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VOLUME 36, ISSUE 06

ASSOCIATION OF SDB AND COGNITIVE DEFICIT IN APOE E4 CARRIERS
Association of Sleep Disordered Breathing and Cognitive Deficit in APOE ε4 Carriers

http://dx.doi.org/10.5665/sleep.2714

Maria Nikodemova, PhD1,2; Laurel Finn, MS1; Emmanuel Mignot, MD, PhD3; Nicole Salzieder, BS1; Paul E. Peppard, PhD1

1Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI; 2Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI; 3Stanford University School of Medicine Center for Sleep Sciences and Department of Psychiatry, Palo Alto, CA



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Study Objectives:

The aim of the study was to determine whether apolipoprotein E epsilon 4 genotype (APOE4) modifies the association of sleep disordered breathing (SDB) with cognitive function in a middle-aged population.

Design:

Cross-sectional analysis of a community-dwelling cohort.

Settings:

Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospitals and Clinics.

Participants:

There were 755 adults from the Wisconsin Sleep Cohort who provided a total of 1,843 polysomnography and cognitive evaluations (most participants were assessed multiple times at approximately 4-y intervals); 56% males, average age 53.9 years (range 30-81 years).

Interventions:

None.

Measurement and Results:

In-laboratory overnight polysomnography was used to assess SDB. Cognition was evaluated by a battery of six neurocognitive tests assessing memory and learning, attention, executive function, and psychomotor efficiency. The APOE4 genotype (ε3/ε4 or ε4/ ε4) was identified in 200 participants. Data were analyzed using linear mixed-effects models, accounting for multiple observations per participant. Cognitive test scores were regressed on SDB categories (AHI < 5, 5 ≤ AHI < 15, AHI ≥ 15); APOE4 and their interaction; and age, education, sex, and body mass index. There was no statistically significant association between SDB and cognitive performance among APOE4-negative individuals. However, in APOE4-positive individuals, those with AHI ≥ 15 had significantly worse performance on the Auditory Verbal Learning Test and the Controlled Oral Word Association Test.

Conclusions:

In APOE4-positive individuals, moderate to severe sleep disordered breathing (AHI ≥ 15) was associated with poorer performance on cognitive tests that require both memory and executive function engagement.

Citation:

Nikodemova M; Finn L; Mignot E; Salzieder N; Peppard PE. Association of sleep disordered breathing and cognitive deficit in APOE ε4 carriers. SLEEP 2013;36(6):873-880.

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