Abstract
Importance Obstructive sleep apnoea (OSA) may increase the risk of dementia, however, studies have reported variable findings. We investigated if undiagnosed OSA in healthy older adults is associated with cognitive decline, and whether low-dose aspirin could attenuate this.
Methods This was conducted as a sub-study of the ASPirin in Reducing Events in the Elderly study. Participants were aged 70 years and above, free of dementia, cardiovascular disease, and known OSA. A limited-channel home sleep study calculated the oxygen desaturation index. Participants were randomised to daily aspirin 100 mg or placebo. Outcomes were the association of OSA, and the interaction of aspirin with OSA, on change in the Modified Mini-Mental State examination (3MS), a test of global cognition, over 3 years. Secondary outcomes were changes in domain specific cognitive tests. Analyses were adjusted for relevant demographic, lifestyle and cardiometabolic factors.
Results Mild OSA, detected in 630 (49.0%) of participants, and moderate/severe OSA, detected in 405 (31.5%) of participants, were associated with lower 3MS scores over 3 years (mild OSA: β −0.58, 95% CI −1.15 to −0.00, p=0.049; moderate/severe OSA: β −0.69, 95% CI-1.32 to −0.05, p=0.035), compared to the 250 (19.5%) participants without OSA. No associations of OSA with decline in domain-specific cognitive tests were observed. Interaction terms were not significant for the effects of aspirin with OSA on change in any cognitive test score.
Conclusions OSA was associated with a small decline in global cognition over 3 years in this healthy older cohort. This decline was not attenuated by aspirin.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: Resmed leased some of the ApneaLink Plus devices used in the study and provided the nasal cannula for the devices free of cost.
Conflicts of interest: Garun S. Hamilton and Matthew T. Naughton have both received equipment free of charge for use in research from Resmed, and Garun S. Hamilton from Phillips Respironics and Air Liquide Healthcare for the same purpose. Fergal J. O'Donoghue has received a grant from Resmed for research purposes and also received equipment free of charge to conduct research from Resmed and Phillips Respironics.
Conflicts of interest: The other authors have no relevant conflicts of interest to declare.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received June 6, 2024.
- Accepted August 2, 2024.
- Copyright ©The authors 2024
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org
