AbstractBackgroundStudies investigating the possible links between obstructive sleep apnea (OSA) and cognitive dysfunction have yet led to heterogenous results. Individual characteristics, such as sex and age, could moderate this association and explain part of this heterogeneity. Here, we characterized the sex‐ and age‐specific association between OSA risk and cognitive performance using longitudinal data from the community‐based Canadian Longitudinal Study on Aging (CLSA) comprehensive cohort.MethodOur sample included 25,393 participants aged 45 to 85 years at baseline (mean = 63 years; 51% women; 78% with post‐secondary degree), recruited between 2011 and 2015 across Canada. Participants with Alzheimer’s and Parkinson’s diagnosis or with history of stroke and of traumatic brain injury were excluded. Participants’ risk for OSA was measured at baseline using the STOP‐B questionnaire, based on risk factors and symptoms of OSA. Participants scoring ³ 3/5 were classified as being at high‐risk for OSA. Neuropsychological tests assessed memory (Rey Auditory Verbal Learning Test), executive functioning (Mental Alternation, Animal Fluency, Controlled Oral Word Association and Stroop tests) and psychomotor speed (Choice Reaction Time) at baseline and at 3‐year follow‐up. We calculated changes (follow‐up – baseline) in each cognitive continuous score and conducted sex‐specific age‐stratified (45‐59; 60–69; 70–85 years) analyses of covariance (ANCOVAs) to estimate the predictive role of baseline OSA risk, adjusting for socio‐demographic, lifestyle and medical comorbidities. The level of significance was set at p<0.05, after false‐discovery rate correction.ResultsIn the whole sample, results show a decline over time only for executive functioning (Mental Alternation, Animal Fluency and Stroop) at 3‐year follow‐up. When analyses were performed according to age and sex, being at high‐risk for OSA was associated with increased reaction times only in women aged 70–85 years (Stroop word: [F = 12.486; 95%CI ‐5.440 to ‐1.554]; Stroop color: [F = 7,870; 95%CI ‐9.843 to ‐1.738]).ConclusionAlthough changes in executive functioning were noted over time in the whole sample, being at high‐risk for OSA only increased the risk of slower processing speed for older women. These findings suggest that the possible detrimental effects of OSA on cognitive health depend on participants’ age and sex.
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