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Observational Study
. 2021 Oct 11;44(10):zsab117.
doi: 10.1093/sleep/zsab117.

Sleep profile predicts the cognitive decline of mild-moderate Alzheimer's disease patients

Adriano D S Targa  1   2 , Iván D Benítez  1   2 , Faridé Dakterzada  3 , Anna Carnes  3 , Montse Pujol  1 , Carmen Jorge  3 , Olga Minguez  1 , Mireia Dalmases  1   2 , Manuel Sánchez-de-la-Torre  2   4 , Ferran Barbé  1   2 , Gerard Piñol-Ripoll  3
Affiliations
Observational Study

Sleep profile predicts the cognitive decline of mild-moderate Alzheimer's disease patients

Adriano D S Targa et al. Sleep. .

Abstract

Study objectives: To investigate the association between sleep and cognitive decline of patients with mild-moderate Alzheimer's disease.

Methods: Observational, prospective study, including consecutive patients diagnosed with mild-moderate Alzheimer's disease. Cerebrospinal fluid was collected for amyloid-beta, total-tau, and phospho-tau levels determination. Also, overnight polysomnography was performed, followed by neuropsychological evaluations at baseline and after 12 months of follow-up. Principal component analysis revealed two profiles of patients in terms of sleep: one with a propensity to deepen the sleep (deep sleepers) and the other with a propensity to spend most of the time in the lighter sleep stage (light sleepers).

Results: The cohort included 125 patients with a median [IQR] of 75.0 [72.0;80.0] years. Deep and light sleepers did not present differences in relation to the cerebrospinal fluid pathological markers and to the cognitive function at the baseline. However, there was a significant difference of -1.51 (95% CI: -2.43 to -0.59) in the Mini-mental state examination after 12 months of follow-up. Accordingly, sleep depth and cognitive decline presented a dose-response relationship (p-for-trend = 0.02). Similar outcomes were observed in relation to the processing speed (Stroop words test, p-value = 0.016) and to the executive function (Verbal fluency test, p-value = 0.023).

Conclusions: Considering the increased cognitive decline presented by light sleepers, the sleep profile may have a predictive role in relation to the cognitive function of patients with mild-moderate Alzheimer's disease. The modifiable nature of sleep sets this behavior as a possible useful intervention to prevent a marked cognitive decline.

Clinical trial information: Role of Hypoxia Ans Sleep Fragmentation in Alzheimer's Disease. and Sleep Fragmentation. Completed. NCT02814045.

Keywords: Alzheimer’s disease; cognitive decline; sleep depth.

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