Age- and Sex-Specific Associations between Obstructive Sleep Apnea Risk and Cognitive Functioning in Middle-Aged and Older Adults: A 3-Year Longitudinal Analysis of the Canadian Longitudinal Study on Aging
Authors List
Julie Legault, BSc1,2, Cynthia Thompson, PhD1, Gregory Moullec, PhD1,3, Andrée-Ann Baril, PhD4, Marie-Ève Martineau-Dussault, BA1,2, Claire André, PhD1,2, Julie Carrier, PhD1,2, Nadia Gosselin, PhD1,2
1Research Center, CIUSSS Nord-de-l'Ile-de-Montreal, Montreal, Qc, Canada
2Department of Psychology, Université de Montréal, Montreal, Qc, Canada
3École de santé publique, Département de Médecine Sociale et Préventive, Université de Montréal, Montreal, Qc, Canada
4Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Qc, Canada
Introduction
It is unclear whether obstructive sleep apnea (OSA) increases risk of cognitive decline. Participants characteristics, such as sex and age, could influence the association between OSA and cognition. Here, we characterized the sex- and age-specific associations between baseline OSA risk and 3-year cognitive changes in middle-aged and older adults.
Methods
We included 24,819 participants (age range: 45-85 years, 51% women) from the Canadian Longitudinal Study on Aging comprehensive cohort. OSA risk was measured at baseline using the STOP-B score. Neuropsychological tests assessed memory, executive functions (word fluency, processing speed and attention, and inhibition), and psychomotor speed at baseline and 3-year follow-up. We performed age and sex-specific linear mixed models to estimate how baseline STOP-B score predicts 3-year cognitive changes.
Results
Men aged 45-59 at high risk for OSA showed a steeper decline in psychomotor speed (+13.2 sec [95%CI: -1.6 to 27.9]), while those aged 60-69 showed a steeper decline in mental flexibility (-1.2 words [95%CI: -1.9 to -0.5]) and processing speed (+0.6 sec [95%CI: 0.3 to 0.9]). We found no association between baseline OSA risk and cognitive changes in men aged 70 and over. Women aged 45-59 at high risk for OSA showed a steeper decline in processing speed (+0.1 sec [95%CI: -0.2 to 0.4]), while those aged 70 and over had a steeper decline in memory (-0.2 word [95%CI: -0.6 to 0.1]) and processing speed (+1.0 sec [95%CI: 0.4 to 1.5]).
Conclusions
We observed multiple associations between baseline OSA risk and cognitive decline, but these associations were affected by age and sex. Women aged 70 and older at high risk of OSA were the only subgroup showing an association with memory performance, which could suggest that they are more vulnerable to neurodegeneration.
Research Funding Source: The Canadian Longitudinal Study on Aging is supported by the Canadian Institutes of Health Research [CIHR; LSA 94473] and the Canada Foundation for Innovation. This work was supported by the CIHR [Community Development Program grant, CDT-142656; Canada Research Chair in Sleep Disorders and Brain Health; Foundation grant, FDN154291; Doctoral Research Award (JL)].
Julie Legault, BSc1,2, Cynthia Thompson, PhD1, Gregory Moullec, PhD1,3, Andrée-Ann Baril, PhD4, Marie-Ève Martineau-Dussault, BA1,2, Claire André, PhD1,2, Julie Carrier, PhD1,2, Nadia Gosselin, PhD1,2
1Research Center, CIUSSS Nord-de-l'Ile-de-Montreal, Montreal, Qc, Canada
2Department of Psychology, Université de Montréal, Montreal, Qc, Canada
3École de santé publique, Département de Médecine Sociale et Préventive, Université de Montréal, Montreal, Qc, Canada
4Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Qc, Canada
Introduction
It is unclear whether obstructive sleep apnea (OSA) increases risk of cognitive decline. Participants characteristics, such as sex and age, could influence the association between OSA and cognition. Here, we characterized the sex- and age-specific associations between baseline OSA risk and 3-year cognitive changes in middle-aged and older adults.
Methods
We included 24,819 participants (age range: 45-85 years, 51% women) from the Canadian Longitudinal Study on Aging comprehensive cohort. OSA risk was measured at baseline using the STOP-B score. Neuropsychological tests assessed memory, executive functions (word fluency, processing speed and attention, and inhibition), and psychomotor speed at baseline and 3-year follow-up. We performed age and sex-specific linear mixed models to estimate how baseline STOP-B score predicts 3-year cognitive changes.
Results
Men aged 45-59 at high risk for OSA showed a steeper decline in psychomotor speed (+13.2 sec [95%CI: -1.6 to 27.9]), while those aged 60-69 showed a steeper decline in mental flexibility (-1.2 words [95%CI: -1.9 to -0.5]) and processing speed (+0.6 sec [95%CI: 0.3 to 0.9]). We found no association between baseline OSA risk and cognitive changes in men aged 70 and over. Women aged 45-59 at high risk for OSA showed a steeper decline in processing speed (+0.1 sec [95%CI: -0.2 to 0.4]), while those aged 70 and over had a steeper decline in memory (-0.2 word [95%CI: -0.6 to 0.1]) and processing speed (+1.0 sec [95%CI: 0.4 to 1.5]).
Conclusions
We observed multiple associations between baseline OSA risk and cognitive decline, but these associations were affected by age and sex. Women aged 70 and older at high risk of OSA were the only subgroup showing an association with memory performance, which could suggest that they are more vulnerable to neurodegeneration.
Research Funding Source: The Canadian Longitudinal Study on Aging is supported by the Canadian Institutes of Health Research [CIHR; LSA 94473] and the Canada Foundation for Innovation. This work was supported by the CIHR [Community Development Program grant, CDT-142656; Canada Research Chair in Sleep Disorders and Brain Health; Foundation grant, FDN154291; Doctoral Research Award (JL)].
