https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/570 2026-04-10T07:33:12Z 2026-04-10T07:33:12Z Kim, Hyeon Jin Choi, Jisun Bae, Hyunjun Kim, Soriul Lee, Seung Ku Shin, Chol https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/79390 2026-03-10T06:30:29Z 2025-10-12T00:00:00Z

Title: Longitudinal trajectories of sleep apnea parameters and cognitive decline: An 8-year follow-up study in a community-based cohort Authors: Kim, Hyeon Jin; Choi, Jisun; Bae, Hyunjun; Kim, Soriul; Lee, Seung Ku; Shin, Chol Abstract: Background and aims: Sleep-disordered breathing, including obstructive sleep apnea (OSA), has been linked to cognitive impairment. However, few studies have examined how changes in OSA severity over time relate to the development of mild cognitive impairment (MCI) in community populations. Methods: We analyzed data from 1,592 participants in a prospective community-based cohort who underwent two home-based polysomnography (PSG) assessments approximately 8 years apart. Cognitive function at follow-up was evaluated using the Seoul Neuropsychological Screening Battery, 2nd edition (SNSB-II). Group-based trajectory modeling and linear mixed-effects models were used to compare longitudinal changes in sleep apnea metrics such as apnea-hypopnea index (AHI) between the MCI (n = 445, mean 65.35 ± 5.51 years, male: 52.8 %) and cognitively normal groups (n = 1146, mean 65.60 ± 5.41 years, male: 46.64 %). Results: Participants who developed MCI exhibited a significantly steeper increase in AHI and RDI over the 8-year period compared to those who remained cognitively normal (p < 0.01). In particular, increases in REM-specific AHI and positional AHI were more pronounced in the women's MCI group, even after adjusting for baseline demographics, BMI, and comorbidities. Conclusions: While OSA is more common in men, longitudinal worsening of sleep apnea is linked to elevated MCI risk, with a more substantial effect in female participants. These results highlight the importance of considering sex-specific vulnerability when screening and managing sleep-disordered breathing in aging populations. Acknowledgement: This study was supported by grants from the NRF funded by MSIT (RS-2024-00359247 to HJ Kim), and KDCA (2011-E71004-00 ~ 2021-E0602-01 to C Shin).

2025-10-12T00:00:00Z Kim, Hyeon Jin Bae, Hyunjun Choi, Jisun Kim, Soriul Lee, Seung Ku Shin, Chol https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/79449 2026-03-10T07:00:20Z 2025-10-12T00:00:00Z

Title: Longitudinal changes in sleep behavior and mild cognitive impairment: An 8-year trajectory analysis in a community-based cohort Authors: Kim, Hyeon Jin; Bae, Hyunjun; Choi, Jisun; Kim, Soriul; Lee, Seung Ku; Shin, Chol Abstract: Background and aims: Sleep disturbances are associated with neurodegenerative diseases. However, the specific sleep characteristics most strongly linked to cognitive decline remain unclear. This study investigates longitudinal changes in sleep behavior over eight years in individuals with and without cognitive impairment. Methods: We analyzed data from 2078 participants in a community-based cohort who underwent cognitive assessment using the Seoul Neuropsychological Screening Battery-II (SNSB-II). Sleep parameters—including duration, latency, efficiency, and chronotype (mid-sleep time on free days corrected for sleep debt, MSFsc)—were derived from the modified Pittsburgh Sleep Quality Index (PSQI). Of the participants, 626 were classified as having mild cognitive impairment (MCI, mean age: 65.63 ± 5.91 years, male: 53.4 %), while 1452 were cognitively unimpaired (mean age: 65.76 ± 5.78 years, male: 47.0 %). Results: At the time of SNSB-II assessment, the MCI group exhibited a significantly earlier chronotype compared to the cognitively unimpaired group (MSFsc: 2.33 ± 1.2 vs. 2.48 ± 1.16, P = 0.0107). This phase advance was also observed eight years before MCI diagnosis (MSFsc: 2.61 ± 1.17 vs. 2.77 ± 1.14, P = 0.00982). In contrast, the other sleep parameters related to sleep quantity - duration, latency, and efficiency in addition to the overall PSQI score showed no significant differences between groups. Conclusions: Earlier chronotype may be an early marker of cognitive decline. Longitudinal monitoring of sleep phase shifts could provide insights into neurodegenerative risk and facilitate early interventions. Acknowledgement: This study was supported by grants from the NRF funded by MSIT (RS-2024-00359247 to HJ Kim), and KDCA (2011-E71004–00–2021-E0602–01 to C Shin).

2025-10-12T00:00:00Z Siddiquee, Ali Tanweer Hwang, Yoonho Kim, Soriul Lee, Seung-ku Lee, Min-hee Kim, Hyeon-jin Kim, Young-jin Kim, Bongjo Hadar, Peter N. Brandon Westover, M. Thomas, Robert Joseph Kim, Nan-hee Shin, Cheol https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/78616 2025-12-01T00:00:32Z 2025-10-01T00:00:00Z

