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      The prevalence of obstructive sleep apnea in mild cognitive impairment: a systematic review

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          Abstract

          Background

          Previous studies have shown that obstructive sleep apnea (OSA) is associated with a higher risk of cognitive impairment or dementia in the elderly, leading to deleterious health effects and decreasing quality of life. This systematic review aims to determine the prevalence of OSA in patients with mild cognitive impairment (MCI) and examine whether an association between OSA and MCI exists.

          Methods

          We searched Medline, PubMed, Embase, Cochrane Central, Cochrane Database of Systematic Reviews, PsychINFO, Scopus, the Web of Science, ClinicalTrials.gov and the International Clinical Trials Registry Platform for published and unpublished studies. We included studies in adults with a diagnosis of MCI that reported on the prevalence of OSA. Two independent reviewers performed the abstract and full-text screening, data extraction and the study quality critical appraisal.

          Results

          Five studies were included in the systematic review. Overall, OSA prevalence rates in patients with MCI varied between 11 and 71% and were influenced by OSA diagnostic methods and patient recruitment locations (community or clinic based). Among studies using the following OSA diagnostic measures– self-report, Home Sleep Apnea Testing, Berlin Questionnaire and polysomnography– the OSA prevalence rates in MCI were 11, 27, 59 and 71%, respectively. In a community-based sample, the prevalence of OSA in patients with and without MCI was 27 and 26%, respectively.

          Conclusions

          Based on limited evidence, the prevalence of OSA in patients with MCI is 27% and varies based upon OSA diagnostic methods and patient recruitment locations. Our findings provide an important framework for future studies to prospectively investigate the association between OSA and MCI among larger community-based cohorts and implement a standardized approach to diagnose OSA in memory clinics.

          PROSPERO registration

          CRD42018096577.

          Electronic supplementary material

          The online version of this article (10.1186/s12883-019-1422-3) contains supplementary material, which is available to authorized users.

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          Most cited references26

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          Prevalence of mild cognitive impairment is higher in men. The Mayo Clinic Study of Aging.

          R Petersen, R Roberts, D S Knopman … (2010)
          We investigated the prevalence of mild cognitive impairment (MCI) in Olmsted County, MN, using in-person evaluations and published criteria. We evaluated an age- and sex-stratified random sample of Olmsted County residents who were 70-89 years old on October 1, 2004, using the Clinical Dementia Rating Scale, a neurologic evaluation, and neuropsychological testing to assess 4 cognitive domains: memory, executive function, language, and visuospatial skills. Information for each participant was reviewed by an adjudication panel and a diagnosis of normal cognition, MCI, or dementia was made using published criteria. Among 1,969 subjects without dementia, 329 subjects had MCI, with a prevalence of 16.0% (95% confidence interval [CI] 14.4-17.5) for any MCI, 11.1% (95% CI 9.8-12.3) for amnestic MCI, and 4.9% (95% CI 4.0-5.8) for nonamnestic MCI. The prevalence of MCI increased with age and was higher in men. The prevalence odds ratio (OR) in men was 1.54 (95% CI 1.21-1.96; adjusted for age, education, and nonparticipation). The prevalence was also higher in subjects who never married and in subjects with an APOE epsilon3epsilon4 or epsilon4epsilon4 genotype. MCI prevalence decreased with increasing number of years of education (p for linear trend <0.0001). Our study suggests that approximately 16% of elderly subjects free of dementia are affected by MCI, and amnestic MCI is the most common type. The higher prevalence of MCI in men may suggest that women transition from normal cognition directly to dementia at a later age but more abruptly.
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            Classification and epidemiology of MCI.

            Rosebud O Roberts, David S. Knopman (2013)
            Mild cognitive impairment (MCI) is an intermediate stage in the trajectory from normal cognition to dementia. Despite controversies about the classification of MCI, recent published criteria for MCI allow better comparison of the prevalence, incidence, and outcomes of MCI. Subjects with MCI have a high rate of progression to dementia over a relatively short period. In this review, we present an overview of the classification of MCI, estimates of the incidence and prevalence of MCI, risk factors for MCI, and the outcomes following an MCI diagnosis.
            Article 0 comments Cited 175 times – based on 0 reviews     Review now
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              Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review and Meta-analysis.

              Yue Leng, Claire T McEvoy, Isabel E. Allen … (2017)
              Growing evidence suggests an association between sleep-disordered breathing (SDB) and cognitive decline in elderly persons. However, results from population-based studies have been conflicting, possibly owing to different methods to assess SDB or cognitive domains, making it difficult to draw conclusions on this association.
              Article 0 comments Cited 129 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Talha Mubashir: talmubashir@gmail.com
                Lusine Abrahamyan: lusine.abrahamyan@theta.utoronto.ca
                Ayan Niazi: ayan.niazi.786@gmail.com
                Deween Piyasena: deweenloji@gmail.com
                Abdul A. Arif: abdul.arif@mail.utoronto.ca
                Jean Wong:
                ORCID: https://orcid.org/0000-0002-7213-4898
                jean.wong@uhn.ca
                Ricardo S. Osorio: Ricardo.OsorioSuarez@nyulangone.org
                Clodagh M. Ryan:
                ORCID: https://orcid.org/0000-0002-2372-965X
                Clodagh.Ryan@uhn.ca
                Frances Chung:
                ORCID: http://orcid.org/0000-0001-9576-3606
                frances.chung@uhn.ca
                Journal
                Journal ID (nlm-ta): BMC Neurol
                Journal ID (iso-abbrev): BMC Neurol
                Title: BMC Neurology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2377
                Publication date (Electronic): 15 August 2019
                Publication date PMC-release: 15 August 2019
                Publication date Collection: 2019
                Volume: 19
                Electronic Location Identifier: 195
                Affiliations
                [1 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Department of Anesthesia and Pain Medicine, , University Health Network, University of Toronto, ; MCL 2-405, 399 Bathurst Rd., Toronto, ON M5T2S8 Canada
                [2 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Institute of Health Policy, Management and Evaluation (IHPME), , University of Toronto, ; Toronto, ON Canada
                [3 ]ISNI 0000 0004 0474 0428, GRID grid.231844.8, Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute, , University Health Network, ; Toronto, ON Canada
                [4 ]ISNI 0000 0001 1090 2022, GRID grid.52539.38, Department of Biology, , University of Trent, ; Peterborough, ON Canada
                [5 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Health Sciences, , University of McMaster, ; Hamilton, ON Canada
                [6 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Department of Life Sciences, , University of Toronto, ; Toronto, ON Canada
                [7 ]ISNI 0000 0004 1936 8753, GRID grid.137628.9, Department of Psychiatry, , NYU School of Medicine, ; New York, NY USA
                [8 ]ISNI 0000 0001 2157 2938, GRID grid.17063.33, Centre of Sleep Health and Research, Department of Medicine, , University Health Network, University of Toronto, ; Toronto, Ontario Canada
                Author information
                https://orcid.org/0000-0002-7213-4898
                https://orcid.org/0000-0002-2372-965X
                http://orcid.org/0000-0001-9576-3606
                Article
                Publisher ID: 1422
                DOI: 10.1186/s12883-019-1422-3
                PMC ID: 6694482
                PubMed ID: 31416438
                SO-VID: 1c0f5501-e5e3-41cd-97d7-57975bacbb43
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 2 April 2019
                Date accepted : 31 July 2019
                Funding
                Funded by: University Health Network Foundation and the Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Neurology
                Keywords: obstructive sleep apnea,mild cognitive impairment,prevalence
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: obstructive sleep apnea, mild cognitive impairment, prevalence

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