Comparison of cognitive performance among different age groups in patients with obstructive sleep apnea

Alchanatis, Manos; Zias, Nikolaos; Deligiorgis, Nikolaos; Liappas, Ioannis; Chroneou, Alexandra; Soldatos, Constantin R.; Roussos, Charis

doi:10.1007/s11325-007-0133-y

Cited by 84 publications

(49 citation statements)

References 33 publications

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“…Our behavioral findings are consistent with previous reports that OSA does not impair performance relative to age-matched control subjects until patients reach middle-age (15). The authors of that study concluded that OSA-related factors, such as sleep fragmentation or brain damage due to hypoxia for many years, may lead to these cognitive differences, and that patients with OSA are particularly vulnerable to cognitive impairment when they reach middle age.…”

Section: Discussionsupporting

confidence: 92%

“…Alchanatis and colleagues (15) reported that middle-aged patients with OSA showed cognitive decline in comparison to age-matched control subjects, whereas cognitive performance of younger patients with OSA on attention tasks was similar to age-matched control subjects. This suggests that age plus OSA may pose a double insult for which the brain may be not able to compensate.…”

mentioning

confidence: 98%

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Obstructive Sleep Apnea and Age

Ayalon¹,

Ancoli‐Israel

Drummond³

2010

Am J Respir Crit Care Med

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Rationale: Healthy aging is associated with cognitive deficits similar to those found in obstructive sleep apnea (OSA). As in OSA, older adults show compensatory cerebral activation during cognitive demands in the face of neurocognitive decline. Objectives: The current study examines whether the combination of increasing age and sleep apnea will lead to a stronger compensatory response than either factor alone, or overwhelm the brain's capacity to compensate. Methods: A total of 14 treatment-naive patients with sleep apnea (aged 25-59 yr) and 14 age-matched healthy control subjects were each divided into two age groups of young (,45 yr) and middleaged (> 45 yr). All underwent a sleep study, followed the next morning by a functional magnetic resonance imaging session that included a sustained attention and a verbal encoding task. A priori contrast analyses compared middle-aged patients with OSA to young patients, young control subjects, and middle-aged control subjects. Measurements and Main Results: Middle-aged patients with OSA showed reduced performance for immediate word recall and slower reaction time during sustained attention compared with the other three groups (middle-aged control, young sleep apnea, and young control). For both tasks, decreased activation was detected for middle-aged sleep apnea relative to the other groups in task-related brain regions. Conclusions: These results suggest that the presence of both sleep apnea and increasing age overwhelmed the brain's capacity to respond to cognitive challenges with compensatory recruitment and to maintain performance. The findings that sleep apnea impairs performance and brain function at a younger age than what might ordinarily be expected underscore the importance of early diagnosis and treatment of sleep apnea.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 98%

Obstructive Sleep Apnea and Age

Ayalon¹,

Ancoli‐Israel

Drummond³

2010

Am J Respir Crit Care Med

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“…It is reported that cognitive functions are worse in hypoxemic OSAS patients than in non-hypoxemic ones [34]. Also the individual factors such as age and obesity have an important effect on cognitive dysfunction [35][36][37]. It is suggested that intermittant hypoxemia, daytime sleepiness and obesity may have an effect on neurocognitive dysfunction in OHS patients.…”

Section: Discussionmentioning

confidence: 99%

The effect of positive airway pressure therapy on neurocognitive functions, depression and anxiety in obesity hypoventilation syndrome

Yıldız

Barış

Tuncel

et al. 2016

4.2 Sleep and Control of Breathing

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Background: The aim of this study is to evaluate the presence of neurocognitive dysfunctions, depression and anxiety and the effect of positive airway pressure (PAP) therapy on these alterations in Obesity Hypoventilation Syndrome (OHS) patients. Methods: Ten healthy normal and obese controls, 10 OHS and 10 OSAS patients were included in the study. Short form-36, Beck Depression Scale and State-Trade Anxiety Inventory (STAI 1-2) were performed. Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MOCA), Enhanced Cued Recall (ECR) and Mini Mental Test (MMT) were used for neurocognitive evaluation. All tests were repeated after one night PAP therapy in OHS and OSAS groups. Results: OHS patients had the lowest scores of physical (PF) and social functioning (SF) in SF-36. The total number of persistent errors and incorrect answers were the highest in OHS group in WCST. The scores of MOCA, ECR and MMT were lower; depression and anxiety scores were higher in OHS group than in controls (p = 0,00). There was a significant increase in the completed categories in OHS after PAP therapy (p = 0,03). There were also significant increases in MOCA, ECR and MMT scores and significant decreases in depression and anxiety scores with respect to PAP therapy. Conclusions: Cognitive dysfunction, depression and anxiety are important under-recognized comorbidities in OHS. It is suggested that short term PAP therapy had positive effects on neurocognitive functions, depression and anxiety but further multicentre, prospective studies with large number of cases are needed to evaluate the effect of long term PAP therapy on these parameters.

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“…The cognitive impairment seen in OSA tends to be more significant with increasing age (24)(25)(26), suggesting that older age groups are more susceptible to the effects of OSA on the brain (27), or that compensatory mechanisms that are perhaps present in younger people and help to recruit other areas of the brain to maintain performance, may no longer be as proficient (28). OSA is increasingly prevalent with age (29), although there tends to be less reported sleepiness in older patients.…”

Section: Review Articlementioning

confidence: 99%

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

Gildeh¹,

Drakatos²,

Higgins³

et al. 2016

J. Thorac. Dis.

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Obstructive sleep apnea (OSA) causes daytime fatigue and sleepiness, and has an established relationship with cardiovascular and metabolic disease. Recent years have seen the emergence of an evidence base linking OSA with an increased risk of degenerative neurological disease and associated cognitive impairment, an accelerated rate of decline in kidney function with an increased risk of clinically significant chronic kidney disease (CKD), and with a significantly higher rate of cancer incidence and death. This review evaluates the evidence base linking OSA with these seemingly unrelated co-morbidities, and explores potential mechanistic links underpinning their development in patients with OSA, including intermittent hypoxia (IH), sleep fragmentation, sympathetic excitation, and immune dysregulation.

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Comparison of cognitive performance among different age groups in patients with obstructive sleep apnea

Cited by 84 publications

References 33 publications

Obstructive Sleep Apnea and Age

Obstructive Sleep Apnea and Age

The effect of positive airway pressure therapy on neurocognitive functions, depression and anxiety in obesity hypoventilation syndrome

Emerging co-morbidities of obstructive sleep apnea: cognition, kidney disease, and cancer

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