Sleep disturbance is increasingly viewed as a potentially modifiable risk factor for Alzheimer's disease (AD). A recent paper published in The Journal of Prevention of Alzheimer’s Disease examined whether genetic risk for Alzheimer’s disease modifies the relationship between sleep complaints, memory, and tau deposition in older women.

This cross-sectional analysis included women aged 65 years or older from the Women: Inflammation Tau Study. Participants completed the Pittsburgh Sleep Quality Index (PSQI), visual and verbal memory testing, and a subset underwent tau PET imaging with [18F]-MK6240. Genetic AD risk was measured using a polygenic hazard score (PHS), which incorporates APOE status and other AD-associated variants. Women were stratified into higher-risk and lower-risk groups using the 75th percentile of PHS.

In the memory sample (N=69), poorer subjective sleep was associated with worse visual memory specifically among women in the higher genetic AD risk group — not across the sample as a whole. No association was found with verbal memory in either risk group.

In the tau PET sample (N=63), poorer sleep was associated with greater tau deposition in Braak III/IV limbic regions, again only among higher-risk women. Sleep complaints were not associated with tau in earlier Braak I/II or later Braak V/VI regions. Sensitivity analyses using APOE e4 status showed a similar pattern: worse sleep was linked to poorer visual memory and greater limbic tau burden among e4 carriers, but not non-carriers.

Clinical Takeaway
Sleep complaints in older women with elevated genetic AD risk may be more than a quality-of-life concern. They may signal vulnerability to early AD-related changes, particularly visual memory decline and limbic tau accumulation. For clinicians, routinely assessing sleep in older women at elevated AD risk may help identify patients who warrant closer cognitive monitoring or more detailed sleep evaluation.

These findings are preliminary. The study was cross-sectional and cannot establish causality, and the sample — predominantly non-Hispanic White women with high educational attainment — limits generalizability to broader populations. Larger longitudinal studies using both subjective and objective sleep measures are needed.

Reference:
Lui KK et al. J Prev Alzheimers Dis . 2026 Aug;13(7):100581. Abstract