Mu Li, Peng Liping, Zhang Zhengjiao, Jie Jing, Jia Siqi, Yuan Haibo
Department of Respiratory Medicine & Sleep Center, The First Hospital of Jilin University, Changchun, China; Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China.
Department of Respiratory Medicine & Sleep Center, The First Hospital of Jilin University, Changchun, China.
Am J Med Sci. 2017 Oct;354(4):399-407. doi: 10.1016/j.amjms.2017.04.020. Epub 2017 Apr 29.
Obstructive sleep apnea (OSA) is commonly associated with cognitive dysfunction, which is more apparent in severe OSA and impairs quality of life. However, the clinical screening methods for these impairments in OSA are still limited. In this study, we evaluated the feasibility of using the Memory and Executive Screening (MES) for assessing cognitive performance in OSA.
Twenty-four patients with nonsevere OSA and 36 patients with severe OSA participated in this study. All participants underwent comprehensive, laboratory-based polysomnography and completed assessments of cognitive function, which included both the MES and the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ).
Both the total MES scores and 5 recall scores of the MES (MES-5R) were significantly lower in the severe OSA group than those in the nonsevere OSA group. The patients with severe OSA performed worse on the memory subtests of the MES-5R, especially on immediate recall. The sensitivity and specificity of the MES for identifying cognitive impairment in patients with OSA were 63.89% and 66.67%, respectively, for a cutoff value of <92 out of 100 points. An optimal cutoff between nonsevere and severe OSA was also set at 45 points (MES-5R) and at 0.94 points (MES ratio). Compared with the MES, the MoCA-BJ had similar sensitivity (61.11%) and specificity (66.67%).
The MES is an acceptable tool for detecting cognitive dysfunction in patients with OSA. The sensitivity and specificity of the MES were similar to those of the MoCA-BJ. The MES-5R and total MES scores can assess the presence and severity of cognitive impairment in patients with severe OSA.
阻塞性睡眠呼吸暂停（OSA）通常与认知功能障碍相关，这在重度OSA中更为明显，并会损害生活质量。然而，针对OSA中这些损害的临床筛查方法仍然有限。在本研究中，我们评估了使用记忆与执行筛查（MES）来评估OSA患者认知表现的可行性。
24例非重度OSA患者和36例重度OSA患者参与了本研究。所有参与者均接受了基于实验室的全面多导睡眠图检查，并完成了认知功能评估，其中包括MES和北京版蒙特利尔认知评估量表（MoCA-BJ）。
重度OSA组的MES总分及MES的5项回忆得分（MES-5R）均显著低于非重度OSA组。重度OSA患者在MES-5R的记忆子测试中表现更差，尤其是在即时回忆方面。对于OSA患者，当MES的截断值设定为低于100分中的92分时，识别认知障碍的敏感性和特异性分别为63.89%和66.67%。非重度和重度OSA之间的最佳截断值也设定为45分（MES-5R）和0.94分（MES比率）。与MES相比，MoCA-BJ具有相似的敏感性（61.11%）和特异性（66.67%）。
MES是检测OSA患者认知功能障碍的一种可接受的工具。MES的敏感性和特异性与MoCA-BJ相似。MES-5R和MES总分可评估重度OSA患者认知障碍的存在及严重程度。
