TY - JOUR
T1 - Association of obstructive sleep apnea and sleep quality with cognitive function
T2 - a study of middle-aged and elderly persons in India
AU - Haldar, Partha
AU - Tripathi, Manjari
AU - Prasad, Kameshwar
AU - Kant, Shashi
AU - Dwivedi, Sada Nand
AU - Vibha, Deepti
AU - Pandit, Awadh Kishor
AU - Srivastava, Achal Kumar
AU - Kumar, Amit
AU - Ikram, MArfan A.
AU - Henning, Tiemeier
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023.
PY - 2024/5
Y1 - 2024/5
N2 - Introduction:Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. Methods: We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. Results: A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score − 0.02, p-value 0.006), memory (− 0.03, 0.014), and G-factor (− 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50–60 years) (− 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (− 0.48, < 0.001), memory (− 0.08, 0.005), and executive domains (− 0.12, < 0.001), but not with information domain. Conclusion: The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
AB - Introduction:Symptoms of obstructive sleep apnea (OSA) and poor sleep quality affect around one in ten people in India. We aimed to determine if OSA symptoms and poor sleep quality are independently associated with cognition in middle-aged and elderly urban Indian populations. Methods: We studied the cross-sectional association between OSA symptoms (by Berlin Questionnaire), poor sleep quality (by Pittsburgh Sleep Quality Index), and cognitive function in adults ≥ 50 years. Using a standard neuropsychological battery for cognitive function, a G-factor was derived as the first rotated principal component assessing domains of information processing, memory, and executive function. The associations of exposures with cognitive measures were modeled using linear regression, adjusted for metabolic risk factors, lifestyle factors, and psychosocial problems, followed by stratified analysis by decadal age group. Results: A total of 7505 adults were enrolled. Excluding those with MMSE < 26 (n 710), of 6795 individuals (49.2% women), mean (SD) age 64.2 (9.0) years, 38.3% had high risk of OSA symptoms, and 15.9% had poor sleep quality. OSA symptoms were negatively associated with cognitive domains of information processing (adjusted beta coefficient of z-score − 0.02, p-value 0.006), memory (− 0.03, 0.014), and G-factor (− 0.11, 0.014) in full-model. Stratified analysis by age group showed significant adverse effects of OSA symptoms on cognition for middle-aged people (50–60 years) (− 0.26, 0.001), but not in later age groups. Poor sleep quality was also associated with lower cognitive scores for G-factor (− 0.48, < 0.001), memory (− 0.08, 0.005), and executive domains (− 0.12, < 0.001), but not with information domain. Conclusion: The findings suggest that both symptoms of OSA and poor sleep quality have a direct adverse impact on cognition in an Indian setting. A modest effect of age on the relationship of OSA and cognition was also observed.
UR - http://www.scopus.com/inward/record.url?scp=85178939049&partnerID=8YFLogxK
U2 - 10.1007/s11325-023-02953-7
DO - 10.1007/s11325-023-02953-7
M3 - Article
C2 - 38055152
AN - SCOPUS:85178939049
SN - 1520-9512
VL - 28
SP - 975
EP - 987
JO - Sleep and Breathing
JF - Sleep and Breathing
IS - 2
ER -