Department of Clinical Neurosciences.
Hotchkiss Brain Institute, and.
Ann Am Thorac Soc. 2021 May;18(5):865-875. doi: 10.1513/AnnalsATS.202004-313OC.
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. 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. Adults ( = 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. 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 ( = 0.003). Memory and information processing speed was lower than age-matched normal values ( < 0.001), with lower MoCA and DSC scores associated with a higher oxygen desaturation index and nocturnal hypoxemia. 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.
阻塞性睡眠呼吸暂停（OSA）与普通人群中轻度认知障碍（MCI）的风险增加有关。然而，OSA 患者睡眠诊所人群中的 MCI 风险特征描述不佳。为了确定 OSA 睡眠诊所人群中 MCI 的患病率，以及哪些患者存在这种并发症的最大风险。招募了 1084 名被转诊到三个学术睡眠中心接受疑似 OSA 检查的成年人，他们在家中进行睡眠呼吸暂停测试或在实验室进行多导睡眠图检查。患者完成了睡眠和病史问卷、蒙特利尔认知评估测试（MoCA）的整体认知、雷氏听觉言语学习测试的记忆、威斯康星州成人智力测验第四版数字符号编码（DSC）的信息处理速度子测试。MoCA 评分 <26（范围 0-30）被定义为 MCI。我们整个患者队列中有 47.9%存在 MCI，中度和重度 OSA 患者中增加到 >55.3%。MoCA<26 的患者主要是年龄较大的男性，伴有更严重的 OSA、低氧血症和血管合并症。与无 OSA 的患者相比，中重度 OSA 患者发生 MCI 的几率高出 >70%（ = 0.003）。记忆和信息处理速度低于年龄匹配的正常值（ < 0.001），较低的 MoCA 和 DSC 评分与较高的氧减饱和指数和夜间低氧血症相关。认知障碍在因疑似 OSA 而被转诊到睡眠诊所的患者中非常普遍，主要发生在年龄较大的男性中，他们患有中重度 OSA 和并发血管合并症。中重度 OSA 是 MCI 的独立危险因素。
