Sleep Apnea Syndrome in an Elderly Population Admitted to a Geriatric Unit: Prevalence and Effect on Cognitive Function

Abstract

Background: Sleep apnea leads to cognitive impairment in older patients, but its association with neurodegeneration remains controversial, and most studies do not distinguish between the more common obstructive form (OSAS) and the rarer central form (CSAS). Objective: The purpose of this study was to assess the prevalence of the different forms of sleep apnea in a cohort of cognitively impaired elderly patients (>70 years) and to investigate their associations with cognitive deficit, weighted against known risk factors for neurodegeneration. Methods: Overnight polygraphy was performed for 76 consecutive patients admitted to our geriatric unit. Their cognitive function was assessed using the Mini Mental-State Exam (MMSE), Mattis Dementia Rating Scale (MDRS) and Stroop test. Multivariable analyses were performed to determine associations between cognitive function and independent variables describing demographics, sleep apnea measures, and cardiovascular risk factors. Results: The cohort comprised 58 women and 18 men aged a mean of 84 years (range, 73-96). Sleep apnea syndrome (SAS) was diagnosed in 48 patients (63%), of which 31 (41%) with OSAS and 17 (22%) with CSAS. Multivariable regression analysis revealed that MDRS was lower in patients with OSAS (β = −10.03, p = 0.018), that Stroop Colors and Words delays increased with AHI (β = 0.17, p = 0.030 and β = 0.31, p = 0.047) and that that Stroop Interference delay was higher in patients with CSAS (β = 24.45, p = 0.002). Conclusion: Sleep apnea is thus highly prevalent in elderly patients with cognitive impairment. OSAS was associated with lower general cognitive function, while CSAS was only associated with increased Stroop Interference delays. Elderly patients with cognitive deficit could benefit from sleep apnea screening and treatment.

Involvement of Hepcidin in Cognitive Damage Induced by Chronic Intermittent Hypoxia in Mice

“…OSA has been identified as an early risk factor for developing neurodegenerative disease, such as Alzheimer's disease (AD) [1,3]. Clinical studies have shown that OSA could accelerate the progression of AD by increasing the formation and accumulation of Aβ 42 in the cerebrospinal fluid (CSF) [4,5]. OSA is often overlooked by patients in the early stage.…”

Lung carcinoma–associated cognitive impairment in a patient with Alzheimer’s disease pathology: A case report

“…The SAS and pathophysiological evidence in isolation cannot fully explain the patient's cognitive impairment. SAS, especially its obstructive form, can induce cognitive impairment, in association with general cognitive impairment 9 . Our current case presented general cognitive impairment 1 year post‐baseline visit, which gradually worsened, despite successful CPAP introduction.…”

“…SAS, especially its obstructive form, can induce cognitive impairment, in association with general cognitive impairment. 9 Our current case presented general cognitive impairment 1 year post-baseline visit, which gradually worsened, despite successful CPAP introduction. The patient did not show the typical cognitive impairment of AD, although the pathophysiological findings using PiB-PET, THK5351-PET, and IMP-SPECT suggested an AD-type impairment.…”

Lung cancer-associated cognitive impairment in a patient with Alzheimer’s disease pathology: A case report

“…SAS can induce cognitive impairment, especially the obstructive form of SAS, which has been associated with general cognitive impairment. 8 Our current case presented general cognitive impairment one year after the baseline visit, which gradually worsened despite the successful introduction of CPAP. The patient did not show the typical cognitive impairment of AD, although the pathophysiological findings using PiB-PET, THK5351-PET, and IMP-SPECT indicated AD type impairment.…”