An observational study in Alzheimer Disease, Dementia and Mild Cognitive Impairment, sponsored by Sunnybrook Health Sciences Centre. Recruiting at 1 site in Canada. Open to participants aged 60 Years to 85 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-01-03.
Sponsored by Sunnybrook Health Sciences Centre · Observational
Sleep apnea is characterized by temporary pauses or stops to participant's breathing. Currently, sleep apnea is diagnosed using an in-lab sleep study, which involves spending a night in a sleep laboratory hooked up to wires on the head, chest, and legs. However, this is not feasible for many older adults. To overcome this barrier, the investigators will utilize an investigational vital signs monitor - the Advanced NeoNatal Epidermal (ANNE) Vital Sign System (Sibel Health, Evanston, IL,USA).
The primary objective of this study is to test the hypothesis that sleep apnea is associated with accelerated cognitive decline in older adults at risk for dementia. The investigators will measure sleep apnea at baseline and 12 months later and relate this to cognitive function at the same time points.
Sex-stratification will be used in analyses as appropriate. Qualitative feedback forms will be used to collect information about participant ease of use and experience with the ANNE Vital Sign System.
Over 500,000 Canadians are currently living with dementia and this is predicted to reach one million in the next two decades. With no effective cures, there is an urgent need to identify and treat causal risk factors. Sleep and circadian rhythm disruption, including sleep deprivation, sleep fragmentation, sleep apnea, and abnormal circadian rhythms, are common. In model organisms, they accelerate development of dementia-associated neuropathologies and accumulating evidence suggests that in older adults they may be associated with a greater risk of dementia and dementia-related structural brain changes.
Sleep apnea is characterized by recurrent episodes of absent (apneas) or reduced (hypopneas) airflow in sleep, accompanied by hypercarbia and hypoxemia, and terminated by arousal and resumption of normal breathing. Sleep apnea is common in adults with Alzheimer's Disease (AD) and other dementias. The prevalence of moderate sleep apnea (apnea hypopnea index (AHI) > 15) in patients with mild AD is estimated at 68% and may be higher in moderate to severe AD. Moreover, a recent meta-analysis suggested that patients with AD have a five-fold increased odds of presenting with sleep apnea than adults with normal cognition.
The overall goal of this study is to test the hypothesis that sleep apnea is associated with accelerated cognitive decline in older adults at risk for dementia. The investigators will measure sleep apnea and its cardiovascular consequences at baseline and 12 months later and relate this to cognitive function at the same time points. To achieve this, the investigators will study participants enrolled in the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CTU) and affiliated trials. The CTU is a Canada-wide study of older adults at risk for dementia, being undertaken by the Canadian Consortium on Neurodegeneration that will begin recruitment in May 2022. It, and affiliated trials, are anticipated to recruit 750 participants from May 2022-April 2024.
In clinical practice, sleep apnea is diagnosed using inpatient polysomnography. However, this is not feasible for many older adults. To overcome this barrier, the investigators will utilize an investigational vital signs monitor - the Advanced NeoNatal Epidermal (ANNE) Vital Sign System (Sibel Inc., Evanston, IL, USA).
The ANNE Vital Sign System is a wireless remote monitoring system consisting of two flexible, soft, and skin-mounted electronic devices for use by researchers and healthcare professionals for continuous collection of physiological data in home and professional healthcare settings. The ANNE Vital Sign System integrates simultaneous synchronized ambulatory measurement of electrocardiography, photoplethysmography with derived pulse oximetry, pulse arrival time with derived beat-to-beat blood pressure, triaxial accelerometry, respiratory rate, and temperature, which would enable accurate measurement of sleep apnea. Indeed, in compelling in-laboratory preliminary data, the investigators show the capacity for the ANNE Vital Sign System to detect and characterize sleep apnea in older patients. The ANNE Vital Sign System is non-invasive, flexible, easy to use, comfortable, and skin safe.
A separate 8-site Canadian in-lab study of the ANNE Vital Sign System is already underway, with participants undergoing diagnostic polysomnography per usual care or in the context of existing research projects approved by an institutional ethics board. ANNE Vital Sign System has an approved Investigational Testing Authorization (ITA) for this in-lab study (ITA application number 319430, approved December 11, 2020).
CTU recruiting sites will refer potential participants to Sunnybrook Research Institute (SRI) to obtain informed consent and then prepare shipment of ANNE Vital Sign System and instructions to participant. After study equipment and materials are shipped to and received by the participant, study staff will instruct the participant on the proper application and use of the ANNE Vital Sign System over remote video-conference. Specifically, study staff will instruct the participant to attach the two sensors of the ANNE Vital Sign System according to manufacturer recommendations. Participants will wear the sensors for 24 hours before removing it themselves at home and shipping back to Sunnybrook Research Institute. This procedure will be completed at two time points: Baseline and 12 months later.
