Sleep disturbances in cognitively asymptomatic patients with histopathologically confirmed AD predict rapid cognitive deterioration
Bibliographic record
Abstract
Abstract Background The temporal relationship between sleep disturbances, Alzheimer’s Disease (AD) pathology, and related cognitive impairment remains controversial. The objective of this study is to determine whether sleep disturbances at baseline predict the rate of cognitive deterioration in cognitively intact subjects with autopsy confirmed AD neuropathology. We also examine the interaction of sleep disturbances with APOE genotype and cerebral amyloid angiopathy (CAA). Method The National Alzheimer’s Disease Coordinating Center (NACC) datasets was used to compare the rate of cognitive decline between subjects with nighttime behaviors [(+)NTB] or without [(‐)NTB] at baseline as assessed by the Neuropsychiatric Inventory Questionnaire Quick Version (NPI‐Q). Cognitive impairment was determined by the Mini‐Mental Status Examination (MMSE) total score. Cognitively normal subjects at baseline were defined as having an initial MMSE score ≥ 24 at the first NACC clinical visit. The rate of cognitive decline was determined based on the individual’s annual MMSE score change over the total clinical visits made. All subjects had a primary neuropathologic diagnosis of Alzheimer’s pathology as determined by both high CERAD score and Braak stage. Result 404 subjects fulfilled the inclusion criteria. The rate of cognitive decline was greater in (+)NTB (74 cases; 3.30 points per year) compared to (‐)NTB (330 cases; 2.45 points per year) (p = 0.016). This significant difference was restricted to APOE ε4 carriers (p = 0.049) and subjects with CAA (p = 0.020), and was absent in non e4 carriers and subjects without CAA. There was no difference between (+)NTB and (‐)NTB in the prevalence of these two factors associated with the rate of cognitive decline (e4 and CAA), suggesting that NTB itself is responsible for the effect observed. Conclusion NPI‐Q assessed nighttime behaviors, a surrogate for sleep disturbances, are associated with more rapidly declining cognition in subjects with Alzheimer’s neuropathology. In addition, this relationship is enhanced in carriers of APOE e4 and cerebral amyloid angiopathy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".