The association of upper airway anatomy with cognitive test performance: the Multi-Ethnic Study of Atherosclerosis
Year: 2023
Type: article
Abstract: BACKGROUND: Numerous upper airway anatomy characteristics are risk factors for sleep apnea, which affects 26% of older Americans, and more severe sleep apnea is associated with cognitive impairment. This study explores the pathophysiology and links between upper airway anatomy, sleep, and cognition. METHODS: Participants in the Multi-Ethnic Study of Atherosclerosis underwent an upper airway MRI, polysomnography to assess sleep measures including the apnea-hypopnea index (AHI) and completed the Cognitive Abilities Screening Instrument (CASI). Two model selection techniques selected from among 67 upper airway measures those that are most strongly associated with CASI score. The associations of selected upper airway measures with AHI, AHI with CASI score, and selected upper airway anatomy measures with CASI score, both alone and after adjustment for AHI, were assessed using linear regression. RESULTS: Soft palate volume, maxillary divergence, and upper facial height were significantly positively associated with higher CASI score, indicating better cognition. The coefficients were small, with a 1 standard deviation (SD) increase in these variables being associated with a 0.83, 0.75, and 0.70 point higher CASI score, respectively. Additional adjustment for AHI very slightly attenuated these associations. Larger soft palate volume was significantly associated with higher AHI (15% higher AHI (95% CI 2%,28%) per SD). Higher AHI was marginally associated with higher CASI score (0.43 (95% CI 0.01,0.85) per AHI doubling). CONCLUSIONS: Three upper airway measures were weakly but significantly associated with higher global cognitive test performance. Sleep apnea did not appear to be the mechanism through which these upper airway and cognition associations were acting. Further research on the selected upper airway measures is recommended.
Source: BMC Neurology
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
Funders: Northwestern University, University of Minnesota, University of Washington, Johns Hopkins University, National Institutes of Health, University of California, Los Angeles, National Institute on Aging, National Heart, Lung, and Blood Institute, National Center for Advancing Translational Sciences
Awards: G1261793039, G1276754516, G1294553593, G1539384734, G1640378483, G1803853571, Wake Forest Clinical and Translational Science Award, G1983464145, G2095942735, G2144938473, G22458031, G2580996367, G2726417417, G2837638605, G290884426, G291913881, Atrial fibrillation burden, vascular disease of the brain and cardiac MRI in MESA, Phenotypic and Molecular Signatures for Sleep Apnea and Related Morbidities, G3570589137, G3595232572, G3919367648, Longitudinal Relationships Among Sleep, Cognition and Alzheimer's Disease Biomarkers: Discerning Causal Associations, Mediators and Susceptibility, G4309390892, G4563812999, G4590187187, G4986157935, G5075046117, G5108002584, G514410172, G5653954166, G6093314662, Institute for Clinical and Translational Research, G6483211850, G66341962, G6856766826, G7166352866, G78770644, Clinical and Translational Science Award, G8145863542, G8761005068, Integrated multi-omics approach to identify early protein biomarkers in Alzheimer's disease and cognitive decline, Multiethnic machine learning brain signatures of ADRD, G991334795
OpenAlex ID: W4388043929