| Autor: |
Beaudin AE; Department of Clinical Neurosciences.; Hotchkiss Brain Institute, and., Raneri JK; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Ayas NT; Sleep Centre, Foothills Medical Centre, Calgary, Alberta, Canada., Skomro RP; Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, British Columbia, Canada; and., Fox N; Sleep Centre, Foothills Medical Centre, Calgary, Alberta, Canada., Hirsch Allen AJM; Sleep Centre, Foothills Medical Centre, Calgary, Alberta, Canada., Bowen MW; Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, British Columbia, Canada; and., Nocon A; Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, British Columbia, Canada; and., Lynch EJ; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Wang M; Department of Clinical Neurosciences.; Hotchkiss Brain Institute, and., Smith EE; Department of Clinical Neurosciences.; Hotchkiss Brain Institute, and., Hanly PJ; Hotchkiss Brain Institute, and.; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. |
| Abstrakt: |
Rationale: Obstructive sleep apnea (OSA) is associated with an increased risk of mild cognitive impairment (MCI) within the general population. However, MCI risk in sleep-clinic populations of patients with OSA is poorly characterized. Objectives: To determine the prevalence of MCI in a sleep-clinic population of patients with OSA and which patients are at the greatest risk for this complication. Methods: Adults ( n = 1,084) referred to three academic sleep centers for suspected OSA who had home sleep apnea testing or in-laboratory polysomnography were recruited. Patients completed sleep and medical history questionnaires, the Montreal Cognitive Assessment Test (MoCA) of global cognition, the Rey Auditory Verbal Learning Test of memory, and the Wechsler Adult Intelligence Scale-Fourth Edition Digit-Symbol Coding (DSC) subtest of information processing speed. Results: A MoCA score <26 (range 0-30) was operationally defined as MCI. MCI was present in 47.9% of our entire patient cohort, increasing to >55.3% in patients with moderate and severe OSA. Patients with a MoCA <26 were predominantly older males with more severe OSA, hypoxemia, and vascular comorbidities. Moderate and severe OSA were independently associated with >70% higher odds for MCI compared with patients with no OSA ( P = 0.003). Memory and information processing speed was lower than age-matched normal values ( P < 0.001), with lower MoCA and DSC scores associated with a higher oxygen desaturation index and nocturnal hypoxemia. Conclusions: Cognitive impairment is highly prevalent in patients referred to sleep clinics for suspected OSA, occurring predominantly in older males with moderate to severe OSA and concurrent vascular comorbidities. Moderate to severe OSA is an independent risk factor for MCI. |
