Andrew E Beaudin1,2, Jill K Raneri3, Najib T Ayas4, Robert P Skomro5, Nurit Fox4, A J Marcus Hirsch Allen4, Matthew W Bowen5, Andrhea Nocon5, Emma J Lynch3, Meng Wang1,2, Eric E Smith1,2, Patrick J Hanly2,3,6. 1. Department of Clinical Neurosciences. 2. Hotchkiss Brain Institute, and. 3. Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 4. Sleep Centre, Foothills Medical Centre, Calgary, Alberta, Canada. 5. Department of Medicine, Respiratory and Critical Care Divisions, University of British Columbia, Vancouver, British Columbia, Canada; and. 6. Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Abstract
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.
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.
Authors: Andrew E Beaudin; Jill K Raneri; Sofia B Ahmed; A J Marcus Hirsch Allen; Andrhea Nocon; Teresa Gomes; Simon Gakwaya; Fréderic Series; John Kimoff; Robert P Skomro; Najib T Ayas; Patrick J Hanly Journal: Sleep Date: 2022-02-14 Impact factor: 5.849
Authors: Magdy K Younes; Andrew E Beaudin; Jill K Raneri; Beth J Gerardy; Patrick J Hanly Journal: J Clin Sleep Med Date: 2022-08-01 Impact factor: 4.324
Authors: Chitra Lal; Indu Ayappa; Najib Ayas; Andrew E Beaudin; Camilla Hoyos; Clete A Kushida; Marta Kaminska; Anna Mullins; Sharon L Naismith; Ricardo S Osorio; Craig L Phillips; Ankit Parekh; Katie L Stone; Arlener D Turner; Andrew W Varga Journal: Ann Am Thorac Soc Date: 2022-08
Authors: Jean Wong; Helen R Doherty; Mandeep Singh; Stephen Choi; Naveed Siddiqui; David Lam; Nishanthi Liyanage; George Tomlinson; Frances Chung Journal: BMC Anesthesiol Date: 2022-09-14 Impact factor: 2.376
Authors: Andrew E Beaudin; Jill K Raneri; Najib T Ayas; Robert P Skomro; Eric E Smith; Patrick J Hanly Journal: J Clin Sleep Med Date: 2022-01-01 Impact factor: 4.062