Subjective cognitive complaints and objective cognitive impairment in patients suspected of obstructive sleep apnea who underwent polysomnography

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-01-11 DOI:10.1002/gps.6055

Chatchawan Rattanabannakit, Sorawich Kuendee, Pecharut Tungwacharapong, Chawanont Pimolsri, Vorapun Senanarong, Wattanachai Chotinaiwattarakul

{"title":"Subjective cognitive complaints and objective cognitive impairment in patients suspected of obstructive sleep apnea who underwent polysomnography","authors":"Chatchawan Rattanabannakit, Sorawich Kuendee, Pecharut Tungwacharapong, Chawanont Pimolsri, Vorapun Senanarong, Wattanachai Chotinaiwattarakul","doi":"10.1002/gps.6055","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Obstructive sleep apnea (OSA) is linked to cognitive impairment. We aimed to investigate subjective cognitive complaints (SCCs) and objective cognitive scores and their relation to polysomnography (PSG) parameters in patients suspected of having OSA.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A prospective cohort cross-sectional study was conducted at Siriraj Hospital. Patients suspected of OSA who were scheduled for PSG were recruited. Cognition was assessed using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT). The Memory Index Score (MIS) was calculated from the MoCA. Subjective cognitive complaint presence was assessed through direct questioning of patients and by employing the Cognitive Change Index rated by self or informants (CCI-I). Patients with severe dementia were excluded.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 258 patients (mean age 61.46 ± 7.05 years, 51.2% female), the mean MoCA score was 23.89 ± 3.89. Based on PSG results, patients were categorized into groups as follows: those without OSA or with mild OSA (combined total of 20.1%), moderate OSA (28.3%), or severe OSA (51.6%). Cognitive Change Index rated by self and CCI-I scores correlated significantly (<i>r</i> = 0.238, <i>p</i> = 0.019) but not with the MoCA score or CTT time. Objective cognitive scores were associated with PSG parameters: total sleep time (TST), sleep onset latency, wake after sleep onset, sleep stages, mean O2 saturation, and time spent with SaO2 below 90% (all <i>p</i> < 0.05). Subjective cognitive scores were not associated with PSG parameters, except CCI-I with TST. Participants with objective cognitive impairment had lower education, higher body mass index, more comorbidities, and lower SCC percentage (all <i>p</i> < 0.05). Patients with moderate to severe OSA had a higher proportion of objective cognitive impairment (64.1%) but a lower incidence of SCC (38.3%) than patients with no OSA or mild OSA. Thirty patients with severe OSA and cognitive impairment received continuous positive airway pressure (CPAP) treatment for a mean of 12.2 months. These patients showed MoCA and MIS improvement, but no significant changes were observed in their CTT and Cognitive Change Index scores.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Most patients with OSA had objective cognitive impairment, but SCC was less frequent in patients with more severe OSA. Several PSG parameters correlated with cognitive scores but not with subjective cognitive scores. Patients with severe OSA may benefit cognitively from CPAP treatment.</p>\n </section>\n </div>","PeriodicalId":14060,"journal":{"name":"International Journal of Geriatric Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gps.6055","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Geriatric Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/gps.6055","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Obstructive sleep apnea (OSA) is linked to cognitive impairment. We aimed to investigate subjective cognitive complaints (SCCs) and objective cognitive scores and their relation to polysomnography (PSG) parameters in patients suspected of having OSA.

Methods

A prospective cohort cross-sectional study was conducted at Siriraj Hospital. Patients suspected of OSA who were scheduled for PSG were recruited. Cognition was assessed using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT). The Memory Index Score (MIS) was calculated from the MoCA. Subjective cognitive complaint presence was assessed through direct questioning of patients and by employing the Cognitive Change Index rated by self or informants (CCI-I). Patients with severe dementia were excluded.

Results

Among 258 patients (mean age 61.46 ± 7.05 years, 51.2% female), the mean MoCA score was 23.89 ± 3.89. Based on PSG results, patients were categorized into groups as follows: those without OSA or with mild OSA (combined total of 20.1%), moderate OSA (28.3%), or severe OSA (51.6%). Cognitive Change Index rated by self and CCI-I scores correlated significantly (r = 0.238, p = 0.019) but not with the MoCA score or CTT time. Objective cognitive scores were associated with PSG parameters: total sleep time (TST), sleep onset latency, wake after sleep onset, sleep stages, mean O2 saturation, and time spent with SaO2 below 90% (all p < 0.05). Subjective cognitive scores were not associated with PSG parameters, except CCI-I with TST. Participants with objective cognitive impairment had lower education, higher body mass index, more comorbidities, and lower SCC percentage (all p < 0.05). Patients with moderate to severe OSA had a higher proportion of objective cognitive impairment (64.1%) but a lower incidence of SCC (38.3%) than patients with no OSA or mild OSA. Thirty patients with severe OSA and cognitive impairment received continuous positive airway pressure (CPAP) treatment for a mean of 12.2 months. These patients showed MoCA and MIS improvement, but no significant changes were observed in their CTT and Cognitive Change Index scores.

Conclusions

Most patients with OSA had objective cognitive impairment, but SCC was less frequent in patients with more severe OSA. Several PSG parameters correlated with cognitive scores but not with subjective cognitive scores. Patients with severe OSA may benefit cognitively from CPAP treatment.

Abstract Image

查看原文本刊更多论文

接受多导睡眠图检查的阻塞性睡眠呼吸暂停疑似患者的主观认知抱怨和客观认知障碍。

目的：阻塞性睡眠呼吸暂停（OSA）与认知障碍有关。我们旨在调查疑似 OSA 患者的主观认知症状（SCCs）和客观认知评分及其与多导睡眠图（PSG）参数的关系：方法：西里拉吉医院开展了一项前瞻性队列横断面研究。方法：在诗礼乐医院开展了一项前瞻性队列横断面研究，招募了计划接受多导睡眠图检查的疑似 OSA 患者。认知能力采用蒙特利尔认知评估（MoCA）和颜色轨迹测试（CTT）进行评估。记忆指数评分（MIS）根据 MoCA 计算得出。通过直接询问患者和使用认知变化指数（CCI-I）评估患者是否存在主观认知症状。严重痴呆症患者被排除在外：258 名患者（平均年龄为 61.46 ± 7.05 岁，51.2% 为女性）的平均 MoCA 得分为 23.89 ± 3.89。根据 PSG 结果，患者被分为以下几组：无 OSA 或轻度 OSA（合计 20.1%）、中度 OSA（28.3%）或重度 OSA（51.6%）。自我评定的认知变化指数与 CCI-I 分数显著相关（r = 0.238，p = 0.019），但与 MoCA 分数或 CTT 时间无关。客观认知评分与 PSG 参数相关：总睡眠时间 (TST)、睡眠开始潜伏期、睡眠开始后唤醒、睡眠阶段、平均氧气饱和度和 SaO2 低于 90% 的时间（均为 p 结论）：大多数 OSA 患者都有客观的认知障碍，但 SCC 在较严重 OSA 患者中的发生率较低。一些 PSG 参数与认知评分相关，但与主观认知评分无关。重度 OSA 患者可能会从 CPAP 治疗中受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.