Association of Sleep Disordered Breathing and Cognitive Deficit in APOE e4 Carriers.

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Abstract

The aim of the study was to determine whether apolipoprotein E epsilon 4 genotype (APOE4) modifies the association of sleep disordered breathing (SDB) with cognitive function in a middle-aged population.Cross-sectional analysis of a community-dwelling cohort.Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospitals and Clinics.There were 755 adults from the Wisconsin Sleep Cohort who provided a total of 1,843 polysomnography and cognitive evaluations (most participants were assessed multiple times at approximately 4-y intervals); 56% males, average age 53.9 years (range 30-81 years).None.In-laboratory overnight polysomnography was used to assess SDB. Cognition was evaluated by a battery of six neurocognitive tests assessing memory and learning, attention, executive function, and psychomotor efficiency. The APOE4 genotype (e3/e4 or e4/ e4) was identified in 200 participants. Data were analyzed using linear mixed-effects models, accounting for multiple observations per participant. Cognitive test scores were regressed on SDB categories (AHI < 5, 5 = AHI < 15, AHI = 15); APOE4 and their interaction; and age, education, sex, and body mass index. There was no statistically significant association between SDB and cognitive performance among APOE4-negative individuals. However, in APOE4-positive individuals, those with AHI = 15 had significantly worse performance on the Auditory Verbal Learning Test and the Controlled Oral Word Association Test.In APOE4-positive individuals, moderate to severe sleep disordered breathing (AHI = 15) was associated with poorer performance on cognitive tests that require both memory and executive function engagement.

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