Project Abstract
This Diversity Supplement to Sleep in Neurocognitive Aging and Alzheimer's Research (SANAR; R01
AG067568) expands the Parent Grant's examination of how obstructive sleep apnea (OSA) accelerates
cognitive decline among US Hispanic/Latino adults, who have > 2-fold risk of dementia and early cognitive
decline compared to non-Hispanic Whites. This Supplement examines gray matter (GM) microstructure
integrity as an OSA-sleep-related marker of accelerated cognitive decline by testing the hypotheses that (1)
OSA is associated with lower GM microstructure integrity, and (2) lower GM microstructure integrity is a
marker of accelerated subclinical cognitive decline. This Supplement aims to (1) determine if prior and
persistent exposures to (a) OSA and (b) OSA-related hypoxemic burden are associated with lower
hippocampal GM microstructure integrity; (2) determine if hippocampal GM microstructure integrity (a) is
associated with average 12-year cognitive change among participants with and without OSA, and (b)
mediates associations between OSA and 12-year average cognitive change; and (3) determine the
independent and interactive association of NDBP and OSA with hippocampal GM microstructure integrity.
This Supplement also provides the Diversity Supplement Candidate with mentored research training,
structured coursework, and preliminary data vital for an NIH career-development award application, to
propel the Diversity Supplement Candidate into a career as an independent physician scientist. This
Supplement will utilize the multi-center (Miami, Bronx, Chicago, San Diego), ethnically diverse, community-
based Hispanic Community Health Study/Study of Latinos (HCHS/SOL), its ancillary studies (SOL-INCA
[R01 AG048642], SOL-INCA-MRI [R01 AG054548]), SOL-INCA2 (R01 AGR56048642), and SANAR
(Parent Grant). The Supplement utilizes data from participants enrolled in Miami (n >600), who at baseline
were cognitively intact middle-DJHG DQG ROGHU DGXOWV ¿ \HDUV ZLWK DQG ZLWKRXW 26$ $W 9LVLW -
2011), studies acquired self-reported sleep data, portable sleep apnea studies, and cognitive evaluations.
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quantified as the mean diffusivity of water measured using diffusion tractography imaging (DTI), a modality
included in the MRI protocol. MRI was obtained 2016-2022. SANAR enriches this data by obtaining 24-hour
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anthropometric, socioeconomic, racial, and medical confounders.