0456 Association of MOCA scores in individuals with Mild Cognitive Impairment-Alzheimer Disease and Obstructive Sleep Apnea

Abstract

Abstract Introduction Mild cognitive impairment (MCI) is considered a transitional stage between normal aging and dementia. Studies have demonstrated an association with rate of progression of MCI and dementia in individuals with OSA compared to those without OSA. The varying degree of hypoxia, sleep fragmentation and poor quality of sleep in OSA patients has been associated with increased risk of stroke, memory impairment, cardiac arrhythmias, dyslipidemia, hypertension, obesity and glucose intolerance. Identifying different variables in sleep study that can be linked with MCI and AD is helpful. We compared patients' MOCA score at the time of sleep study and compared it with multiple macro and micro variables tested on the sleep study. Methods Data was presented as mean ± (SD) or median [25th, 75th percentiles] for continuous variables and N (%) for categorical variables. Comparisons were performed between baseline MOCA groups (0-17 vs. 18-30) using two-sample T-test or Wilcoxon rank sum test for continuous variables based on distribution, and chi-square test or Fisher’s exact test for categorical variables. Linear regression was used to assess the relationship between baseline MOCA and sleep measures before and after adjustment for covariates. Covariates included age, gender, race, and BMI. Results Patients with smaller MOCA score were older (71.4 ± 8.7 vs. 68.1 ± 9.4, p=0.002), predominantly black (17.8% vs. 10.8%, p=0.013), weigh lower (median [IQR]: 80.5 [69.2, 94.0] vs. 86.2 [74.0, 99.0], p=0.023) and had less prevalence in ADHD, anxiety, depression, GERD and headache (p=0.034,0.024,0.013,0.016,0.040, respectively). After covariates adjustment (age, sex, race and BMI), when percent sleep time with SaO2< 90% increase 10%, MOCA would decrease 0.24 (coefficient -0.21, 95%CI [-0.41,-0.01], p=0.043); when SaO2 nadir increased 10%, MOCA would increase 0.68 (coefficient 0.68, 95%CI [0.05,1.32], p=0.035); when sleep stage %N1 increased 1%, MOCA would decrease 0.04 (coefficient -0.04, 95%CI [-0.08,-0.01], p=0.011). Conclusion Changes in oxygen levels during sleep showed direct correlation between MOCA score in individuals with MCI and AD, at the time of sleep study. Decline in MOCA scores were directly associated with degree of hypoxia observed during the sleep studies. The study showed association of worsening MCI and AD with lower oxygen levels in patients with OSA. Support (if any)