title: Association of sleep disordered breathing and cognitive deficit in APOE ε4 carriers.
abstract: OBJECTIVE
  The aim of the study was to determine whether apolipoprotein E epsilon 4 genotype (APOE4) modifies the association of sleep disordered breathing (SDB) with cognitive function in a middle-aged population.
  
  
  METHODS
  Cross-sectional analysis of a community-dwelling cohort.
  
  
  METHODS
  Sleep laboratory at the Clinical Research Unit of the University of Wisconsin Hospitals and Clinics.
  
  
  METHODS
  There were 755 adults from the Wisconsin Sleep Cohort who provided a total of 1,843 polysomnography and cognitive evaluations (most participants were assessed multiple times at approximately 4-y intervals); 56% males, average age 53.9 years (range 30-81 years).
  
  
  METHODS
  None.
  
  
  RESULTS
  In-laboratory overnight polysomnography was used to assess SDB. Cognition was evaluated by a battery of six neurocognitive tests assessing memory and learning, attention, executive function, and psychomotor efficiency. The APOE4 genotype (ε3/ε4 or ε4/ ε4) was identified in 200 participants. Data were analyzed using linear mixed-effects models, accounting for multiple observations per participant. Cognitive test scores were regressed on SDB categories (AHI < 5, 5 ≤ AHI < 15, AHI ≥ 15); APOE4 and their interaction; and age, education, sex, and body mass index. There was no statistically significant association between SDB and cognitive performance among APOE4-negative individuals. However, in APOE4-positive individuals, those with AHI ≥ 15 had significantly worse performance on the Auditory Verbal Learning Test and the Controlled Oral Word Association Test.
  
  
  CONCLUSIONS
  In APOE4-positive individuals, moderate to severe sleep disordered breathing (AHI ≥ 15) was associated with poorer performance on cognitive tests that require both memory and executive function engagement.
authors.affiliation: Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53726, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Nikodemova
authors.forename: Laurel
authors.initials: L
authors.lastname: Finn
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mignot
authors.forename: Nicole
authors.initials: N
authors.lastname: Salzieder
authors.forename: Paul E
authors.initials: PE
authors.lastname: Peppard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics* / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000235:genetics*; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000235:genetics*
chemical_list: D053327:Apolipoprotein E4
keywords: APOE4; cognitive deficit; sleep apnea