INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #48 Sleep Apnea, Hypertension, and Tau Pathology in Older Women with Increased Alzheimer’s Risk Kitty Lui, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States Xin Wang, University of California San Diego, La Jolla, United States Melanie Dratva, University of California San Diego, La Jolla, United States Nadine Heyworth, University of California San Diego, La Jolla, United States Pamela DeYoung, University of California San Diego, La Jolla, United States Atul Malhotra, University of California San Diego, La Jolla, United States Erin Sundermann, University of California San Diego, La Jolla, United States Sarah Banks, University of California San Diego, La Jolla, United States Category: Sleep and Sleep Disorders Keyword 1: dementia - Alzheimer's disease Keyword 2: sleep Keyword 3: hypertension Objective: Hypertension is a common comorbidity of obstructive sleep apnea (OSA), and both are risk factors for Alzheimer’s disease (AD) that have been linked to tau pathology. Older women have similar OSA risk compared with older men, yet are often underdiagnosed. Furthermore, AD disproportionately impacts older women, who also accumulate pathological tau faster than older men. Here, in the Women: Inflammation Tau Study (WITS), we examined OSA prevalence in older women with heightened AD risk and, among participants with OSA, we investigated the relationships between OSA features and tau pathology and explored whether hypertension modified these relationships. Participants and Methods: In WITS, women have a polygenic hazard score≥50^th percentile and mild cognitive impairment indicated by the telephone-Montreal Cognitive Assessment (range:13-20). Participants completed at-home sleep tests to derive OSA features of apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean and nadir oxygen saturation (OSat), and time in bed (TIB) with OSat<88%. They also underwent ¹⁸F-MK6240 positron emission tomography (PET) to determine tau deposition. Standardized uptake value ratios (SUVRs) were calculated in the following regions: Braak stages I/II, III/IV, and V/VI, and the meta-temporal region. Hypertension status was determined by participant self-report as having or being treated for high blood pressure on the STOP-BANG questionnaire. In women with OSA, linear regression models were used to examine the moderating effects of hypertension on the associations between OSA features and tau PET SUVR. Results: We report on 26 women (aged:72.3±3.9 years) enrolled in WITS thus far, none of whom had prior OSA diagnoses. 19 women (73.1%) met OSA diagnosis (AHI≥5/hr; 10 mild, 9 moderate). Of the 19 women with OSA, 10 (52.6%) reported a diagnosis of hypertension on the STOP-BANG (9 of those women had moderate OSA). Amongst women with OSA, there were significant interactions of hypertension×mean OSat (b=-0.11, p=0.04) and hypertension×TIB with OSat<88% (b=0.40, p=0.01) on Braak stages I/II whereby lower mean OSat and more TIB with OSat<88% were associated with more pathological tau in Braak stages I/II only in those with hypertension. Similarly, there was a significant interaction of hypertension×TIB with OSat<88% on Braak stages III/IV (b=0.28, p=0.01), such that more TIB with OSat<88% was related to greater tau burden in Braak stages III/IV only in those with hypertension. Lastly, there were significant and trend-level interactions of hypertension×AHI (b=0.02, p=0.06), hypertension×ODI(b=0.02, p=0.07), and hypertension×TIB with OSat<88% (b=0.29, p=0.04) on the meta-temporal ROI, whereby greater OSA severity and more TIB with OSat<88% were associated with higher tau levels in the meta-temporal ROI only in those with hypertension. Conclusions: In these preliminary results, undiagnosed OSA was highly prevalent in older women and those with moderate OSA tended to have hypertension. Among women with OSA, more severe OSA features was associated with greater tau burden in temporal and neocortical association regions only in women with hypertension. The combined effect of greater OSA severity and hypertension may exacerbate pathological tau, which points to the possibility that diagnosis and treatment of both conditions may mitigate AD risk, especially for older women. Future longitudinal studies could be designed to investigate this further.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #48

