Biomarkers of dementia in obstructive sleep apnea
Article [Accepted Manuscript]
Abstract(s)
Epidemiologic and mechanistic evidence is increasingly supporting the notion that obstructive sleep
apnea is a risk factor for dementia. Hence, the identification of patients at risk of cognitive decline due
to obstructive sleep apnea may significantly improve preventive strategies and treatment decisionmaking. Cerebrospinal fluid and blood biomarkers obtained through genomic, proteomic and
metabolomic approaches are improving the ability to predict incident dementia. Therefore, fluid
biomarkers have the potential to predict vulnerability to neurodegeneration in individuals with
obstructive sleep apnea, as well as deepen our understanding of pathophysiological processes linking
obstructive sleep apnea and dementia. Many fluid biomarkers linked to Alzheimer’s disease and
vascular dementia show abnormal levels in individuals with obstructive sleep apnea, suggesting that
these conditions share common underlying mechanisms, including amyloid and tau protein
neuropathology, inflammation, oxidative stress, and metabolic disturbances. Markers of these processes
include amyloid-β, tau proteins, inflammatory cytokines, acute-phase proteins, antioxydants and
oxidized products, homocysteine and clusterin (apolipoprotein J). Thus, these biomarkers may have the
ability to identify adults with obstructive sleep apnea at high risk of dementia and provide an
opportunity for therapeutic intervention. Large cohort studies are necessary to establish a specific fluid
biomarker panel linking obstructive sleep apnea to dementia risk.
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