Use of positive airway pressure in mild cognitive impairment to delay progression to dementia

Abstract Introduction Adherence to continuous positive airway pressure (CPAP) may delay cognitive decline in older adults with obstructive sleep apnea (OSA) and amnestic mild cognitive impairment (MCI), defined as deficits in memory that do not significantly impact daily functioning. The aim of this analysis was to identify predictors of CPAP adherence in this population. Methods Data are from Memories 2, an ongoing multisite clinical trial on the effect of treatment of moderate to severe OSA on cognitive decline in older adults 65-85 years of age who have amnestic MCI. Unadjusted and adjusted linear models were used to examine predictors of mean hours of CPAP use at 3 months. Predictors were age, sex (male/female), race (White/Non-White), education (more than high school, less than high school), Apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), and CPAP Comfort and Confidence scores at 7 days. Collinearity in the adjusted model for CPAP use at 3 months was examined using the variance inflation factor. Results Of 57 participants, most were male (54%), White (72%), with a mean age of 66.3 years (SD: 6.1). Mean AHI in this sample was 35.1 (SD: 19.9), with mean daily hours of CPAP use at 3 months 5.3 hours (SD: 2.3). Adjusted linear model results demonstrated that younger age (β=-0.13, SE=0.04, p=0.0032), White race (β=2.56, SE=0.58, p<0.0001), and higher 7-day CPAP Confidence score (β=0.48, SE=0.17, p=0.0086) were significantly associated with CPAP use at 3 months. Sex, education, AHI, ESS, and CPAP comfort were not statistically significant predictors of adherence. Conclusion Tailored interventions to increase self-efficacy during the first 7 days of CPAP treatment, especially in Non-Whites and those older than 74 years, may improve long-term CPAP adherence in older adults with amnestic MCI. Support R01AG054435

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Medical Health Records-Based Mild Cognitive Impairment (MCI) Prediction for Effective Dementia Care

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179223 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9223

Author(s):

Soo-Jin Lim ◽

Zoonky Lee ◽

Lee-Nam Kwon ◽

Hong-Woo Chun

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Incubation Period ◽

Model Development ◽

Optimal Timing ◽

Dementia Risk ◽

Common Risk Factors ◽

Global Threat ◽

Delay Progression

Dementia is a cognitive impairment that poses a global threat. Current dementia treatments slow the progression of the disease. The timing of starting such treatment markedly affects the effectiveness of the treatment. Some experts mentioned that the optimal timing for starting the currently available treatment in order to delay progression to dementia is the mild cognitive impairment stage, which is the prior stage of dementia. However, medical records are typically only available at a later stage, i.e., from the early or middle stage of dementia. In order to address this limitation, this study developed a model using national health information data from 5 years prior, to predict dementia development 5 years in the future. The Senior Cohort Database, comprising 550,000 samples, were used for model development. The F-measure of the model predicting dementia development after a 5-year incubation period was 77.38%. Models for a 1- and 3-year incubation period were also developed for comparative analysis of dementia risk factors. The three models had some risk factors in common, but also had unique risk factors, depending on the stage. For the common risk factors, a difference in disease severity was confirmed. These findings indicate that the diagnostic criteria and treatment strategy for dementia should differ depending on the timing. Furthermore, since the results of this study present new dementia risk factors that have not been reported previously, this study may also contribute to identification of new dementia risk factors.

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PAP use in mild cognitive impairment to delay progression to dementia

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.8536 ◽

2020 ◽

Vol 16 (8) ◽

pp. 1397-1397 ◽

Cited By ~ 1

Author(s):

Michelangelo Maestri ◽

Claudio Liguori ◽

Enrica Bonanni ◽

Biancamaria Guarnieri

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Delay Progression

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Review for "Expression profiling of precuneus layer III cathepsin D‐immunopositive pyramidal neurons in mild cognitive impairment and Alzheimer's disease: Evidence for neuronal signaling vulnerability"

10.1002/cne.24929/v2/review1 ◽

2020 ◽

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Expression Profiling ◽

Cathepsin D ◽

Pyramidal Neurons ◽

Neuronal Signaling

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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