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Sleep-disordered breathing and cognitive impairment in elderly Japanese-American men
Daniel J Foley1, Kamal Masaki, Lon White
1Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD 20892, USA. foleyd@gw.nia.nih.gov
Study Objective:
To assess the association between sleep-disordered breathing and cognitive functioning in an elderly cohort of Japanese-American men.
Design:
Cross-sectional study.
Setting:
The Honolulu-Asia Aging Study of Sleep Apnea, Oahu, Hawaii.
Participants:
718 men between 79 and 97 years of age examined in 1999 and 2000.
Measurements:
Apnea-hypopnea index from in-home overnight polysomnography, performance on the Cognitive Abilities Screening Instrument, body mass index, neck circumference, Epworth Sleepiness Scale, snoring, Center for Epidemiologic Studies Depression 11-item depression scale, physical disability, and history of heart disease, stroke, hypertension, diabetes, and dementia.
Results:
Less than 30% of the men had no sleep-disordered breathing (apnea-hypopnea index < 5) and nearly one-fifth (19%) had severe sleep-disordered breathing (apnea-hypopnea index > or = 30). Severe sleep-disordered breathing was associated with higher body mass index, habitual snoring, and daytime drowsiness. No association was found between sleep-disordered breathing and cognitive functioning, including measures of memory function, concentration, and attention.
Conclusions:
Sleep-disordered breathing was associated with more drowsiness but not with poor performance on standardized cognitive tests used to screen for Alzheimer disease and other dementias in older persons. Because a healthy-participant effect may have contributed to this finding, more extensive cognitive testing may be necessary to reveal more subtle deficits from sleep-disordered breathing.