Details

Autor(en) / Beteiligte

• Jung, Y
• Silber, MH
• Tippmann-Peikert, M
• St Louis, EK
• Smith, GE
• Ferman, TJ
• Knopman, DS
• Petersen, RC
• Boeve, BF

Titel

1154 THE EFFECTS OF CPAP ON COGNITIVE AND FUNCTIONAL MEASURES IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT AND ALZHEIMER’S DEMENTIA

Ist Teil von

• Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A430-A431

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Introduction: Untreated OSA may worsen cognitive and functional impairment in patients with mild cognitive impairment (MCI) and Alzheimer’s dementia (AD). It is unclear whether CPAP provides prolonged cognitive and functional improvement in these patients. We examined the effects of CPAP on cognitive and functional outcomes over one year in patients with MCI and AD. Methods: Twenty-nine patients with MCI or AD with clinical features of OSA underwent overnight polysomnography. CPAP compliance was defined as nightly CPAP use ≥ 4 hours for ≥70% of the nights. Mini-Mental Status Examination (MMSE), Epworth Sleepiness Scale (ESS), Record of Independent Living (ROIL), Geriatric Depression Scale (GDS), and a 10-point Quality of Life (QOL) scale were obtained at baseline, 1-, 6- and 12-month follow-up. The primary analysis was performed using last observation carried forward method to account for incomplete follow-up. In addition, changes in the aforementioned measures from baseline to each follow-up visit were evalauted. Two-sided non-parametric statistics were utilized with p-values < 0.05 being considered statistically significant. Results: Eighteen patients with MCI (Clinical Dementia Rating [CDR] 0.5) and 11 patients with AD (CDR 1.0) with a median age of 73 years (interquartile range [IQR] 62–76) were included in the study. The median apnea-hypopnea index was 10.0 (IQR 7.0–22.5). Fourteen patients were compliant with CPAP use. No differences were found in sleep apnea severity or CPAP compliance between patients with MCI and AD. Baseline MMSE, ESS, ROIL, GDS and QOL did not differ between CPAP compliant and non-compliant patients. The primary analysis revealed that the ability to manage complex activities of daily living (based on the ROIL) significantly improved in CPAP compliant patients (p=0.026), although MMSE, ESS, GDS and QOL did not change over time. The subanalysis demonstrated improved MMSE in patients who were CPAP-compliant for 12 months (p=0.036), although the rest of the measures did not change. Conclusion: Treatment of OSA with CPAP may improve functional activities of daily living in patients with MCI and AD. Support (If Any): The Alzheimer’s Association, Robert H. and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program of the Mayo Foundation, NIH AG06786 and AG16574