Sleep‐Disordered Breathing and Cognition in Older Women

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Abstract
OBJECTIVES: To investigate the association between objectively measured sleep‐disordered breathing (SDB) and cognitive impairment in community‐dwelling older women and to determine whether the apolipoprotein E (APOE) ɛ4 allele modifies this association.DESIGN: Cross‐sectional.SETTING: Participants' homes and two sites of the Study of Osteoporotic Fractures (SOF).PARTICIPANTS: Four hundred forty‐eight women with a mean age±standard deviation (SD) of 82.8±3.4.MEASUREMENTS: Participants completed the Mini‐Mental State Examination (MMSE), Trail Making Test Part B (Trails B), and polysomnography (PSG). SDB indices were the apnea–hypopnea index (AHI), the central apnea index (CAI), and oxygen saturation (SaO2) nadir less than 80%. APOE ɛ4 was determined for a subset of 242 women. Cognitive impairment was defined as 1.5 SDs or more from the sample mean on either cognitive test (MMSE or Trails B).RESULTS: All SDB indices were associated with cognitive impairment according to the MMSE (AHI (per SD, odds ratio (OR)=1.4, 95% confidence interval (CI)=1.03–1.9), AHI of ≥30 (OR=3.4, 95% CI=1.4–8.1), SaO2 nadir P for interaction=.08).CONCLUSION: SDB is an important risk factor for cognitive impairment in older women, especially those with the APOE ɛ4 allele. Mechanisms linking these disorders need to be identified.