Anne-Cécile Troussière1, Christelle Monaca Charley2, Julia Salleron3, Florence Richard4, Xavier Delbeuck1, Philippe Derambure2, Florence Pasquier1, Stéphanie Bombois1. 1. University Lille North of France, CHU, Lille, France EA 1046, Lille, France Memory Clinic, Lille, France. 2. University Lille North of France, CHU, Lille, France EA 1046, Lille, France Department of Neurophysiology and Sleep Unit, Lille, France. 3. University Lille North of France, CHU, Lille, France Department of Public Health and Biostatistic Unit, Lille, France. 4. University Lille North of France, CHU, Lille, France Department of Public Health and Biostatistic Unit, Lille, France INSERM UMR 744, Institut Pasteur, Lille, France.
Abstract
BACKGROUND: It is essential to detect and then treat factors that aggravate Alzheimer's disease (AD). Here, we sought to determine whether or not continuous positive airway pressure (CPAP) therapy for sleep apnoea syndrome (SAS) slows the rate of cognitive decline in mild-to-moderate AD patients. METHODS: Between January 2003 and June 2011, we included consecutive, mild-to-moderate AD patients (a Mini Mental State Examination (MMSE) score at inclusion ≥15) with severe SAS as determined by video-polysomnography (an apnoea-hypopnoea index ≥30). In this single-blind, proof-of-concept trial, we analysed the mean decline in the annual MMSE score (the main outcome measure) according to whether or not the patients had received CPAP therapy. The decline was computed for each patient and for the first 3 years of follow-up. RESULTS: Of the 23 included patients, 14 underwent CPAP treatment. The CPAP and non-CPAP groups did not differ significantly in terms of their demographic characteristics or MMSE score at baseline. The median annual MMSE decline was significantly slower in the CPAP group (-0.7 (-1.7; +0.8)) than in the non-CPAP group (-2.2 (-3.3; -1.9); p=0.013). CONCLUSIONS: In this pilot study, CPAP treatment of severe SAS in mild-to-moderate AD patients was associated with significantly slower cognitive decline over a three-year follow-up period. Our results emphasise the importance of detecting and treating SAS in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: It is essential to detect and then treat factors that aggravate Alzheimer's disease (AD). Here, we sought to determine whether or not continuous positive airway pressure (CPAP) therapy for sleep apnoea syndrome (SAS) slows the rate of cognitive decline in mild-to-moderate ADpatients. METHODS: Between January 2003 and June 2011, we included consecutive, mild-to-moderate ADpatients (a Mini Mental State Examination (MMSE) score at inclusion ≥15) with severe SAS as determined by video-polysomnography (an apnoea-hypopnoea index ≥30). In this single-blind, proof-of-concept trial, we analysed the mean decline in the annual MMSE score (the main outcome measure) according to whether or not the patients had received CPAP therapy. The decline was computed for each patient and for the first 3 years of follow-up. RESULTS: Of the 23 included patients, 14 underwent CPAP treatment. The CPAP and non-CPAP groups did not differ significantly in terms of their demographic characteristics or MMSE score at baseline. The median annual MMSE decline was significantly slower in the CPAP group (-0.7 (-1.7; +0.8)) than in the non-CPAP group (-2.2 (-3.3; -1.9); p=0.013). CONCLUSIONS: In this pilot study, CPAP treatment of severe SAS in mild-to-moderate ADpatients was associated with significantly slower cognitive decline over a three-year follow-up period. Our results emphasise the importance of detecting and treating SAS in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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