Sleep Disordered Breathing Associated with Higher Risk of Cognitive Impairment in Older Women

Printer-friendly versionPDF version

New research, co-authored by Susan Redline, MD, a researcher in the Division of Sleep Medicine at BWH, finds that sleep disordered breathing is associated with and precedes a higher risk of cognitive impairment in older women.

Sleep disordered breathing (SDB) has been associated with poor cognition in previous research, but it had been unclear whether SDB preceded this impairment in cognition. New research, co-authored by Susan Redline, MD, a researcher in the Division of Sleep Medicine at Brigham and Women's Hospital (BWH), finds that SDB is associated with and precedes a higher risk of cognitive impairment in older women. These findings are published in the August 10, 2011 issue of the Journal of the American Medical Association.

"Even after adjusting for age, body mass index, education, diabetes, and baseline cognitive scores, we found that indices of hypoxia, but not sleep fragmentation or duration, were associated with increased risk for mild cognitive impairment and dementia, suggesting that hypoxia is a likely mechanism through which SDB increases risk for cognitive impairment," said Redline, who directed the Sleep Reading Center for the study.

Researchers studied nearly 300 women with a mean age of 82, free of dementia at initial examination. Between 2002-2004, 105 of these women were diagnosed with SDB defined as having 15 or more apneas and intermittent hypoxemia per hour of sleep. Five years later, they followed up with the women to determine their cognitive status, which was classified as normal, dementia, or mild cognitive impairment (MCI). Researchers found that compared to the women without SDB, those with SDB were nearly two-fold more likely to develop cognitive impairment.

"More research is needed to explore the association between hypoxia and risk of MCI/dementia which could provide clues into the mechanisms through which SDB might promote cognitive impairment," said Redline. "Given the high prevalence of both SDB and cognitive impairment among older adults, the possibility of an association between the two conditions, even a modest one, has the potential for a large public health impact. This prospective study supports the need for intervention studies to assess whether treatment of SDB may prevent the development of cognitive impairment."

The lead author is Kristine Yaffe, MD of the University of California, San Francisco. Katie Stone, PhD, of California Pacific Medical Center, is a co-author who directed the Coordinating Center for the study, and Susan Redline, MD, of BWH, is a co-author who directed the sleep study analysis. This research was conducted using The Study of Osteoporotic Fractures (SOF) cohort, which is supported by National Institutes of Health.

RELATED LINKS
Brigham and Women's Hospital Division of Sleep Medicine
Sleep Medicine Research

Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. BWH is the home of the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 900 physician-investigators and renowned biomedical scientists and faculty supported by more than $ 537 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit Brigham and Women's Hospital .