Previous studies suggested that sleep apnea is associated with neurocognitive impairments but did not examine populations most likely to have clinically relevant impairments. Cross-sectional, retrospective analyses were performed on 108 patients (65 with Mild Cognitive Impairment, 43 with dementia) seen in an academic medical center. Results indicated that severity of oxygen desaturation was associated with cognitive impairments in attention and executive function domains, even after controlling for age, sex, education and depressive symptoms. Strength of associations was influenced by cardiovascular disease. Screening for nocturnal oxygen desaturation may be a useful procedure to assess for a potentially reversible cause of cognitive impairment.

The objective of this study was to determine the effectiveness of the Rey 15-Item Test in elderly individuals with and without cognitive impairment and to develop new indices to function with this population, if needed. The sample consisted of 185 individuals referred for outpatient neuropsychological evaluation. All were clinically evaluated and administered the Rey 15-Item Test (RFIT) with recognition as part of this procedure. Significant differences were present between those passing and failing the RFIT on referral question; working status; age; and diagnosis of cognitive impairment. Individuals age 60+ failed the test at rates in excess of 35%. Diagnosis also played a role with those with more severe cognitive diagnosis failing at higher rates; even in those with no diagnosis, however, 19% of elderly individuals did not produce a passing score. The extant cutoff scores commonly used with the RFIT produce unacceptably high false positive error rates to be a useful freestanding Performance Validity Test (PVT) with individuals above age 59. The introduction of a new combination score and use of rare scores and patterns of scores improves the psychometric properties of the RFIT when used with elderly adults. Cautious use of PVTs is warranted until they have been validated with aged populations.

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