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Inflammation and Neurocognitive Damage Markers in Elderly People with Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) and neurocognitive damage could have similar pathophysiological mechanisms. Biomarkers in elderly
seems to be associated to neurocognitive damage and inflammation, like 100β protein, brain-derived neurotrophic factor (BDNF), cortisol and interleukins. Association between these biomarkers is still poorly investigated in the elderly with OSA.
To assess the association between biomarkers of inflammation and neurocognitive damage with the presence of OSA.
Cross-sectional study from ongoing cohort MEDIDAS with data collected between May 2014 to May 2018, at tertiary Hospital in Southern Brazil, which included individuals from both genders, aged 65 to 80 years old, physically independent with OSA. We excluded patients with chronic diaseases, marked elevation in 24-hour ambulatory blood pressure > 180/110 mmHg, cognitive deficit according to Mini Mental State Examination (MEEM) and presence of Alzheimer or Parkinson disease. Individuals were divided in two groups – without OSA: apnea-hypopnea index (AHI) ≤ 5 events/hour and with OSA: AHI ≥ 30 events/hour. Blood aliquots were obtained for analysis of the inflammatory markers cortisol, Interleukin (IL) 1β, 6, 10 and tumor necrosis factor alpha (TNF-α)(Abbott®, USA and Millipore®, USA), and neurocognitive damage markers (BDNF and s100β protein)(Millipore®, USA). Results with probability of alpha error <0,05 are considered statistically significant. This study was approved by Research Ethics Committee of this Institution under number 2019-0529 and protocol was registered in Clinicaltrials.gov with identification number NCT04882020.
Of the 274 seniors screened, according to exclusion criteria 38 were included in each group (without OSA; with OSA). Both groups presented similar mean age (71 ± 5,5 vs. 70 ± 4,8 years; p = 0,826). In the group with OSA, mostly were men (63,4%), with higher body mass index (27,0 ± 4,5 vs. 30,4 ± 5,4 kg/m²; p = 0,003). The OSA group had higher TNF-α serum levels (20372 ± 1337 vs. 25627 ± 1851 mg/dL; p = 0,025), but no difference in serum levels of s100β, BDNF, cortisol, IL -1β, IL-6, IL-10 groups. There was a correlation between serum levels of TNF-α and OSA group (p = 0,292; p > 0,012), but not with the other analyzed inflammatory markers.
In the elderly, except for serum levels of TNF-α, OSA is not associated with inflammatory and neurocognitive markers.
Elderly; Inflammation; Neurodegenerative Diseases
Lauren Sezerá Costa, Jéssica Cristina de Cezaro, Laura Côrtes, Chaiane Piccin Facco, Denis Martinez, Ruy Silveira Moraes