Abstract Details

Title Obstructive Sleep Apnea and White Matter Abnormalities in Older Adults with Mild Cognitive Impairment and Dementia

Topic Aging and Dementia

Presentation(s) P07 - (-)

Poster/Presentation
Number 152

Objective

Background BACKGROUND: OSA has been associated with cognitive impairment (Canessa and Ferini-Strambi, 2011) and with white matter changes (Harbison et al. 2003); however, the association between OSA and cerebral white-matter hyperintensities (WMH) on magnetic resonance imaging (MRI) in patients with mild cognitive impairment (MCI) and dementia has not been previously studied.

Design/Methods DESIGN/METHODS: From 419 patients with MCI and dementia referred in 2010-2012 to the Nantz National Alzheimer Center, 170 completed a comprehensive neuropsychological battery, a sleep evaluation (polysomnography), and brain MRI protocol. Mean age of participants was 74 years (SD 11.0). Severity of OSA was measured by the apnea-hypopnea index (AHI), the respiratory disturbance index (RDI), and the lowest oxygen saturation. Deep and periventricular WMH were assessed on T2-weighted sequences using the Fazekas visual scale.

Results RESULTS: Eighty-five percent of the patients had OSA. The extent of WMH was significantly associated with the AHI (r = 0.20, p < 0.023), and the RDI (r = 0.26, p < 0.002). WMH was negatively correlated with executive function measured by Luria's kinetic melodies task (r = -0.18), verbal fluency (r = -0.25), and the executive clock-drawing (CLOX) task (r = -0.19), but not with the remaining cognitive functions (episodic memory, language, orientation, or visual perception). Executive function measured by CLOX was negatively correlated with the AHI (r = -0.17) and the RDI (r = -0.21).

Conclusions CONCLUSIONS: Obstructive sleep apnea is common in MCI and in dementia and is associated with cerebral white-matter hyperintensities and poor executive function, but not with impairment of the areas of cognition most characteristically affected in Alzheimer's disease. This finding suggests that the pathophysiology of both disorders may differ and that treatment of sleep apnea may have beneficial cognitive effects.

Authors/Disclosures
Belen Pascual, PhD (Houston Methodist Hospital) PRESENTER	The institution of Prof. Pascual has received research support from NIH. The institution of Prof. Pascual has received research support from NIH.
Gustavo C. Roman, MD, FAAN (Methodist Neurological Institute)	The institution of Dr. Roman has received research support from Brain Chamistry Labs.
Javier Triana	No disclosure on file
	No disclosure on file
Bryan M. Spann, DO, PhD	No disclosure on file
Aparajitha K. Verma, MD (UT Health-Neurosciences)	No disclosure on file
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
Joanna Dojillo, MSc (MediciNova, Inc.)	No disclosure on file

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