3,678 studies on the registry are indexed under Alzheimer Disease; 869 are open to participants now.
This study's planned enrollment of 750 is above the median of 200 across 751 observational studies indexed under Alzheimer Disease.
Browse Alzheimer Disease studies →Sunnybrook Health Sciences Centre is the lead sponsor of 566 studies on the registry; 134 are open to participants now.
Of its 6 completed or terminated interventional studies of FDA-regulated products, 2 (33%) have results posted.
Counted across the registry records on this site, refreshed daily.
Enrolled participants in the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CTU) and affiliated trials. All participants will be individuals ages 60-85 classified as Not Dementia according to Canadian Consortium for Neurodegeneration in Aging (CCNA) criteria and classified as being at increased risk of dementia.
For reference, inclusion criteria of CTU affiliated studies from which we will recruit may include, but are not limited to, the following list:
Meets criteria for No Dementia and one of the following (according to CCNA Criteria):
Exclusion Criteria:
For reference, exclusion criteria of CTU affiliated studies from which we will recruit may include, but are not limited to, the following list:
Meets criteria for No Dementia and one of the following (according to CCNA Criteria): 1. Cognitively Unimpaired 2. Cognitively Unimpaired plus Subjective Cognitive Impairment 3. Mild Cognitive Impairment (MCI) AND Classified as being at increased risk of dementia based on at least one of the following: 1. First-degree family history of dementia 2. Self-Reported or documented current and/or history at midlife (45-60 years) of the following risk factors: i. Hypertension ii. Hypercholesterolemia iii. Body Mass Index \> 30 kg/m2 iv. Physical Inactivity v. Insomnia vi. Vascular-metabolic risk
Device: ANNE Vital Sign System
The ANNE Vital Sign System is a wireless remote monitoring system consisting of two flexible, soft, and skin-mounted electronic devices for use by researchers and healthcare professionals for continuous collection of physiological data in home and professional healthcare settings. The ANNE Vital Sign System integrates simultaneous synchronized ambulatory measurement of electrocardiography, photoplethysmography with derived pulse oximetry, pulse arrival time with derived beat-to-beat blood pressure, triaxial accelerometry, respiratory rate, and temperature, which would enable accurate measurement of sleep apnea. Indeed, in compelling in-laboratory preliminary data, we show the capacity for the ANNE Vital Sign System to detect and characterize sleep apnea in older patients. The ANNE Vital Sign System is non-invasive, flexible, easy to use, comfortable, and skin safe.
Apnea Hypopnea Index
Number of times per hour breathing slows or stops
Time frame: Baseline
Apnea Hypopnea Index
Number of times per hour breathing slows or stops
Time frame: 12-months
Oxygen Desaturation Index
Number of times per hour oxygen dips 4% or more
Time frame: Baseline
Oxygen Desaturation Index
Number of times per hour oxygen dips 4% or more
Time frame: 12-months
Hypoxemia Burden
integral area under the desaturation curve
Time frame: Baseline
Hypoxemia Burden
integral area under the desaturation curve
Time frame: 12-months
Time with oxygen saturation below 90% (O2<90)
As described in title
Time frame: Baseline
Time with oxygen saturation below 90% (O2<90)
As described in title
Time frame: 12-months
Sex-stratification on Apnea Hypopnea Index
Sex-related effects on Apnea Hypopnea Index
Time frame: Baseline
Sex-stratification on Apnea Hypopnea Index
Sex-related effects on Apnea Hypopnea Index
Time frame: 12-months
Sex-stratification on Oxygen Desaturation Index
Sex-related effects on Oxygen Desaturation Index
Time frame: Baseline
Sex-stratification on Oxygen Desaturation Index
Sex-related effects on Oxygen Desaturation Index
Time frame: 12-months
Sex-stratification on Hypoxemia Burden
Sex-related effects on Hypoxemia Burden
Time frame: Baseline
Sex-stratification on Hypoxemia Burden
Sex-related effects on Hypoxemia Burden
Time frame: 12-months
Sex-stratification on Time with oxygen saturation below 90% (O2<90)
Sex-related effects on Time with oxygen saturation below 90% (O2\<90)
Time frame: Baseline
Sex-stratification on Time with oxygen saturation below 90% (O2<90)
Sex-related effects on Time with oxygen saturation below 90% (O2\<90)
Time frame: 12-months
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — LORIS is a web-based database solution for neuroimaging and other research data that is physically located at McGill University in Montreal. It will store data that has been processed to remove any direct identifiers of an individual study participant. Study subjects will be assigned a unique coded study identification number (LORIS Project Study Centre ID (PSCID)) that will be used to store their data. Local study sites will be responsible for storing all participant identifying information (name, contact, e-mail address) in secured encrypted databases and to maintain the master file that links the participant to their unique LORIS PSCID.
Supporting information: Study protocol, Sap
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Sunnybrook Health Sciences Centre