Sleep Disordered Breathing and Alzheimer's Disease Prevention, New York City

Preliminary data show that within the cognitively-normal elderly population, Sleep Disordered Breathing (SDB) is associated with biomarker changes which have been shown to be useful in predicting future dementia in older adults. These findings raise the question as to whether Alzheimer's disease (AD) tissue damage causes SDB in the elderly, or alternatively, if SDB acts as a risk factor for AD neurodegeneration. In the proposed study, researchers will investigate these hypotheses in cognitively normal elderly by examining the longitudinal associations between SDB and cognitive decline, brain imaging, and Cerebrospinal Fluid (CSF) biomarkers for neurodegeneration; while the secondary goal is to launch a pilot treatment study to aid in interpreting the hypotheses and to examine the effects of nasal continuous positive airway pressure (CPAP) on cognitive decline and neurodegeneration.

The purpose of this study is to analyze the association between risk for Alzheimer’s disease and abnormal breathing during the night. This study has two goals:

1. To improve the understanding of the long term association between risk for Alzheimer’s disease (AD) and Sleep Disordered Breathing (SDB) in the elderly (SDB are a group of disorders characterized by abnormalities of respiratory pattern -pauses in breathing- or the amount of ventilation during sleep).

2. To conduct a small exploratory treatment study for prevention of AD using a CPAP machine in those subjects that have moderate-to-severe SDB. CPAP is an FDA (Federal Drug Administration) approved treatment that uses mild air pressure during sleep to keep the airway open.

The study includes:

• Complete physical and neurological exams
• Clinical blood analysis
• Memory evaluations
• Structural and ASL MRI scans
• Lumbar Puncture
• Home-monitoring studies for Sleep Apnea
• 6-month Clinical Trial with CPAP if moderate-severe Sleep Apnea is diagnosed