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Abstract

Introduction

Mild cognitive impairment (MCI), which is considered an “at risk” state for Alzheimer’s disease (AD), comorbid with obstructive sleep apnea (OSA), is prevalent in older adults. Little is known about the effect of adherence to continuous positive airway pressure (CPAP) treatment on cognition in older adults with mild OSA and MCI. We aimed to explore whether long-term CPAP use may improve cognition in this population.

Methods

We conducted a secondary analysis of data from Memories 1, a 1-year quasi-experimental trial of the effect of CPAP adherence in older adults with MCI and OSA. Seventeen participants with MCI and mild OSA (AHI 10-14, mean age 72.1±8.9 years) were divided into 2 groups based on their CPAP adherence over 1 year: 1) CPAP adherent group (CPAP+) with average CPAP use ≥4 hr per night, n=7; and 2) CPAP non-adherent group (CPAP-) with average CPAP use <4 hr per night, n=10. Descriptive analyses, along with general linear and logistic regression models were utilized to examine the changes in cognition and everyday function from baseline across 1 year between groups.

Results

Baseline demographics, clinical and sleep characteristics were largely comparable between groups. Those in the CPAP+ group compared to CPAP- demonstrated a significant improvement in psychomotor/cognitive processing speed (PE=1.94, SE= 0.70, 95%CI=0.44-3.44, p<0.05) with an effect size of 1.39. Eight participants improved on the clinical dementia rating scale (CDR), while 6 worsened or unchanged. Twelve participants rated themselves improved on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale (ADCS-CGIC), while 3 reported their status worsened or unchanged. While not statistically significant (likely due to the small sample size), the CPAP+ group had greater than 8-fold increased odds of improving on the CDR (OR=8.33, 95%CI=0.63-110, p=0.11) and greater than 9-fold increased odds of improving on the ADCS-CGIC (OR=9.55, 95%CI=0.33-278.83, p=0.19), compared to the CPAP- group.

Conclusion

Long-term CPAP use may be a potentially effective intervention to improve cognition in older adults with mild OSA and MCI.

Support (If Any)

NIH-NIA R01AG054435;NIH-NIA R01AG034682

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Topic:
Issue Section:
B. Clinical Sleep Science and Practice > VI. Adults: Sleep and Aging, Sleep and Gender
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