Braley Tiffany J, Lyu Xiru, Dunietz Galit Levi, Schulz Paul C, Bove Riley, Chervin Ronald D, Paulson Henry L, Shedden Kerby
Division of Sleep Medicine, Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Division of Neuroimmunology, Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Sleep Adv. 2024 Oct 22;5(1):zpae077. doi: 10.1093/sleepadvances/zpae077. eCollection 2024.
To evaluate sex-specific associations between known or suspected obstructive sleep apnea (OSA) and dementia risk over 10 years among older women and men.
This study included 18 815 women and men age 50+ years (dementia-free at baseline) who participated in the Health and Retirement Study (HRS), a nationally representative cohort of US adults. Presence of OSA was defined by self-reported diagnosis or key HRS items that correspond to elements of a validated OSA screening tool (STOP-Bang). Incident dementia cases were identified using a validated, HRS-based algorithm derived from objective cognitive assessments. Survey-weighted regression models based on pseudo-values were utilized to estimate sex- and age-specific differences in cumulative incidence of dementia by OSA status.
Data from 18 815 adults were analyzed, of which 9% of women and 8% of men (weighted proportions) met criteria for incident dementia. Known/suspected OSA was more prevalent in men than in women (weighted proportions 68% vs. 31%). Unadjusted sex-stratified analyses showed that known/suspected OSA was associated with higher cumulative incidence of dementia across ages 60-84 years for women and men. By age 80, relative to adults without known/suspected OSA, the cumulative incidence of dementia was 4.7% higher (CI 2.8%, 6.7%) for women with known/suspected OSA, and 2.5% (CI 0.5%, 4.5%) for men with known/suspected OSA, respectively. Adjusted associations between age-specific OSA and cumulative incidence of dementia attenuated for both women and men but remained statistically significant.
OSA contributes to dementia risk in older adults, particularly women. This study illuminates the impact of a potentially modifiable yet frequently overlooked risk factor for dementia onset.
评估老年女性和男性中已知或疑似阻塞性睡眠呼吸暂停（OSA）与10年内痴呆风险之间的性别特异性关联。
本研究纳入了18815名年龄在50岁及以上（基线时无痴呆）的女性和男性，他们参与了健康与退休研究（HRS），这是一个具有全国代表性的美国成年人队列。OSA的存在通过自我报告的诊断或与经过验证的OSA筛查工具（STOP-Bang）要素相对应的关键HRS项目来定义。使用基于客观认知评估得出的经过验证的、基于HRS的算法确定新发痴呆病例。基于伪值的调查加权回归模型用于估计按OSA状态划分的痴呆累积发病率的性别和年龄特异性差异。
分析了18815名成年人的数据，其中9%的女性和8%的男性（加权比例）符合新发痴呆的标准。已知/疑似OSA在男性中比在女性中更普遍（加权比例68%对31%）。未调整的性别分层分析表明，已知/疑似OSA与60至84岁年龄段的女性和男性痴呆累积发病率较高相关。到80岁时，相对于没有已知/疑似OSA的成年人，已知/疑似OSA的女性痴呆累积发病率高4.7%（CI 2.8%，6.7%），已知/疑似OSA的男性高2.5%（CI 0.5%，4.5%）。按年龄分层的OSA与痴呆累积发病率之间的调整关联在女性和男性中均减弱，但仍具有统计学意义。
OSA会增加老年人，尤其是女性的痴呆风险。这项研究阐明了一个潜在可改变但经常被忽视的痴呆发病风险因素的影响。