Title: Obstructive Sleep Apnea and Cerebral Microbleeds in Middle-Aged and Older Adults Authors: Siddiquee, Ali Tanweer; Hwang, Yoonho; Kim, Soriul; Lee, Seung-ku; Lee, Min-hee; Kim, Hyeon-jin; Kim, Young-jin; Kim, Bongjo; Hadar, Peter N.; Brandon Westover, M.; Thomas, Robert Joseph; Kim, Nan-hee; Shin, Cheol Abstract: IMPORTANCE The association of obstructive sleep apnea (OSA) with risk of incident cerebral microbleeds (CMBs) is unknown. OBJECTIVE To investigate the association between OSA severity and risk of incident CMBs in the late middle-aged general population. DESIGN, SETTING, AND PARTICIPANTS This cohort study included eligible participants who had in-home overnight polysomnography data and brain magnetic resonance imaging done at baseline (2011-2014) and 4-year follow-ups (first follow-up, 2015-2018, and second follow-up, 2019-2022) from an ongoing longitudinal cohort study of a Korean community of adults. Data were analyzed from March 2024 through January 2025. EXPOSURES OSA severity was categorized by apnea-hypopnea index levels as no OSA (0-4.9 events/h), mild OSA (5.0-14.9 events/h), and moderate to severe OSA (≥15.0 events/h). MAIN OUTCOMES AND MEASURES CMBs were defined as well-defined focal areas (<10 mm in diameter) of very low signal intensity on gradient echo T2*-weighted images. Modified Poisson regression (robust error variance) was used to estimate relative risk (RR), with 95% CIs, of incident CMBs by OSA group; adjustment was done for age, sex, education level, body mass index, physical activity level, smoking and drinking status, total and low-density lipoprotein cholesterol level, hypertension, diabetes, age-related white matter changes, change in apnea-hypopnea index level, change in body mass index, and mean arterial pressure of the corresponding follow-up. RESULTS Of 1441 study participants (mean [SD] age, 57.75 [5.53] years; 759 female [52.67%]), 436 participants (30.25%) and 193 participants (13.39%) had mild and moderate to severe OSA at baseline, respectively; 812 participants had no OSA. The cumulative incidence rate of CMBs in non-OSA, mild OSA, and moderate to severe OSA groups was 15 participants (1.85%), 7 participants (1.61%), and 9 participants (4.66%), respectively, at 4 years and 27 participants (3.33%), 14 participants (3.21%), and 14 participants (7.25%), respectively, at 8 years. In multivariable modified Poisson models, participants with moderate to severe OSA compared with the non-OSA group had an increased risk of developing CMBs at 8 years (RR, 2.14; 95% CI, 1.08-4.23; P = .02). These results were unaffected by the presence or absence of APOE-ε4 carrier status. No significantly increased risks were observed at 4 years or in the mild OSA group at any time. CONCLUSIONS AND RELEVANCE In this study, moderate to severe OSA was independently associated with an increased risk of incident CMBs over an 8-year follow-up. These results add to the evidence for the importance of sleep apnea to brain health. © 2025 Elsevier B.V., All rights reserved.

2025-10-01T00:00:00Z Lee, Grace Yoojin Choi, Yun Ho Kim, Dongwon Jang, Miso Kim, Hong-Kyu Nam, Hyo-Jung Park, Sungwon Kim, Mi Jung Hwang, Yoon Ho Lee, Seung Ku Shin, Chol Kim, Namkug https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/76209 2026-01-09T00:30:09Z 2025-10-01T00:00:00Z

Title: Deep Learning Analysis of White Matter Hyperintensity and its Association with Comprehensive Vascular Factors in Two Large General Populations Authors: Lee, Grace Yoojin; Choi, Yun Ho; Kim, Dongwon; Jang, Miso; Kim, Hong-Kyu; Nam, Hyo-Jung; Park, Sungwon; Kim, Mi Jung; Hwang, Yoon Ho; Lee, Seung Ku; Shin, Chol; Kim, Namkug Abstract: Although the relationships between basic clinical parameters and white matter hyperintensity (WMH) have been studied, the associations between vascular factors and WMH volume in general populations remain unclear. We investigated the associations between clinical parameters including comprehensive vascular factors and WMH in two large general populations. This retrospective, cross-sectional study involved two populations: individuals who underwent general health examinations at the Asan Medical Center (AMC) and participants from a regional cohort, the Korean Genome and Epidemiology Study (KoGES). WMH volume was quantified using the deep learning model nnU-Net. The associations between vascular factors and WMH volume were analyzed using multivariate linear regression. Individuals in the AMC cohort (n = 7471) had a mean [SD] age of 58.0 [9.2] years, and the KoGES participants (n = 2511), 59.2 [6.8] years. The normalized and logit-transformed WMH volumes for the AMC and KoGES were - 8.5 [1.3] and - 7.9 [1.2], respectively. The presence of carotid plaque, brachial-ankle pulse wave velocity, Agaston score, and coronary artery stenosis were associated with WMH volume after adjustments (AMC: carotid plaque beta 0.13; 95% CI, 0.06-0.20; p < 0.001, baPWV beta 0.001; CI 0-0.001; p < 0.001, Agaston score beta 0.0003; CI 0.0001-0.0005; p < 0.001, minimal-to-mild coronary artery stenosis beta 0.20; CI 0.12-0.29; p < 0.001, moderate-to-severe coronary artery stenosis beta 0.30; CI 0.15-0.44; p < 0.001, KoGES: carotid plaque beta 0.15; CI 0.02-0.27; p = 0.02, baPWV beta 0.0004; CI 0-0.001; p = 0.001). Vascular parameters, reflecting atherosclerotic changes in carotid and coronary arteries and arterial stiffness, were independently associated with WMH volume in the general population.

2025-10-01T00:00:00Z