[Obstructive sleep apnea as an aggravating factor of cognitive impairment in vascular cognitive disorder]

To evaluate the impact of severe obstructive sleep apnea syndrome (OSAS) on cognitive function and the severity of anxiety-depressive symptoms in patients with moderate vascular cognitive disorder (VCD), and identify the most susceptible cognitive domains.

Fifty-one patients with moderate VCD were examined. The main group consisted of patients with moderate VCD and severe OSAS (n=26, AHI≥30), compared to patients with moderate VCD but without OSAS (n=25, AHI<5). Cardiorespiratory monitoring was used to diagnose OSAS. Neuropsychological testing included the Montreal Cognitive Assessment Scale (MoCA); the Beck Depression Inventory (BDI), which includes the cognitive-affective subscale (BDI (C-A)), the somatic symptoms of depression subscale (BDI (S-P)) and the total score (BDI, total score); the State-Trait Anxiety Inventory (STAI), which includes trait (STAI-T) and state anxiety (STAI-S); the Frontal Assessment Battery (FAB); the FCSRT-IR (Free and Cued Selective Reminding Test - Immediate Recall), which includes an assessment of free recall (FCSRT-IR, FR), playback with prompt (FCSRT-IR, CR), total score (FCSRT-IR, total score) and Index of Sensitivity of Cueing; Symbol Digit Modalities Test (SDMT).

In the main group, lower scores were observed on the FAB (p=0.043), SDMT (p<0.001), FCSRT-IR (total score) (p=0.002), and MoCA (p=0.001) scales, indicating more pronounced cognitive impairment. There were higher rates of depressive symptoms in BDI (total score) (p=0.001), BDI (S-P) (p<0.001), but a low level of anxiety in STAI-S (p=0.001).

Severe OSAS in patients with moderate VCD is associated with more severe impairment of executive functions, processing speed, psychomotor reactions, and increased levels of depressive symptoms with low levels of anxiety.