Abstract Details

Title Association of Nighttime Behaviours with Rate of Cognitive Decline in Pathologically Confirmed AD Patients: Role of Gender and Comorbidities

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 10-005

Objective

To investigate the association between sleep disturbances at any point during the course of disease and the rate of cognitive decline in all autopsy-confirmed, high-load Alzheimer’s disease (AD) pathology subjects regardless of initial cognitive and sleep status.

Background While short-term studies conducted have suggested a close reciprocal relationship between cognitive function and sleep abnormalities with AD pathology, long term trends with associated pathological substrates and comorbidities in AD patients of all cognitive levels remain largely understudied.

Design/Methods Data collected by the National Alzheimer’s Coordinating Centre (NACC) was used. All subjects were pathologically confirmed high-load AD, corresponding to a high Braak stage and CERAD score. Other primary pathological diagnoses were excluded. The Neuropsychiatric Inventory Questionnaire Quick Version’s (NPI-Q) nighttime behaviour (NTB) was used as a surrogate for sleep disturbances. Cognitive decline was measured by the subject’s change in Mini-Mental Status Examination (MMSE) scores over the course of their annual visits. Regression analyses were used to determine the association between NTB and rate of cognitive decline.

Results 667 subjects were included in the study with collection periods averaging a span of 2.86 years. Subjects presenting NTB decreased in MMSE scores at a significantly faster rate than subjects lacking NTB (p = 0.036). This significance was seen with stratification to males (p = 0.024) and males lacking Lewy bodies, cerebral lacunes or large arterial infarctions at autopsy, or recent history of hypertension or atrial fibrillation.

Conclusions A faster rate of cognitive decline is associated with the presence of nighttime behaviours in high-load Alzheimer’s subjects, with a more pronounced difference when focusing on males who lacked certain pathology or vascular risk factors.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
David G. Munoz, MD (University of Toronto)	No disclosure on file