Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research

Bubu, Omonigho Michael; Andrade, Alessandro Vivas; Umasabor‐Bubu, Ogie Queen; Hogan, Megan; Turner, Arlener D.; Leon, Mony J. de; Ogedegbe, Gbenga; Ayappa, Indu; G, Girardin Jean-Louis; Jackson, Melinda L.; Varga, Andrew W.; Osorio, Ricardo S.

doi:10.1016/j.smrv.2019.101250

Cited by 204 publications

(174 citation statements)

References 189 publications

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“…The main findings of the considered studies are, for reader's convenience, summarized in Table 1. It has been already demonstrated by several studies (Bubu et al, 2020;Kuo et al, 2020) that OSA may induce an alteration in cerebrospinal fluid (CSF) β-amyloid, particularly Aβ 40 and Aβ 42 and T-tau and/or P-tau protein levels, which are also the known pathological hallmarks of AD. Intermittent hypoxia and sleep fragmentation, that is, the common OSA processes, have been identified as the fundamental processes that can generate neurodegenerative changes.…”

Section: Resultsmentioning

confidence: 99%

“…Despite the fact that underlying mechanisms and causes for AD are still not completely understood, researchers generally agree that extracellular β-amyloid build-up (plaques) and intraneuronal neurofibrillary (tau) tangles accumulated throughout the brain are the hallmarks of AD (Querfurth and LaFerla, 2010). The amyloid plaques were also found in individuals with OSA, supporting a possible connection between OSA and an increased risk for development of AD (Bubu et al, 2020). The purpose of this study is to (i) assess this association between OSA and AD, (ii) identify the population that is more susceptible to OSA and AD, and (iii) find if treatment of OSA may affect the progress of AD.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

Kuo

Hsiao²,

Lo³

et al. 2021

Front. Aging Neurosci.

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Obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are common in the elderly population. Obstructive sleep apnea that may cause significant changes in the cerebrospinal fluid β-amyloid and T-tau and/or P-tau protein levels is often identified as a risk factor for development of AD. Although the underlying mechanisms of AD are still not fully understood, a hypothesis associating OSA with AD has been already proposed. In this systematic mini-review, we first discuss the recent findings supporting the association of OSA with an increased risk of AD and then provide evidence suggesting the positive effect of OSA treatment on a reduced risk of AD.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

Kuo

Hsiao²,

Lo³

et al. 2021

Front. Aging Neurosci.

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“…We also did not assess all 16 controls for OSA with polysomnography, and there is a possibility – albeit small – that some of this group may have had undiagnosed OSA. Regardless of these limitations, the insights from studies such as ours are important for understanding the neural substrates of cognitive functioning in OSA patients, particularly in light of the growing body of evidence that untreated OSA puts an individual at a greater risk of later-life cognitive decline ( Yaffe et al, 2011 ; Bubu et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated to affect ~4% of middle aged adults ( Young et al, 1993 ), rising to up to 60% of the elderly ( Ancoli-Israel et al, 1991 ). OSA is associated with significant daytime consequences, including excessive sleepiness, depressive symptoms, and cognitive deficits ( Jackson et al, 2011a ), with an increased risk of cognitive decline and Alzheimer’s disease ( Bubu et al, 2020 ). Approximately half of all patients with OSA have some form of memory impairment, and are at risk of premature age-related memory decline ( Yaffe et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Integrity of Multiple Memory Systems in Individuals With Untreated Obstructive Sleep Apnea

et al. 2020

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Obstructive sleep apnea (OSA) is associated with working- and autobiographical-memory impairments, and high rates of mood disorder. This study aimed to examine (i) behavioral responses and (ii) neural activation patterns elicited by autobiographical and working memory tasks in moderate-severe untreated OSA patients and healthy controls, and (iii) whether variability in autobiographical and working memory activation are associated with task performance, OSA severity and psychological symptomatology (depression, anxiety). In order to control for the potential confounding effect of elevated rates of clinical depression in OSA, we excluded individuals with a current psychiatric condition. Seventeen untreated OSA participants and 16 healthy controls were comparable with regards to both activation and behavioral performance. OSA was associated with worse subclinical mood symptoms and poorer personal semantic memory. Higher levels of nocturnal hypoxia were associated with increased activation in the occipital cortex and right cerebellum during the working memory task in OSA participants, however, no significant relationships between activation and task performance or depressive/anxiety symptomatology were observed. The neurocognitive substrates supporting autobiographical recall of recent events and working memory in younger, recently diagnosed individuals with OSA appear to be indistinguishable from healthy age-matched individuals. These findings point to the importance of early diagnosis and treatment of OSA in order to preserve cognitive function.

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“…Hamilton Depression Scale (HAMD) score is ≥17, pseudo-dementia caused by depression and other emotional abnormalities. [12,13] , or diagnosed as sleep apnea syndrome by multiple physiological sleep tests (Polysomnography, PSG).…”

Section: Exclusion Criteriamentioning

confidence: 99%

Acupuncture for amnestic mild cognitive impairment (aMCI): study protocol for a pilot multicenter, randomized, parallel controlled trial

Zhang¹,

Kuang²,

Tang³

et al. 2020

Preprint

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Background: Patients with amnesic mild cognitive impairment (aMCI) are more likely to develop Alzheimer's disease (AD) than corresponding age normal population. Because AD is irreversible, early intervention for aMCI patients seems important and urgent. We have designed a pilot multicenter, randomized, parallel controlled trial to assess the efficacy and safety of acupuncture on aMCI, and explore the feasibility of acupuncture in the treatment of aMCI, so as to provide a reference for large-sample clinical trials in the next stage. Method: We designed a pilot multicenter, randomized, parallel controlled trial. This trial aims to test the feasibility of carrying out a large-sample clinical trial. In this trial, 50 eligible patients with aMCI will be included and allocated to acupuncture group (n = 25) or sham acupuncture group (n = 25) at random. Subjects will accept treatment 2 times a week for 12 weeks continuously, with a total of 24 treatment sessions. We will select six acupoints (GV20, GV14, bilateral BL18 , bilateral BL23). For the clinical outcomes, the primary outcome is Montreal cognitive assessment (MoCA), which will be assessed from baseline to the end of this trial. And the secondary outcomes are Mini-mental State Examination (MMSE), Delayed Story Recall (DSR), Clinical Dementia Rating scale (CDR), Global Deterioration Scale (GDS), Activity of Daily Life (ADL), Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog), brain Magnetic Resonance Imaging (MRI) , brain functional Magnetic Resonance Imaging (fMRI) and Event-related potential (ERP) P300, which will be assessed before and after treatment. In addition, we will asses the safety outcomes from baseline to the end of this trial and feasibility outcome after treatment. We will evaluate neuropsychological assessment scale (MoCA, MMSE, ADAS-cog) at 3 months and 6months after treatment. Discussion: This pilot trial aims to explore the feasibility of the trial, and verify essential information of its efficacy and safety. This pilot study will provide a preliminary basis for carrying out a larger clinical trial of acupuncture on aMCI in near future. Trial registration: Chinese Clinical Trial Registry , ChiCTR1900021557. Registered on 27 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35460. Keywords: amnestic Mild Cognitive Impairment , Acupuncture, Clinical trial

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Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research

Cited by 204 publications

References 189 publications

Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer's Disease: Systematic Mini-Review

Integrity of Multiple Memory Systems in Individuals With Untreated Obstructive Sleep Apnea

Acupuncture for amnestic mild cognitive impairment (aMCI): study protocol for a pilot multicenter, randomized, parallel controlled trial

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