Aging, Cognitive Decline, and Dementia
Sleep-disordered breathing is increasingly associated with cognitive decline and dementia risk via hypoxia, sleep fragmentation, inflammation, and vascular pathways.
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Association of Sleep-Disordered Breathing with Cognitive Function and Risk of Cognitive Decline.
Leng Y, McEvoy CT, Allen IE, Yaffe K.
Large cohort analysis demonstrating that sleep-disordered breathing is associated with poorer cognitive performance and increased risk of cognitive decline, supporting airway evaluation as part of dementia risk assessment.
[JAMA Network Open, 2021]
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Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review and Meta-Analysis.
Big-picture synthesis: sleep-disordered breathing is associated with worse cognition and higher risk of cognitive impairment across population studies.
[JAMA Neurology (2017)]
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Sleep-Disordered Breathing, Hypoxia, and Risk of Mild Cognitive Impairment and Dementia in Older Women.
Prospective data showing SDB (especially with hypoxia) predicts later MCI/dementia risk in older adults, the “this is not just snoring” paper.
[JAMA (2011)]
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Association Between Obstructive Sleep Apnea and Brain White Matter Hyperintensities in a Population-Based Cohort in Germany.
Connects OSA to structural brain injury markers (white matter hyperintensities) that track with vascular cognitive risk.
[JAMA Network Open (2021)]
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Obstructive Sleep Apnea Severity Affects Amyloid Burden in Cognitively Normal Elderly: A Longitudinal Study.
Longitudinal evidence linking OSA physiology to Alzheimer’s-type amyloid burden changes in cognitively normal older adults.
[American Journal of Respiratory and Critical Care Medicine]
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Sleep-Disordered Breathing Advances Cognitive Decline in the Elderly (ADNI Cohort); CPAP Associated with Delayed Onset.
In ADNI, SDB is linked to earlier cognitive decline, and CPAP use is associated with later onset (translation: treatment timing matters).
[Neurology (2015)]
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Obstructive Sleep Apnea and Longitudinal Alzheimer’s Disease Biomarker Changes.
OSA diagnosis is associated with longitudinal changes in amyloid/tau biomarkers (PET/CSF) in normal, MCI, and AD groups.
[SLEEP (2019)]
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Cognitive Effects of Treating Obstructive Sleep Apnea in Alzheimer’s Disease: A Randomized Controlled Study.
RCT signal that treating comorbid OSA in AD can improve aspects of cognition (this is the “don’t ignore treatable physiology” argument).
[Journal of the American Geriatrics Society (2008)]
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Sex-Specific Dementia Risk in Known or Suspected Obstructive Sleep Apnea: a 10-Year Longitudinal Population-Based Study.
Big real-world longitudinal data: OSA status tracks with dementia incidence over a decade.
[SLEEP Advances (2024)]
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Association Between Sleep Apnoea and Risk of Cognitive Impairment and Alzheimer’s Disease: a Meta-Analysis of Cohort-Based Studies.
Cohort-only meta-analysis: summarizes the dementia/AD risk signal and flags differences based on how OSA was diagnosed (PSG vs codes/self-report).
[Sleep and Breathing (Published 2023; Volume 2024)]
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https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782215
https://jamanetwork.com/journals/jamaneurology/fullarticle/2649259
https://europepmc.org/article/MED/21828324
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784763
https://pmc.ncbi.nlm.nih.gov/articles/PMC6020410/
https://rossleep.ru/wp-content/uploads/2015/06/osorio2015.pdf
https://academic.oup.com/sleep/article/42/6/zsz048/5362540
https://teams.semel.ucla.edu/sites/default/files/publications/Nov%202008%20-%20Cognitive%20Effects%20of%20Treating%20Obstructive%20Sleep%20Apnea%20in%20Alzheimer%27s.pdf
https://academic.oup.com/sleepadvances/article/5/1/zpae077/7831433
https://link.springer.com/article/10.1007/s11325-023-02934-w