# Using a Health Disparity Research Framework to examine mechanisms linking Obstructive Sleep Apnea with higher Alzheimer’s disease risk in older Blacks/African-Americans

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $1,716,849

## Abstract

PROJECT ABSTRACT/SUMMARY
Blacks/African-Americans (blacks) have two times the risk of developing Alzheimer’s disease (AD) compared to
non-Hispanic whites (whites), in part attributable to the higher prevalence of vascular risk factors. Examining
other risk factors and delineating pathological mechanisms associated with this higher AD-risk in older blacks is
a critical initial step needed to optimize patient care paradigms. Obstructive sleep apnea (OSA) is one such risk
factor. Notably, blacks have a higher burden of OSA with excessive daytime sleepiness (EDS), which is associated
with longitudinal amyloid-PET uptake. OSA is associated with decreased non rapid eye movement (NREM) slow
wave sleep/activity (SWS/SWA) and increased inflammation, both of which affect amyloid and tau pathology.
NREM SWS/SWA and inflammation are also associated with changes in cognition in late-life, and are more
burdensome in blacks. The current proposal will utilize a health disparities research framework related to aging
to: (i) investigate within and between race effects of OSA on AD pathology. (ii) Identify decreased NREM
SWS/SWA and increased inflammation as potential intermediate mechanisms linking OSA and AD. (iii)
Examine whether socio-structural determinants of health (SDOH) can help explain racial heterogeneity in OSA-
AD outcomes. Our
neurodegeneration,
central hypothesis is that black OSA subjects will exhibit higher tau and greater
as well as reduced NREM SWS/SWA and increased inflammation compared to white OSA
subjects, in the context of amyloid burden. Furthermore, we hypothesize SDOH (i.e., environmental, socio-
structural, and behavioral factors) and vascular risk will mediate racial heterogeneity in OSA-AD outcomes. We
will test our central hypothesis in a sample of 300 community-dwelling cognitively normal (CN) subjects; ages
55-85 matched on race (2:1), age and sex, and balanced by education, income and BMI. Subjects will include 150
controls (100 blacks & 50 whites), and 150 newly diagnosed OSA subjects with EDS (100 blacks & 50 whites).
This proposal will recruit from the community, 125 new black subjects [80 OSA and 45 controls] and leverage
existing data and resources in 175 (75 blacks [20 OSA and 55 controls] & 100 whites [50 OSA and 50 controls])
community-dwelling CN subjects with similar eligibility criteria, from NYU Alzheimer’s Disease Research Center
and two-affiliated ongoing NIH supported R01 studies (R01AG056031 and R01AG056531). Subjects will
undergo 2 nights of at-home sleep monitoring for OSA, followed by 5 days of actigraphy and sleep logs. Clinical
visits will include full clinical evaluation, neuropsychological tests and clinical labs on visit 1; 1 night of nocturnal
polysomnography (NPSG) recording on visit 2; neuroimaging measures of vascular burden, amyloid (18F-
florbetaben) and tau (18F-PI2620) PET-MRI on visits 3 and 4 respectively, at baseline and at 2.5 years follow-up.
Importantly, we will prioritize acquisition of SDOH d...

## Key facts

- **NIH application ID:** 10844428
- **Project number:** 5R01AG082278-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** OMONIGHO A MICHAEL Bubu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,716,849
- **Award type:** 5
- **Project period:** 2023-06-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844428

## Citation

> US National Institutes of Health, RePORTER application 10844428, Using a Health Disparity Research Framework to examine mechanisms linking Obstructive Sleep Apnea with higher Alzheimer’s disease risk in older Blacks/African-Americans (5R01AG082278-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10844428. Licensed CC0.

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