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Brain and cognitive correlates of sleep fragmentation in elderly subjects with and without cognitive deficits

Authors
  • André, Claire1
  • Tomadesso, Clémence1, 2
  • de Flores, Robin1, 2
  • Branger, Pierre1
  • Rehel, Stéphane1
  • Mézenge, Florence1, 2
  • Landeau, Brigitte1, 2
  • Sayette, Vincent de la1
  • Eustache, Francis1
  • Chételat, Gaël1, 2
  • Rauchs, Géraldine1
  • 1 Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
  • 2 Université Normandie, Inserm, UNICAEN, Inserm UMR-S 1237, GIP Cyceron, Caen, France
Type
Published Article
Journal
Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
Publisher
Elsevier
Publication Date
Feb 08, 2019
Volume
11
Pages
142–150
Identifiers
DOI: 10.1016/j.dadm.2018.12.009
PMID: 30788411
PMCID: PMC6369144
Source
PubMed Central
Keywords
License
Unknown

Abstract

Introduction Sleep disturbances are increasingly recognized as a risk factor for Alzheimer's disease. However, no study has assessed the relationships between objective sleep fragmentation (SF) and brain and cognitive integrity across different cognitive stages, from cognitively unimpaired elderly subjects to patients with subjective cognitive decline and/or mild cognitive impairment. Methods 30 cognitively unimpaired elderly participants and 36 patients with subjective cognitive decline and/or mild cognitive impairment underwent a neuropsychological evaluation, structural MRI, 18F-fluorodeoxyglucose, and 18F-florbetapir-PET scans, and an actigraphy recording over a minimum of six consecutive nights. Multiple regression and mediation analyses were performed between SF parameters, neuroimaging data, and cognitive scores. Results In cognitively unimpaired elderly participants, SF intensity mediated the association between frontohippocampal hypometabolism and lower executive functioning. Moreover, to a lower extent, increased SF variability was related to thalamic atrophy and ventromedial prefrontal amyloid burden. However, in patients with subjective cognitive decline and/or mild cognitive impairment, SF no longer contributed to the expression of cognitive deficits. Discussion These findings suggest that SF may directly contribute to lower cognitive performance in cognitively unimpaired elderly subjects. Therefore, treating sleep disturbances before the onset of cognitive deficits may help to cope with brain alterations and maintain cognitive functioning.

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