, NYU; Arjun V Masurkar, NYU; Andrew W Varga, Icahn School of Medicine at Mount Sinai; Ricardo S Osorio, NYU
• Language: English
• Date: 2021-12-10
• Publisher: FRONTIERS MEDIA SA
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Bubu, Williams, Umasabor-Bubu, Kaur, Turner, Blanc, Cejudo, Mullins, Parekh, Kam, Osakwe, Nguyen, Trammell, Mbah, de Leon, Rapoport, Ayappa, Ogedegbe, Jean-Louis, Masurkar, Varga and Osorio.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fnagi.2021.763264
• Title of Journal or Parent Work: FRONTIERS IN AGING NEUROSCIENCE
• Volume: 13
• Start Page: 763264
• End Page: 763264
• Grant/Funding Information: This study was supported by the National Institute of Aging and the National Heart Lung and Blood Institute at the National Institutes of Health [K23AG068534, L30-AG064670, CIRAD P30AG059303 Pilot, P30AG066512 NYU ADRC Developmental Project, R25HL105444, R01HL118624, R21AG049348, R21AG055002, R01AG056031, R01AG022374, R21AG059179, R01AG056682, R01AG056531, K07AG05268503, and K25HL151912], the American Academy of Sleep Medicine Foundation [BS-231-20 and BS-233-20], and the Alzheimer’s Association [AARGD-21-848397]. The NACC database is funded by NIA/NIH grant U01 AG016976. NACC data are contributed by the NIA-funded ADCs: P30 AG019610 [principal investigator (PI) Eric Reiman], P30 AG013846 (PI Neil Kowall), P30 AG062428-01 (PI James Leverenz), P50 AG008702 (PI Scott Small), P50 AG025688 (PI Allan Levey), P50 AG047266 (PI Todd Golde), P30 AG010133 (PI Andrew Saykin), P50 AG005146 (PI Marilyn Albert), P30 AG062421-01 (PI Bradley Hyman), P30 AG062422-01 (PI Ronald Petersen), P50 AG005138 (PI Mary Sano), P30 AG008051 (PI Thomas Wisniewski), P30 AG013854 (PI Robert Vassar), P30 AG008017 (PI Jeffrey Kaye), P30 AG010161 (PI David Bennett), P50 AG047366 (PI Victor Henderson), P30 AG010129 (PI Charles DeCarli), P50 AG016573 (PI Frank LaFerla), P30 AG062429-01 (PI James Brewer), P50 AG023501 (PI Bruce Miller), P30 AG035982 (PI Russell Swerdlow), P30 AG028383 (PI Linda Van Eldik), P30 AG053760 (PI Henry Paulson), P30 AG010124 (PI John Trojanowski), P50 AG005133 (PI Oscar Lopez), P50 AG005142 (PI Helena Chui), P30 AG012300 (PI Roger Rosenberg), P30 AG049638 (PI Suzanne Craft), P50 AG005136 (PI Thomas Grabowski), P30 AG062715-01 (PI Sanjay Asthana), P50 AG005681 (PI John Morris), and P50 AG047270 (PI Stephen Strittmatter). The funders had no role in the conception or preparation of this manuscript.
• Keywords: cardiovascular disease; Neurosciences & Neurology; MODELS; BRAIN; Science & Technology; HYPERTENSION; Alzheimer's disease; Neurosciences; sleep disturbance; Life Sciences & Biomedicine; amnestic mild cognitive impairment; QUALITY; DURATION; biomarkers; Geriatrics & Gerontology; INCIDENT DEMENTIA
• Research Categories: Biology, Biostatistics; Health Sciences, Epidemiology; Health Sciences, Radiology

Abstract

Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alzheimer’s disease (AD) stage-progression in normal, community-dwelling older adults and evaluate their combined risk beyond that of established AD biomarkers. Methods: Longitudinal data from the National Alzheimer’s Coordinating Center Uniform-Dataset. SD data (i.e., SD+ vs. SD-), as characterized by the Neuropsychiatric Inventory-Questionnaire, were derived from 10,600 participants at baseline, with at-least one follow-up visit. A subset (n = 361) had baseline cerebrospinal fluid (CSF) biomarkers and MRI data. The Framingham heart study general cardiovascular disease (FHS-CVD) risk-score was used to quantify vascular risk. Amnestic mild cognitive impairment (aMCI) diagnosis during follow-up characterized AD stage-progression. Logistic mixed-effects models with random intercept and slope examined the interaction of SD and vascular risk on prospective aMCI diagnosis. Results: Of the 10,600 participants, 1,017 (9.6%) reported SD and 6,572 (62%) were female. The overall mean (SD) age was 70.5 (6.5), and follow-up time was 5.1 (2.7) years. SD and the FHS-CVD risk-score were each associated with incident aMCI (aOR: 1.42 and aOR: 2.11, p < 0.01 for both). The interaction of SD and FHS-CVD risk-score with time was significant (aOR: 2.87, p < 0.01), suggesting a synergistic effect. SD and FHS-CVD risk-score estimates remained significantly associated with incident aMCI even after adjusting for CSF (Aβ, T-tau, P-tau) and hippocampal volume (n = 361) (aOR: 2.55, p < 0.01), and approximated risk-estimates of each biomarker in the sample where data was available. Conclusions: Clinical measures of sleep and vascular risk may complement current AD biomarkers in assessing risk of cognitive decline in older adults.