Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms

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  • dc.contributor.author Stankeviciute, Laura
  • dc.contributor.author Blackman, Jonathan
  • dc.contributor.author Tort-Colet, Núria
  • dc.contributor.author Fernández-Arcos, Ana
  • dc.contributor.author Sánchez Benavides, Gonzalo
  • dc.contributor.author Suárez-Calvet, Marc
  • dc.contributor.author Iranzo, Alex
  • dc.contributor.author Molinuevo, José Luis
  • dc.contributor.author Gispert López, Juan Domingo
  • dc.contributor.author Coulthard, Elizabeth
  • dc.contributor.author Grau-Rivera, Oriol
  • dc.date.accessioned 2024-10-28T07:21:13Z
  • dc.date.available 2024-10-28T07:21:13Z
  • dc.date.issued 2024
  • dc.description.abstract Sleep disturbances are prevalent in Alzheimer's disease (AD), affecting individuals during its early stages. We investigated associations between subjective sleep measures and cerebrospinal fluid (CSF) biomarkers of AD in adults with mild cognitive symptoms from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, considering the influence of memory performance. A total of 442 participants aged >50 years with a Clinical Dementia Rating (CDR) score of 0.5 completed the Pittsburgh Sleep Quality Index questionnaire and underwent neuropsychological assessment, magnetic resonance imaging acquisition, and CSF sampling. We analysed the relationship of sleep quality with CSF AD biomarkers and cognitive performance in separated multivariate linear regression models, adjusting for covariates. Poorer cross-sectional sleep quality was associated with lower CSF levels of phosphorylated tau and total tau alongside better immediate and delayed memory performance. After adjustment for delayed memory scores, associations between CSF biomarkers and sleep quality became non-significant, and further analysis revealed that memory performance mediated this relationship. In post hoc analyses, poorer subjective sleep quality was associated with lesser hippocampal atrophy, with memory performance also mediating this association. In conclusion, worse subjective sleep quality is associated with less altered AD biomarkers in adults with mild cognitive symptoms (CDR score 0.5). These results could be explained by a systematic recall bias affecting subjective sleep assessment in individuals with incipient memory impairment. Caution should therefore be exercised when interpreting subjective sleep quality measures in memory-impaired populations, emphasising the importance of complementing subjective measures with objective assessments.
  • dc.description.sponsorship Data used in the preparation of this article were obtained from the Longitudinal Cohort Study (LCS), delivered by the European Prevention of Alzheimer's Disease (EPAD) Consortium. As such investigators within the EPAD-LCS and EPAD Consortium contributed to the design and implementation of EPAD and/or provided data but did not participate in the analysis or writing of this report. A complete list of EPAD Investigators can be found at: https://ep-ad.org/wp-content/uploads/2020/12/202010_List-of-epadistas.pdf. The EPAD-LCS was launched in 2015 as a public–private partnership, led by Chief Investigator Professor Craig Ritchie MB BS. This work used data and/or samples from the EPAD project which received support from the EU/EFPIA Innovative Medicines Initiative Joint Undertaking EPAD grant agreement number 115736 and an Alzheimer's Association Grant (SG21-818099-EPAD).
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Stankeviciute L, Blackman J, Tort-Colet N, Fernández-Arcos A, Sánchez-Benavides G, Suárez-Calvet M, et al. Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms. J Sleep Res. 2024 Aug;33(4):e14108. DOI: 10.1111/jsr.14108
  • dc.identifier.doi http://dx.doi.org/10.1111/jsr.14108
  • dc.identifier.issn 0962-1105
  • dc.identifier.uri http://hdl.handle.net/10230/68360
  • dc.language.iso eng
  • dc.publisher Wiley
  • dc.relation.ispartof J Sleep Res. 2024 Aug;33(4):e14108
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/115736
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/948677
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/847648
  • dc.rights © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.subject.keyword Alzheimer's disease
  • dc.subject.keyword Pittsburgh Sleep Quality Index (PSQI)
  • dc.subject.keyword Biomarkers
  • dc.subject.keyword Cerebrospinal fluid (CSF)
  • dc.subject.keyword Dementia
  • dc.subject.keyword Memory impairment
  • dc.subject.keyword Mild cognitive impairment (MCI)
  • dc.subject.keyword Sleep
  • dc.title Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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