Ming-Shao Tsai1,2,3,4, Hsueh-Yu Li4,5, Chung-Guei Huang6,7,8, Robert Y L Wang7, Li-Pang Chuang2,4,9, Ning-Hung Chen4,9, Chi-Hung Liu2,4,10, Yao-Hsu Yang3,11,12, Chia-Yen Liu3, Cheng-Ming Hsu1,12, Wen-Nuan Cheng13, Li-Ang Lee2,4,5. 1. Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 2. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 3. Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 4. Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 5. Department of Otolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 6. Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 7. Research Center for Emerging Viral Infections, Chang Gung University, Taoyuan, Taiwan. 8. Graduate Institute of Biomedical Sciences, Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 9. Department of Pulmonary and Critical Care Medicine, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan. 10. Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 11. Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 12. School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 13. Department of Sports Sciences, University of Taipei, Taipei, Taiwan.
Abstract
OBJECTIVE: To assess the risk of Alzheimer's disease (AD) in patients with obstructive sleep apnea (OSA) with or without treatment based on real-world evidence. STUDY DESIGN: Retrospective cohort study. METHODS: Patients newly diagnosed with OSA during 1997-2012 were identified using the National Health Insurance Research Database of Taiwan. Patients without OSA were randomly selected and matched in a 1:4 ratio by age, sex, urbanization level, and income. All patients were followed up until death or the end of 2013. The primary outcome was AD occurrence. RESULTS: This study included 3,978 OSA patients and 15,912 non-OSA patients. OSA was independently and significantly associated with a higher incidence of AD in an adjusted Cox proportional hazard model (adjusted hazard ratio: 2.12; 95% confidence interval [CI], 1.27-3.56). The average period of AD detection from the time of OSA occurrence was 5.44 years (standard deviation: 2.96). Subgroup analyses revealed that the effect of OSA remained significant in patients aged ≥60 years, male subgroups, patients without CPAP or surgical treatment, and patients without pharmacological therapies. Patients with OSA who received treatment (continuous positive airway pressure or surgery) exhibited a significantly reduced risk of AD compared with those without treatment (incidence rate ratio 0.23, 95% CI, 0.06-0.98). CONCLUSION: OSA is independently associated with an increased risk of AD. Treatment for OSA reduces the AD risk in OSA patients. AD irreversibility renders OSA as a potential modifiable target for slowing or preventing the process of AD development. LEVEL OF EVIDENCE: IV Laryngoscope, 130:2292-2298, 2020.
OBJECTIVE: To assess the risk of Alzheimer's disease (AD) in patients with obstructive sleep apnea (OSA) with or without treatment based on real-world evidence. STUDY DESIGN: Retrospective cohort study. METHODS:Patients newly diagnosed with OSA during 1997-2012 were identified using the National Health Insurance Research Database of Taiwan. Patients without OSA were randomly selected and matched in a 1:4 ratio by age, sex, urbanization level, and income. All patients were followed up until death or the end of 2013. The primary outcome was AD occurrence. RESULTS: This study included 3,978 OSApatients and 15,912 non-OSApatients. OSA was independently and significantly associated with a higher incidence of AD in an adjusted Cox proportional hazard model (adjusted hazard ratio: 2.12; 95% confidence interval [CI], 1.27-3.56). The average period of AD detection from the time of OSA occurrence was 5.44 years (standard deviation: 2.96). Subgroup analyses revealed that the effect of OSA remained significant in patients aged ≥60 years, male subgroups, patients without CPAP or surgical treatment, and patients without pharmacological therapies. Patients with OSA who received treatment (continuous positive airway pressure or surgery) exhibited a significantly reduced risk of AD compared with those without treatment (incidence rate ratio 0.23, 95% CI, 0.06-0.98). CONCLUSION:OSA is independently associated with an increased risk of AD. Treatment for OSA reduces the AD risk in OSApatients. AD irreversibility renders OSA as a potential modifiable target for slowing or preventing the process of AD development. LEVEL OF EVIDENCE: IV Laryngoscope, 130:2292-2298, 2020.
Authors: Monica Moon Shieu; Afsara Zaheed; Carol Shannon; Ronald David Chervin; Alan Conceicao; Henry Lauris Paulson; Tiffany Joy Braley; Galit Levi Dunietz Journal: Neurology Date: 2022-05-06 Impact factor: 11.800
Authors: Omonigho M Bubu; Ogie Q Umasabor-Bubu; Arlener D Turner; Ankit Parekh; Anna E Mullins; Korey Kam; Madeline K Birckbichler; Fahad Mukhtar; Alfred K Mbah; Natasha J Williams; David M Rapoport; Mony de Leon; Girardin Jean-Louis; Indu Ayappa; Andrew W Varga; Ricardo S Osorio Journal: Alzheimers Dement Date: 2020-10-08 Impact factor: 21.566
Authors: Reshma Aziz Merchant; Richard Jor Yeong Hui; Sing Cheer Kwek; Meena Sundram; Arthur Tay; Jerome Jayasundram; Matthew Zhixuan Chen; Shu Ee Ng; Li Feng Tan; John E Morley Journal: Front Med (Lausanne) Date: 2020-07-08