Original Investigation |

Self-reported Sleep and β-Amyloid Deposition in Community-Dwelling Older Adults

Adam P. Spira, PhD1; Alyssa A. Gamaldo, PhD2; Yang An, MS2; Mark N. Wu, MD, PhD3; Eleanor M. Simonsick, PhD2; Murat Bilgel, BS2,4; Yun Zhou, PhD5; Dean F. Wong, MD, PhD5,6; Luigi Ferrucci, MD, PhD2; Susan M. Resnick, PhD2
[+] Author Affiliations
1Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
2Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
3Departments of Neurology and Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Maryland
4Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland
5Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
6Departments of Psychiatry and Behavioral Sciences and Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Neurol. 2013;70(12):1537-1543. doi:10.1001/jamaneurol.2013.4258.
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Importance  Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest links between sleep and Alzheimer disease biomarkers. Studies are needed that evaluate whether sleep variables are associated with neuroimaging evidence of β-amyloid (Aβ) deposition.

Objective  To determine the association between self-reported sleep variables and Aβ deposition in community-dwelling older adults.

Design, Setting, and Participants  Cross-sectional study of 70 adults (mean age, 76 [range, 53-91] years) from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging, a normative aging study.

Exposure  Self-reported sleep variables.

Main Outcomes and Measures  β-Amyloid burden, measured by carbon 11–labeled Pittsburgh compound B positron emission tomography distribution volume ratios (DVRs).

Results  After adjustment for potential confounders, reports of shorter sleep duration were associated with greater Aβ burden, measured by mean cortical DVR (B = 0.08 [95% CI, 0.03-0.14]; P = .005) and precuneus DVR (B = 0.11 [0.03-0.18]; P = .007). Reports of lower sleep quality were associated with greater Aβ burden measured by precuneus DVR (B = 0.08 [0.01-0.15]; P = .03).

Conclusions and Relevance  Among community-dwelling older adults, reports of shorter sleep duration and poorer sleep quality are associated with greater Aβ burden. Additional studies with objective sleep measures are needed to determine whether sleep disturbance causes or accelerates Alzheimer disease.

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Unadjusted Distribution Volume Ratios (DVRs) of Carbon 11–Labeled Pittsburgh Compound B Positron Emission Tomography Images by Sleep Duration

Images from 4 axial sections demonstrate that shorter self-reported sleep duration is associated with greater β-amyloid (Aβ) burden. Participants reporting more than 7 hours of sleep (n = 19) have the least Aβ burden, those reporting no more than 6 hours (n = 17) have the most, and those reporting more than 6 to no more than 7 hours (n = 26) have an intermediate level of burden. The rightmost column contains structural images from the Montreal Neurological Institute (MNI) space template.28,29 Scale represents DVR.

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