HAI Book 2025 - Flipbook - Page 226
Banks, Sarah
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Estradiol-dependent associations between sleep complaints and tau
deposition in women at elevated AD risk
Kitty Lui1,2,4, Xin Wang2, Pam Deyong3, Atul Malhotra3, Erin Sundermann4, Sarah Banks2,4
1
SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, US
UC San Diego, Dept. of Neurosciences, La Jolla, CA, US
3
UC San Diego, Dept. of Medicine, La Jolla, CA, US
4
UC San Diego, Dept. of Psychiatry, La Jolla, CA, US
2
Background: Poor sleep has a complex, likely bidirectional relationship with Alzheimer9s Disease (AD) pathology,
yet is often overlooked in the work up for dementia risk. Older women are more vulnerable to AD, and report worse
sleep quality than men. Estradiol levels are predictive of sleep quality in premenopausal and perimenopausal
women, but are rarely assessed in older women. In older women at elevated risk for AD, we examined the
relationship between sleep complaints and pathological tau, and whether this was moderated by estradiol levels.
Methods: 50 women (72.5±4.2y) participating in the Women: Inflammation Tau Study; Inclusion criteria were
elevated polygenic risk for AD, or family history of dementia, and mild cognitive impairment on screening. The
Pittsburgh Sleep Quality Index assessed subjective sleep quality. They also underwent 18F-MK6240 positron
emission tomography to determine tau deposition. Standardized uptake value ratios were calculated in Braak
stage III/IV regions, using eroded cerebellum grey matter as the reference. Estradiol was measured using liquid
chromatography with tandem mass spectrometry in plasma samples, and results were divided into tertiles
withing this cohort. We tested the associations between sleep and tau, and the estradiol9s moderating effect,
controlling for age, body mass index, and years of education.
Results: Worse subjective sleep quality was associated with more pathological tau (b=0.06, p=0.048), and lower
levels of estradiol (b=-3.66, p
