Davidescu Darius A, Goman Anca, Voita-Mekeres Florica, Bradacs Aliz I, Sabina Florina Solea F, Csep Andrei N, Szilagyi Gheorghe, Motofelea Alexandru C, Davidescu Lavinia
Pulmonology, Doctoral School of Biomedical Sciences, University of Oradea, Oradea, ROU.
Morphological Disciplines, University of Oradea, Oradea, ROU.
Cureus. 2024 Sep 24;16(9):e70085. doi: 10.7759/cureus.70085. eCollection 2024 Sep.
Obstructive Sleep Apnea (OSA) is a chronic condition associated with cognitive impairment and various comorbidities. This prospective study evaluated cognitive deficits in OSA patients and identified clinical factors affecting cognitive function. Seventy-two participants were assessed using polysomnography (PSG) and the Montreal Cognitive Assessment (MoCA). Findings revealed significantly lower MoCA scores in severe OSA patients compared to those with mild or moderate OSA. Severe OSA patients had a median MoCA score of 23.5 (20.0-25.0), indicating more significant cognitive impairment, while those with normal OSA severity had the highest median score of 28.5 (27.8-29.2). Mild and moderate OSA patients had median scores of 26.5 (21.0-28.0) and 25.0 (23.80-26.0), respectively (p < 0.008). Logistic regression showed that ex-smoking status negatively impacted MoCA scores more in the unadjusted model (p = 0.003) than in the adjusted one (p = 0.018). Forced Vital Capacity (FVC) positively correlated with MoCA scores, stronger in the unadjusted model (p < 0.001 vs. p < 0.03). Higher Oxygen Desaturation Index (ODI) correlated with higher MoCA scores while increasing Apnea-Hypopnea Index (AHI) severity correlated with lower MoCA scores in both models. A significant negative correlation was found between age and MoCA score (r = -0.473, p < 0.001), and between MoCA score and AHI (r = -0.350, p < 0.003). This study highlights the need for sensitive cognitive screening tools like MoCA in evaluating OSA patients, linking cognitive impairment closely with OSA severity and other clinical factors.
阻塞性睡眠呼吸暂停(OSA)是一种与认知障碍及多种合并症相关的慢性疾病。这项前瞻性研究评估了OSA患者的认知缺陷,并确定了影响认知功能的临床因素。使用多导睡眠图(PSG)和蒙特利尔认知评估量表(MoCA)对72名参与者进行了评估。研究结果显示,与轻度或中度OSA患者相比,重度OSA患者的MoCA得分显著更低。重度OSA患者的MoCA得分中位数为23.5(20.0 - 25.0),表明认知障碍更为显著,而OSA严重程度正常的患者中位数得分最高,为28.5(27.8 - 29.2)。轻度和中度OSA患者的中位数得分分别为26.5(21.0 - 28.0)和25.0(23.80 - 26.0)(p < 0.008)。逻辑回归分析显示,在未调整模型中,既往吸烟状态对MoCA得分的负面影响(p = 0.003)大于调整后模型(p = 0.018)。用力肺活量(FVC)与MoCA得分呈正相关,在未调整模型中相关性更强(p < 0.001对p < 0.03)。在两个模型中,较高的氧饱和度下降指数(ODI)与较高的MoCA得分相关,而呼吸暂停低通气指数(AHI)严重程度增加与较低的MoCA得分相关。年龄与MoCA得分之间存在显著负相关(r = -0.473,p < 0.001),MoCA得分与AHI之间也存在显著负相关(r = -0.350,p < 0.003)。本研究强调了在评估OSA患者时需要像MoCA这样敏感的认知筛查工具,将认知障碍与OSA严重程度及其他临床因素紧密联系起来。