Abstract
BackgroundThe relationship between obstructive sleep apnoea (OSA) and cognitive decline remains controversial, especially in the elderly population. We used data from the HypnoLaus study to assess associations between OSA and longitudinal cognitive changes in a sample of community-dwelling elderly individuals.
MethodsWe studied associations between polysomnographic OSA parameters (of breathing/hypoxaemia and sleep fragmentation) and cognitive changes over a 5-year period, after adjustment for potential confounders. The primary outcome was the annual change in cognitive scores. The moderating effects of age, sex and apolipoprotein E4 (ApoE4) status were also examined.
Results358 elderly individuals without dementia were included (71.0±4.2 years; men 42.5%). A lower mean oxygen saturation during sleep was associated with a steeper decline in Mini-Mental State Examination (B=-0.12, p=0.004), Stroop test condition 1 (B=0.53, p=0.002) and delayed free recall of the Free and Cued Selective Reminding Test (B=-0.05, p=0.008). A longer time spent asleep with an oxygen saturation <90% was associated with a steeper decline in Stroop test condition 1 (B=0.47, p=0.006). Moderation analysis showed that apnoea-hypopnoea index and oxygen desaturation index were associated with a steeper decline in global cognitive function, processing speed and executive function only in older participants, men and ApoE4 carriers.
ConclusionsOur results provide evidence of the contribution of OSA and nocturnal hypoxaemia to cognitive decline in the elderly population.
Footnotes
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Conflicts of interest: R. Heinzer is member of the medical advisory board of Dreem and Nightbalance (Philips) and received speaker's fees or honorarium from ResMed, Philips, Jazz, and Inspire. Other authors have nothing to disclose.
- ReceivedAugust 18, 2022.
- AcceptedJanuary 29, 2023.
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