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The association of subjective sleep characteristics and plasma biomarkers of Alzheimer’s disease pathology in older cognitively unimpaired adults with higher amyloid-β burden

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Abstract

We aimed to investigate the association of subjective sleep characteristics and plasma Alzheimer’s disease (AD) biomarkers in older cognitively unimpaired adults with higher amyloid-β (Aβ) burden. Unimpaired cognition was determined by education-adjusted performance for the Mini-Mental State Examination and exclusion of dementia and mild cognitive impairment via standardized neuropsychological tests. We used Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The participants also underwent examination of plasma AD biomarkers and 18F-florbetapir PET scan. Correlation and multiple linear regression analyses were used to investigate the association between subjective sleep characteristics and AD biomarkers. A total of 335 participants were included and 114 were Aβ-PET positive. Multivariable regression analysis showed sleep duration > 8 h and sleep disturbance were associated with Aβ deposition in total participants. Two multiple linear regression models were applied and the results revealed in participants with Aβ-PET (+), falling asleep at ≥ 22:00 to ≤ 23:00 was associated with higher levels of Aβ42 and Aβ42/40. Other associations with higher Aβ42/40 and standard uptake value ratio contained sleep efficiency value, sleep efficiency ≥ 75%, no/mild daytime dysfunction and PSQI score ≤ 5. Higher p-Tau-181 level was associated with sleep latency > 30 min in Aβ-PET (+) group and moderate/severe sleep disturbance in Aβ-PET (–) group. Our data suggests sleep duration ≤ 8 h and no/mild sleep disturbance may be related to less Aβ burden. In participants with Aβ deposition, falling asleep at 22:00 to 23:00, higher sleep efficiency (at least ≥ 75%), no/mild daytime dysfunction, sleep latency ≤ 30 min, and good sleep quality may help improve AD pathology.

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Availability of data and materials

The datasets collected and/or analyzed during this study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Natural Science Foundation of China (82171198; 82071472; 81901102), Shanghai Municipal Science and Technology Major Project (No. 2018SHZDZX01) and ZJLab, the Guangdong Provincial Key S&T Program (2018B030336001) and Shanghai Pujiang Program (21PJ1423100).

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Authors and Affiliations

  1. Department of Gerontology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, China

    Heling Chu, Ya Miao, Chenxi Ren & Qihao Guo

  2. Health Management Center, School of Medicine, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China

    Chuyi Huang

  3. PET Center, Huashan Hospital, Fudan University, Shanghai, China

    Yihui Guan & Fang Xie

  4. Department of Data and Analytics, WuXi Diagnostics, Shanghai, China

    Zhuo Fang

Authors
  1. Heling Chu
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  4. Chenxi Ren
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  5. Yihui Guan
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  6. Fang Xie
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  7. Zhuo Fang
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  8. Qihao Guo
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Contributions

HC designed the study, analyzed the data and drafted of the manuscript. CH revised the manuscript. YM collected the data. CR collected and processed the blood sample. YG had a major role in PET experiments and data analyses. FX assisted in the PET experiments. ZF conceptualized the study. QG conceptualized and designed the study, and revised the manuscript. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to Zhuo Fang or Qihao Guo.

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Conflicts of interest

The authors declare that they have no competing interests.

Ethical approval and consent to participate

This study was approved by the ethical standards of the Ethics Committee of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (No. 2019-032), and written informed consent was provided by each patient’s next of kin/participant.

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Chu, H., Huang, C., Miao, Y. et al. The association of subjective sleep characteristics and plasma biomarkers of Alzheimer’s disease pathology in older cognitively unimpaired adults with higher amyloid-β burden. J Neurol 270, 3008–3021 (2023). https://doi.org/10.1007/s00415-023-11626-0

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  • DOI: https://doi.org/10.1007/s00415-023-11626-0

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