Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Psychology Department, University of Wisconsin-Milwaukee, Madison, WI, USA.
J Alzheimers Dis. 2023;95(2):427-435. doi: 10.3233/JAD-220910.
Emerging evidence suggests that age-related changes in cerebral health may be sensitive to vascular risk modifiers, such as physical activity and sleep.
We examine whether cardiorespiratory fitness modifies the association of obstructive sleep apnea (OSA) severity with MRI-assessed measures of cerebral structure and perfusion.
Using data from a cross-sectional sample of participants (n = 129, 51% female, age range 49.6-85.3 years) in the Wisconsin Sleep Cohort study, we estimated linear models of MRI-assessed total and regional gray matter (GM) and white matter (WM) volumes, WM hyperintensity (WMH:ICV ratio), total lesion volume, and arterial spin labeling (ASL) cerebral blood flow (CBF), using an estimated measure of cardiorespiratory fitness (CRF) and OSA severity as predictors. Participants' sleep was assessed using overnight in-laboratory polysomnography, and OSA severity was measured using the apnea-hypopnea index (AHI), or the mean number of recorded apnea and hypopnea events per hour of sleep. The mean±SD time difference between PSG data collection and MRI data collection was 1.7±1.5 years (range: [0, 4.9 years]).
OSA severity was associated with reduced total GM volume (β=-0.064; SE = 0.023; p = 0.007), greater total WM lesion volume (interaction p = 0.023), and greater WMHs (interaction p = 0.017) in less-fit subjects. Perfusion models revealed significant differences in the association of AHI and regional CBF between fitness groups (interaction ps < 0.05).
This work provides new evidence for the protective role of cardiorespiratory fitness against the deleterious effects of OSA on brain aging in late-middle age to older adults.
新出现的证据表明，大脑健康的年龄相关性变化可能对血管风险修饰因子敏感，如体力活动和睡眠。
我们研究心肺健康状况是否会改变阻塞性睡眠呼吸暂停（OSA）严重程度与 MRI 评估的大脑结构和灌注之间的关联。
利用威斯康星州睡眠队列研究的横断面样本中参与者的数据（n=129，51%为女性，年龄范围 49.6-85.3 岁），我们使用心肺健康状况的估计值（CRF）和 OSA 严重程度作为预测指标，估计了 MRI 评估的总及区域灰质（GM）和白质（WM）体积、WM 高信号（WMH：ICV 比值）、总病变体积和动脉自旋标记（ASL）脑血流（CBF）的线性模型。参与者的睡眠使用夜间实验室多导睡眠图进行评估，OSA 严重程度使用呼吸暂停-低通气指数（AHI）或每小时睡眠记录的呼吸暂停和低通气事件的平均数量进行测量。PSG 数据采集和 MRI 数据采集之间的平均时间差为 1.7±1.5 年（范围：[0，4.9 年]）。
在体力活动水平较低的参与者中，OSA 严重程度与总 GM 体积减少（β=-0.064；SE=0.023；p=0.007）、总 WM 病变体积增加（交互作用 p=0.023）和 WMH 增加（交互作用 p=0.017）相关。灌注模型显示 AHI 与区域 CBF 之间的关联在不同健康状况的人群中存在显著差异（交互作用 p<0.05）。
这项工作为心肺健康对中老年至老年人中 OSA 对大脑衰老的有害影响的保护作用提供了新的证据。
