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Sex Differences in the Impact of Obstructive Sleep Apnea on Age-Related Brain Aging: A KoGES Study

Poster No:

1185 

Submission Type:

Abstract Submission 

Authors:

MAITHREYEE DEVI1, aram cho2, Song E Kim3, Regina EY Kim4, Soriul Soriul Kim4, Seung Ku Lee4, Hyeon Jin Kim5, Chol Shin4, Hyang Woon Lee6

Institutions:

1Computational Medicine, System Health Science & Engineering Program, Ewha Womans University, Seoul, South Korea, 2Nursing Science, System Health Science & Engineering Program, Ewha womans university, Seoul, South Korea, 3Departments of Neurology, College of Medicine, Ewha Womans University, Seoul, South Korea, 4Institute for Human Genomic Study, College of Medicine, Korea University, Ansan, South Korea, 5Department of Neurology, College of Medicine, Korea University, Ansan, South Korea, 6Departments of Neurology,Computational Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea

First Author:

MAITHREYEE DEVI  
Computational Medicine, System Health Science & Engineering Program, Ewha Womans University
Seoul, South Korea

Co-Author(s):

aram cho  
Nursing Science, System Health Science & Engineering Program, Ewha womans university
Seoul, South Korea
Song E Kim  
Departments of Neurology, College of Medicine, Ewha Womans University
Seoul, South Korea
Regina EY Kim  
Institute for Human Genomic Study, College of Medicine, Korea University
Ansan, South Korea
Soriul Soriul Kim  
Institute for Human Genomic Study, College of Medicine, Korea University
Ansan, South Korea
Seung Ku Lee  
Institute for Human Genomic Study, College of Medicine, Korea University
Ansan, South Korea
Hyeon Jin Kim, MD  
Department of Neurology, College of Medicine, Korea University
Ansan, South Korea
Chol Shin  
Institute for Human Genomic Study, College of Medicine, Korea University
Ansan, South Korea
Hyang Woon Lee, MD, PhD  
Departments of Neurology,Computational Medicine, College of Medicine, Ewha Womans University
Seoul, South Korea

Introduction:

The intrinsic connection of obstructive sleep apnea (OSA), a sleep-breathing disorder with accelerated cognitive aging, has been the center of interest in recent studies. Individuals with obstructive sleep apnea are found to exhibit structural and functional brain alterations. Furthermore, the pattern of brain aging differs by sex and/or gender. This study targets to investigate sex/gender-specific changes in the complex relationships between age and cognitive function, underscoring the impact of the severity of OSA on brain atrophy and cognitive impairment among middle- to elderly-aged healthy individuals.

Methods:

In this population-based cohort study, data were provided by the Korean Genome and Epidemiology Study (KoGES), where approximately 2,457 individuals (50.1% men) aged between 49 and 80 years were participated. For the study purpose, participants were categorized into four age groups: ~55 years (36.5%), 56-60 years (31.9%), 61-65 years (13.6%), and ~66 years (18.1%). The comprehensive evaluation methods include whole-night polysomnography, neuropsychological assessment, and T1-weighted magnetic resonance imaging (MRI). OSA was assessed by apnea-hypopnea index (AHI) scores. An analysis of covariance (ANCOVA) interaction effects was done to determine sex differences in the severity of OSA in various age ranges. In addition, multiple mediation analyses were performed after adjusting demographic and clinical factors to find out the mediating effects of OSA in between age-associated cognitive declines.

Results:

Analysis of covariance (ANCOVA) showed a significant interaction effect between the sex* age subgroups on AHI (F:4.56, p:0.003), suggesting the association between sex and AHI scores is influenced by age. Notably, scores of AHI increase were generally higher for men in most age groups, showing a tendency for accelerated deterioration in older adulthood.

Additionally, in men, multiple mediation results revealed the significance of AHI alongside total gray matter volume, particularly involving cortical areas in the parietal and cerebrum, as mediators between age and cognitive scores, including verbal fluency, mini-mental state examination (MMSE), and trail-making test, respectively. whereas there is no significance for women.

Conclusions:

Our findings suggest the sex-specific effects of obstructive sleep apnea on accelerated brain aging, as demonstrated by MRI volumetry across diverse age groups. Notably, this study highlights the complex relationships among OSA severity on brain aging and how these factors are influenced by age and sex. Men are more vulnerable to the detrimental effects of OSA related to early cognitive decline, affecting a wide range of brain areas, including the cortical gray matter. These findings highlight the significance of improving lifestyle choices to maintain optimal brain health, particularly in men, who tend to have greater rates of hazardous lifestyle habits and substantial cardiovascular co-morbidity. However, further investigation is warranted to unravel the underlying factors contributing to these sex-specific differences.

Higher Cognitive Functions:

Executive Function, Cognitive Control and Decision Making 2

Lifespan Development:

Aging 1

Keywords:

Aging
Cognition
MRI
Other - Sex, Obstructive Sleep Apnea, Brain Aging

1|2Indicates the priority used for review
Supporting Image: 2024OHBM_GraphicalAbstract.png
   ·Graphical Abstract
 

Provide references using author date format

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