Sleep Disordered Breathing and Incident Cognitive Decline and Dementia: ARIC

项目概要/摘要 痴呆症和轻度认知障碍在美国老年人中很常见，但尽管他们有巨大的， 日益增长的负担相对较少的是知道的特点，导致认知能力下降。最近 流行病学和病理生理学的证据都表明， 睡眠特点和认知障碍，由于血管病因和阿尔茨海默病。 然而，对这种关系的理解还处于起步阶段。 我们建议探讨异常睡眠特征与认知障碍风险的关系 利用来自社区动脉粥样硬化风险（ARIC）队列和 睡眠心脏健康研究。ARIC是一项基于人群的前瞻性流行病学队列研究， 几次随访，包括1996 - 1998年的一次访视（访视4，年龄54 - 73岁）和一次持续访视（ARIC访视 5/神经认知研究（ARIC NCS，2011 - 2013，年龄69 - 88））。睡眠心脏健康研究，其中包括 ARIC参与者的一个子集，发生在（1995 - 1998），大约与ARIC访视4同时进行。一 共有1，892人参加了ARIC访视4，并在家中进行了夜间多导睡眠图检查， 睡眠心脏健康研究 我们假设，异常的睡眠特征（包括缺氧和 呼吸紊乱、睡眠碎片和睡眠持续时间）与中年人的 认知障碍将探讨几种认知表型，利用综合 目前正在通过ARIC-NCS收集神经认知数据。这些包括1）临床痴呆症和轻度 认知损害，2）通过在ARIC进行的3项认知测试的变化评估的认知下降 访视4（1996 - 1998）和在ARIC NCS中重复（2011 - 2013），和3）脑血管MRI标记物 疾病（即，白色高信号体积、腔隙性梗死的数量）和阿尔茨海默病（即， 海马和灰质体积）。 从拟议的研究结果将产生深刻的影响，对理解之间的关系， 中年的睡眠和晚年的认知异常睡眠特征和认知障碍是 这两种情况在老年人中非常普遍，并且异常的睡眠特征可以修改 通过现有的干预措施。因此，阐明异常的睡眠特征是否在睡眠中起作用， 认知障碍的病因学具有重要的公共卫生意义。

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.