Sleep Apnea, Hypertension, and Tau Pathology in Older Women with Increased Alzheimer’s Risk

Kitty Lui, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States
Xin Wang, University of California San Diego, La Jolla, United States
Melanie Dratva, University of California San Diego, La Jolla, United States
Nadine Heyworth, University of California San Diego, La Jolla, United States
Pamela DeYoung, University of California San Diego, La Jolla, United States
Atul Malhotra, University of California San Diego, La Jolla, United States
Erin Sundermann, University of California San Diego, La Jolla, United States
Sarah Banks, University of California San Diego, La Jolla, United States

Category: Sleep and Sleep Disorders

Keyword 1: dementia - Alzheimer's disease
Keyword 2: sleep
Keyword 3: hypertension

Objective:

Hypertension is a common comorbidity of obstructive sleep apnea (OSA), and both are risk factors for Alzheimer’s disease (AD) that have been linked to tau pathology. Older women have similar OSA risk compared with older men, yet are often underdiagnosed. Furthermore, AD disproportionately impacts older women, who also accumulate pathological tau faster than older men. Here, in the Women: Inflammation Tau Study (WITS), we examined OSA prevalence in older women with heightened AD risk and, among participants with OSA, we investigated the relationships between OSA features and tau pathology and explored whether hypertension modified these relationships.

Participants and Methods:

In WITS, women have a polygenic hazard score≥50^th percentile and mild cognitive impairment indicated by the telephone-Montreal Cognitive Assessment (range:13-20). Participants completed at-home sleep tests to derive OSA features of apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean and nadir oxygen saturation (OSat), and time in bed (TIB) with OSat<88%. They also underwent ¹⁸F-MK6240 positron emission tomography (PET) to determine tau deposition. Standardized uptake value ratios (SUVRs) were calculated in the following regions: Braak stages I/II, III/IV, and V/VI, and the meta-temporal region. Hypertension status was determined by participant self-report as having or being treated for high blood pressure on the STOP-BANG questionnaire. In women with OSA, linear regression models were used to examine the moderating effects of hypertension on the associations between OSA features and tau PET SUVR.

Results:

We report on 26 women (aged:72.3±3.9 years) enrolled in WITS thus far, none of whom had prior OSA diagnoses. 19 women (73.1%) met OSA diagnosis (AHI≥5/hr; 10 mild, 9 moderate). Of the 19 women with OSA, 10 (52.6%) reported a diagnosis of hypertension on the STOP-BANG (9 of those women had moderate OSA). Amongst women with OSA, there were significant interactions of hypertension×mean OSat (b=-0.11, p=0.04) and hypertension×TIB with OSat<88% (b=0.40, p=0.01) on Braak stages I/II whereby lower mean OSat and more TIB with OSat<88% were associated with more pathological tau in Braak stages I/II only in those with hypertension. Similarly, there was a significant interaction of hypertension×TIB with OSat<88% on Braak stages III/IV (b=0.28, p=0.01), such that more TIB with OSat<88% was related to greater tau burden in Braak stages III/IV only in those with hypertension. Lastly, there were significant and trend-level interactions of hypertension×AHI (b=0.02, p=0.06), hypertension×ODI(b=0.02, p=0.07), and hypertension×TIB with OSat<88% (b=0.29, p=0.04) on the meta-temporal ROI, whereby greater OSA severity and more TIB with OSat<88% were associated with higher tau levels in the meta-temporal ROI only in those with hypertension.

Conclusions:

In these preliminary results, undiagnosed OSA was highly prevalent in older women and those with moderate OSA tended to have hypertension. Among women with OSA, more severe OSA features was associated with greater tau burden in temporal and neocortical association regions only in women with hypertension. The combined effect of greater OSA severity and hypertension may exacerbate pathological tau, which points to the possibility that diagnosis and treatment of both conditions may mitigate AD risk, especially for older women. Future longitudinal studies could be designed to investigate this further.