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P3‐089: Incidence of dementia is very high in oldest‐old participants with amnestic MCI and other cognitive impairments: Results from The 90+ study
Author(s) -
Peltz Carrie B.,
Berlau Daniel J.,
Corrada Maria M.,
Kawas Claudia H.
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1583
Subject(s) - dementia , incidence (geometry) , medicine , cognition , cognitive impairment , population , gerontology , pediatrics , psychology , psychiatry , disease , environmental health , optics , physics
impairment (MCI) and dementia. Methods: We studied 298 dementia free women (mean age 82.3 6 3.2 years at baseline) participating in the SOFWISE study with overnight polysomnography (PSG) and clinically adjudicated cognitive status approximately 5 years later. An apnea-hypopnea index (AHI) score 15 events/hr was used to define SDB. Arousal index (arousals per hour of sleep) was used as a marker of sleep disruption and hypoxia was measured using oxygen desaturation (deSat) index (ODI), percent sleep time in apnea or hypopneas with 3% oxyhemoglobin deSat, and percent sleep time with< 90% Sa02. These predictors were analyzed in separate multivariate-adjusted logistic regression models (adjusted for age, race, education, BMI, myocardial infarction, diabetes, and baseline cognitive score) for likelihood of developing MCI or dementia. Results: At baseline, 105 (35.2%) women had SDB and after 5-years of follow-up 47 (44.8%) developed MCI/dementia, while MCI or dementia was observed in only 31.1% (60/ 193) of women without SDB. Presence of SDB doubled the odds of developing MCI/dementia (odds ratio [OR] 1⁄4 2.33, 95% confidence interval [CI] 1.28 4.25) compared to women without SDB. MCI or dementia was not related arousal index (OR 0.90, 95% CI 0.44 1.84 for highest tertile 22.6 vs. lowest terile <14.6). Of the hypoxia markers, ODI ( 15 events/ hr of sleep) and percent sleep time in apnea and hypopnea (highest tertile 7.04% vs. lowest tertile < 2.26%) increased odds of developing MCI/dementia (OR 2.05, 95% CI 1.15 3.67 and OR 2.23, 95% CI 1.10 4.54, respectively) but percent sleep time with < 90% Sa02 did not. Conclusions: The presence of SDB greatly increased the risk of developing cognitive impairment 5-years later in older women. These findings suggest that hypoxia is the likely mechanism through which SDB increases risk for cognitive changes in older adults.