Sleep Apnea and the Risk of Dementia: A Population-Based 5-Year Follow-Up Study in Taiwan

Abstract

BackgroundSleep apnea (SA) has been associated with cognitive impairment. However, no data regarding the risk of dementia in patients with SA has been reported in the general population. This retrospective matched-control cohort study was designed to estimate and compare the risk of dementia in SA and non-SA patients among persons aged 40 and above over a 5-year period follow-up.MethodsWe conducted a nationwide 5-year population-based study using data retrieved from the Longitudinal Health Insurance Database 2005 (LHID2005) in Taiwan. The study cohort comprised 1414 patients with SA aged 40 years who had at least 1 inpatient service claim or 1 ambulatory care claim. The comparison cohort comprised 7070 randomly selected patients who were matched with the study group according to sex, age, and index year. We performed Cox proportional-hazards regressions to compute the 5-year dementia-free survival rates after adjusting for potentially confounding factors.ResultsThe SA patients in this study had a 1.70-times greater risk of developing dementia within 5 years of diagnosis compared to non-SA age- and sex-matched patients, after adjusting for other risk factors (95% confidence interval (CI) = 1.26-2.31; P < .01). For the gender-dependent effect, only females with SA were more likely to develop dementia (adjust HR: 2.38, 95% CI =1.51–3.74; P < .001). For the age-dependent effect of different genders, males with SA aged 50-59 years had a 6.08 times greater risk for developing dementia (95% CI = 1.96-18.90), and females with SA aged ≥ 70 years had a 3.20 times greater risk of developing dementia (95% CI =1.71–6.00). For the time-dependent effect, dementia may be most likely to occur in the first 2.5 years of follow-up (adjusted HR:2.04, 95% CI =1.35-3.07).ConclusionsSA may be a gender-dependent, age-dependent, and time-dependent risk factor for dementia.

Sleep-disordered breathing in the elderly: is it distinct from that in the younger or middle-aged populations?

“…Among 298 older women (mean age: 82.3 years), those with SDB, had an increased risk of developing cognitive impairment, compared to those without SDB (9). A 5-year population-based cohort study involving nearly 8,000 subjects, also demonstrated that SDB patients had 1.70-times greater risk of developing dementia compared to age-and sex-matched non-SDB patients, and its statistical significance persisted in the 50-59 [adjusted hazard ratio (HR): 3.63; 95% CI, 1.67-7.88] years old and ≥70 (adjusted HR: 1.53; 95% CI, 1.01-2.33) years old groups (10). Because of the limited data on the relationship between SDB and CV morbidity or mortality in the elderly, the applicability of the results derived from the younger or middle-aged population is uncertain.…”

Influence of insomnia and emotional disorders on the development of cognitive impairment in patients with chronic brain ischemia and arterial hypertension

“…Согласно существующим данным, риск развития КН, а также прогрессирования лёгких КН до деменции снижается при соблюдении пра-вильного режима питания (средиземномор-ской диеты [4-8] с высоким содержанием продуктов растительного происхождения) и создании когнитивного резерва, адекватной физической нагрузки, снижении артериаль-ного давления. Кроме того, ряд авторов ука-зывают на актуальность нарушений сна для развития КН [9][10][11][12][13].…”

“…Chang и соавт. показали, что риск развития деменции прямо связан с предшес-твующими нарушениями сна у пациента [9,10]. В выполненном ранее исследовании M. Jelicic и соавт.…”

Are Sleep Disturbances a Risk for Chronic Traumatic Encephalopathy? Only the Shadow Knows

“…17,18 Recently, epidemiologic studies have identifi ed a link between both OSA and insomnia, and subsequent development of dementia. 19,20 With respect to OSA, a variety of neuroimaging studies suggest evidence of brain neuronal loss or dysfunction. 21 Gray matter abnormalities also have been observed some, [22][23][24] but not all studies of patients with chronic insomnia.…”