Sleep-Disordered Breathing Predicts Risk for Cognitive Impairment in Elderly
Sleep-disordered breathing in elderly patients might be used to predict future risk of cognitive impairment.
Older adults with sleep-disordered breathing (SDB) have a 26% greater risk for the development of cognitive impairment and a small risk for deterioration of executive function compared with adults without SDB, according to results of a meta-analysis published in the journal JAMA Neurology.
Investigators examined 14 cross-sectional and prospective studies featuring a total of 4,288,419 women and men and included information on SDB and Alzheimer's disease, cognitive impairment, or dementia. Across these studies, standard cognitive tests and/or a diagnosis for cognitive impairment provided the basis for which outcomes were judged. A pooled analysis of 6 prospective studies demonstrated that patients with SDB were 26% more likely to have cognitive impairment develop (risk ratio, 1.26; 95% CI, 1.05-1.50) compared with people without SDB.
Researchers performed a pooled analysis of 7 cross-sectional studies, showing that people with SDB also had somewhat worse executive function (standard mean difference, -0.05; 95% CI, -0.09 to 0.00). In addition, one study evaluated immediate memory and the other studies examined delayed recall. Based on their findings, the authors of the meta-analysis concluded that the incidence of SDB was not associated with significant memory impairment.
These findings show that SDB in elderly patents might provide prognostic utility for the risk for cognitive impairment, and care providers “should closely follow patients who experience significant levels of SDB for the occurrence of cognitive dysfunction and might consider administering full neuropsychological batteries in some instances.”
The researchers believe that the limited data available from published research reduced their ability to perform a subgroup analysis, particularly one based on age. Additionally, the investigators comment that most studies included in this meta-analysis lacked adjustment for important confounders that might have affected the results.
Leng Y, McEvoy CT, Allen IE, Yaffe K. Association of sleep-disordered breathing with cognitive function and risk of cognitive impairment: a systematic review meta-analysis [published online August 28, 2017]. JAMA Neurol. doi: 10.1001/jamaneurol.2017.2180