The Role of Sleep in Alzheimer's Disease Disparities

Examine the role of disturbed sleep and delineate pathological mechanisms associated with higher AD-risk in older blacks as a critical initial step needed to optimize patient care paradigms.

This proposal will examine whether Blacks with obstructive sleep apnea (OSA) exhibit higher tau-PET and greater neurodegeneration for a given level of amyloid burden compared to Whites. The proposal will also examine the role of socioeconomic status, cumulative stress exposure and vascular risk as mediators of any observed race-specific effects in micro-level sleep physiology and inflammation on tau-PET and neurodegeneration. Long-term goal is to increase sleep quality, and control vascular risk using non-invasive ambulatory methods as novel therapeutic targets for AD prevention in Blacks.

This study is innovative because: 1) It has the unique potential of identifying biomarker differences that may suggest race-related social/physiologic mechanisms for AD-expression. 2) It will investigate in blacks whether racial differences exist in the association of micro-level changes in sleep physiology, and in-vivo regional tau PET signal in the context of amyloid burden, especially with objective measurements of sleep and AD. 3) It has the unique potential to generate novel empirical evidence to support racial differences of the effect of SDOH, stress and inflammation on the relationship

Black participants with OSA will exhibit higher tau and greater neurodegeneration, and have reduced NREM SWA and increased inflammation compared to whites for the same level of tauopathy, with SDOH and vascular risk measures mediating observed race-specific effects. Thus, this innovative study represents a novel approach to racial-dependent strategies for diagnosis and assessment of therapeutic interventions. It will foster design of studies that target SES measures, sleep quality, and control of vascular risk as novel therapeutic targets for AD prevention in blacks.