Sleep Disordered Breathing and Incident Cognitive Decline and Dementia: ARIC

项目摘要/摘要 痴呆症和轻度认知障碍在美国老年人中很常见，尽管他们有巨大的 不断增加的负担对导致认知能力下降的特征知之甚少。近期 流行病学和病理生理学的证据都表明，异常可能与 由于血管原因和阿尔茨海默病引起的睡眠特征和认知障碍。 然而，对这种关系的理解还处于初级阶段。 我们建议探讨异常睡眠特征与认知损害风险的关系。 利用社区动脉粥样硬化风险(ARIC)队列和 睡眠心脏健康研究。ARIC是一个以人群为基础的前瞻性流行病学队列，它已经 几次后续访问，包括1996-1998年的访问(访问4，年龄54-73岁)和正在进行的访问(ARIC访问 5/神经认知研究(ARIC NCS，2011-2013，年龄69-88岁)。睡眠心脏健康研究，其中包括 ARIC参与者的一部分在(1995-1998年)举行，与ARIC访问的时间大致相同。 共有1,892人参加了ARIC第四次访视，并在家中进行了夜间多导睡眠监测 睡眠心脏健康研究。 我们假设异常的睡眠特征(包括低氧和 呼吸紊乱、睡眠片断和睡眠持续时间)与患高血压的风险有关 晚年的认知障碍。将探索几种认知表型，利用综合 目前通过ARIC-NCS收集的神经认知数据。这些包括1)临床痴呆症和轻度痴呆 认知障碍，2)通过ARIC实施的3项认知测试的变化来评估认知能力下降 来访4次(1996-1998年)，并在ARIC NCS重复(2011-2013年)；3)脑血管MRI标记物 疾病(即脑白质高信号体积、腔隙梗死数目)和阿尔茨海默病(即 海马区和灰质体积)。 拟议的研究结果将对理解两国之间的关系产生深远影响 中年睡眠，晚年认知。睡眠特征异常和认知障碍有 这两种情况在老年人中都很普遍，不正常的睡眠特征都可以修改 通过现有的干预措施。因此，阐明异常睡眠特征是否在 认知障碍的病因学对公共卫生具有至关重要的意义。

Project Summary/Abstract Dementia and mild cognitive impairment are common among U.S elderly, yet despite their immense and growing burden relatively little is known about characteristics which lead to cognitive decline. Recent evidence, both epidemiological and pathophysiological, has suggested a possible relation between abnormal sleep characteristics and cognitive impairment due to both vascular etiologies and Alzheimer's disease. However, understanding of this relation is in its infancy. We propose to explore the relation of abnormal sleep characteristics to risk of cognitive impairment over 15 years of follow-up utilizing data from the Atherosclerosis Risk in Communities (ARIC) cohort and the Sleep Heart Health Study. ARIC is a population-based prospective epidemiologic cohort, which has had several follow-up visits, including a visit in 1996-1998 (Visit 4, ages 54-73) and an ongoing visit (ARIC Visit 5/Neurocognitive Study (ARIC NCS, 2011-2013, ages 69-88)). The Sleep Heart Health Study, which included a subset of ARIC participants, took place in (1995-1998), at approximately the same time as ARIC Visit 4. A total of 1,892 individuals participated in both ARIC Visit 4 and had in-home overnight polysomnography as part of the Sleep Heart Health Study. We hypothesize that that abnormal sleep characteristics (inclusive of measures of hypoxia and disordered breathing, sleep fragmentation, and sleep duration) in middle age are associated with risk of cognitive impairment later in life. Several cognitive phenotypes will be explored, utilizing comprehensive neurocognitive data presently being collected through ARIC-NCS. These include 1) clinical dementia and mild cognitive impairment, 2) cognitive decline as assessed by change in 3 cognitive tests administered at ARIC Visit 4 (1996-1998) and repeated in ARIC NCS (2011-2013), and 3) brain MRI markers of cerebral vascular disease (i.e. white matter hyperintensity volume, number of lacunar infarcts) and Alzheimer's disease (i.e. hippocampal and gray matter volume). Results from the proposed study will have a profound impact on the understanding of relations between sleep in middle-age and cognition in later life. Abnormal sleep characteristics and cognitive impairment are both highly prevalent among older adults, and abnormal sleep characteristics are amenable to modification through existing interventions. Therefore, elucidating whether abnormal sleep characteristics play a role in the etiology of cognitive impairment is of vital public health importance.