Cited by 465Circadian rhythm and melatoninDementia and Cognitive Impairment ResearchSleep and related disorders

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Circadian Rest-Activity Pattern Changes in Aging and Preclinical Alzheimer Disease

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Musiek, Erik S., Bhimasani, Meghana, Zangrilli, Margaret A., Morris, John C., Holtzman, David M., Ju, Yo-El S.·2018·JAMA Neurology

DOI 10.1001/jamaneurol.2017.4719PMC PMC5885197

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Abstract

Importance: Circadian rhythm disturbances occur in symptomatic Alzheimer disease (AD) and have been hypothesized to contribute to disease pathogenesis. However, it is unknown whether circadian changes occur during the presymptomatic phase of the disease. Objective: To examine the associations between circadian function, aging, and preclinical AD pathology in cognitively normal adults. Design, Setting, and Participants: This cross-sectional study was conducted using community volunteers from the Knight Alzheimer's Disease Research Center at Washington University in St Louis. Cognitively normal participants (n = 205) underwent 7 to 14 days of actigraphy in their home environment between 2010 and 2012, in addition to clinical assessment, amyloid imaging with Pittsburgh Compound B (PiB), and cerebrospinal fluid biomarker collection. Data collected from 3 years before to 6 months after actigraphy were included. Sixteen participants were excluded owing to incomplete data collection. Main Outcomes and Measures: Circadian rhythm analysis was performed on actigraphy data using 3 methods: cosinor, nonparametric, and empirical mode decomposition. Preclinical AD was assessed by longitudinal clinical assessment, amyloid imaging with PiB, and cerebrospinal fluid biomarker collection. Results: Data from 189 participants were included in the analyses. The mean (SD) age was 66.6 (8.3) years, and 121 participants (64%) were women. Older age (β = .247; P = .003) and male sex (β = .170; P = .04), in the absence of amyloid pathology, were associated with a significant increase in intradaily variability, a nonparametric measure of rest-activity rhythm fragmentation, as well as decreased amplitude by several measures. After correction for age and sex, the presence of preclinical amyloid plaque pathology, assessed by positive PiB imaging (mean [SD], 0.804 [0.187] for PiB negative vs 0.875 [0.178] for PiB positive; P = .05) or increasing cerebrospinal fluid phosphorylated-tau to amyloid β 42 ratio (β = .231; P = .008), was associated with increased intradaily variability, indicating rest-activity rhythm fragmentation. Conclusions and Relevance: Preclinical AD is associated with rest-activity rhythm fragmentation, independent of age or sex. Aging was also associated with circadian dysfunction independently of preclinical AD pathology, particularly in men. The presence of circadian rhythm abnormalities in the preclinical phase of AD suggests that circadian dysfunction could contribute to early disease pathogenesis or serve as a biomarker of preclinical disease.

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Authors: Musiek, E. S., Bhimasani, M., Zangrilli, M. A., Morris, J. C., Holtzman, D. M., & Ju, Y.-E. S.
Affiliations: Washington University in St. Louis (US)
Corresponding author: Ju, Yo-El S.
ORCID: Musiek, Erik S.
Morris, John C.
Holtzman, David M.
Ju, Yo-El S.
Venue: JAMA Neurology
Publisher: American Medical Association (AMA)
Published: 2018-05-01
Volume: 75
Issue: 5
Pages: 582
ISSN: 2168-6149 (ISSN-L)
DOI: 10.1001/jamaneurol.2017.4719
PMC: PMC5885197
OpenAlex: W2792021696
Cited by: 465
References: 70
Citations by year: 2026: 59 · 2025: 75 · 2024: 64 · 2023: 52 · 2022: 50 · 2021: 58 · 2020: 57 · 2019: 32 · 2018: 18
FWCI: 23.17
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Neurology (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (KL2TR000450, UL1TR002345, KL2TR002346)
National Institute on Aging (P50AG005681, P01AG003991, P01AG026276)
National Institute of Neurological Disorders and Stroke (K23NS089922, K08NS079405, P01NS074969)
National Center for Research Resources (UL1RR024992)
National Center for Advancing Translational Sciences
Topics: Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: circadian rhythm, preclinical Alzheimer's disease, aging, actigraphy, intradaily variability, Pittsburgh compound B, amyloid-beta 42, circadian dysfunction, sex differences, cognitive aging, empirical mode decomposition, cosinor analysis, nonparametric statistics, sleep-wake cycle
MeSH terms: Aged, Aging, Alzheimer Disease, Aniline Compounds, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Peptide Fragments, Thiazoles, Amyloid beta-Peptides, tau Proteins, Statistics, Nonparametric, Chronobiology Disorders, Positron-Emission Tomography, Actigraphy

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Circadian Rest-Activity Pattern Changes in Aging and Preclinical Alzheimer Disease

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