Age differences in the association of obstructive sleep apnea risk with cognition and quality of life

Abstract

Summary Using a sample of 2925 stroke-free participants drawn from a national population-based study, we examined cross-sectional associations of obstructive sleep apnea risk (OSA) with cognition and quality of life and whether these vary with age, while controlling for demographics and co-morbidities. Included participants from the REasons for Geographic And Racial Differences in Stroke Study were aged 47-93. OSA risk was categorized as high or low based on responses to the Berlin Sleep Questionnaire. Cognitive function was assessed with standardized fluency and recall measures. Depressive symptoms were assessed with the four-item Center for Epidemiologic Studies Depression Scale. Health-related Quality of Life (HRQoL) was assessed with the Medical Outcomes Study Short Form-12 (SF-12). MANCOVA statistics were applied separately to the cognitive and quality of life dependent variables while accounting for potential confounders (demographics, co-morbidities). In fully adjusted models, those at high risk for OSA had significantly lower cognitive scores (Wilks’ Lambda = 0.996, F(3, 2786) = 3.31, p < .05) and lower quality of life (depressive symptoms and HRQoL) (Wilks’ Lambda = 0.989, F(3, 2786) = 10.02, p < .0001). However, some of the associations were age-dependent. Differences in cognition and quality of life between those at high and low obstructive sleep apnea risk were most pronounced during middle age, with attenuated effects after age 70.

Risk of obstructive sleep apnea, excessive daytime sleepiness and depressive symptoms in a Nigerian elderly population

“…However, the relationship between age and OSA risk in the elderly has not been commonly explored. Our finding is similar to that of a study conducted in the Southern stroke belt of the United States on a large sample with an age range of 49–93 years and a mean age of 67.5 years [26] . In the study, the subjects who were at a high risk for OSA were significantly younger than the low risk subjects.…”

Sleep apnea severity and depressive symptoms in a population-based study

“…It has been demonstrated that younger persons at risk for sleep apnea reported more depressive symptoms than those not at risk, in contrast to elderly people. 31 Furthermore, older people are more likely to underreport depressive symptoms compared with younger people, 32 which could attenuate the association of sleep apnea and depressive symptoms in middle-aged and elderly persons. Depressive symptoms could also be an indicator of poor health in elderly persons and thus is less specific for sleep apnea in our sample than in clinical samples.…”

Healthcare Service Utilization by Patients with Obstructive Sleep Apnea: A Population-Based Study

“…However, elderly patients (67~89 years old) with OSA only had higher risks of CVDs and hyperlipidemia compared to those without OSA [ 18 ]. In addition, a study in the US also reported that disparities in cognitive function and quality of life between patients with high and low risks of OSA were most obvious in the middle-aged group, but the effect was attenuated in those aged over 70 years [ 36 ].…”