title: Modeling the effects of obstructive sleep apnea and hypertension in Vietnam veterans with PTSD.
abstract: OBJECTIVE
  The present work aimed to extend models suggesting that obstructive sleep apnea (OSA) is associated with worse cognitive performance in community-dwelling older adults. We hypothesized that in addition to indices of OSA severity, hypertension is associated with worse cognitive performance in such adults.
  
  
  METHODS
  The PTSD Apnea Clinical Study recruited 120 community-dwelling, male veterans diagnosed with PTSD, ages 55 and older. The Rey Auditory Verbal Learning Test (RAVLT) and Color-Word Interference Test (CWIT) were measures of auditory verbal memory and executive function, respectively. Apnea-hypopnea index (AHI), minimum and mean pulse oximeter oxygen saturation (min SpO(2), mean SpO(2)) indicators were determined during standard overnight polysomnography. Multivariate linear regression and receiver operating characteristic (ROC) curve analyses were performed.
  
  
  RESULTS
  In regression models, AHI (β = -4.099; p < 0.01) and hypertension (β = -4.500; p < 0.05) predicted RAVLT; hypertension alone (β = 9.146; p < 0.01) predicted CWIT. ROC analyses selected min SpO(2) cut-points of 85% for RAVLT (κ = 0.27; χ² = 8.23, p < 0.01) and 80% for CWIT (κ = 0.25; χ² = 12.65, p < 0.01). Min SpO(2) cut-points and hypertension were significant when added simultaneously in a regression model for RAVLT (min SpO(2), β = 4.452; p < 0.05; hypertension, β = -4.332; p < 0.05), and in separate models for CWIT (min SpO(2), β = -8.286; p < 0.05; hypertension, β = -8.993; p < 0.01).
  
  
  CONCLUSIONS
  OSA severity and presence of self-reported hypertension are associated with poor auditory verbal memory and executive function in older adults.
authors.affiliation: Department of Veterans Affairs, VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA. lisakino@stanford.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kinoshita
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Yesavage
authors.forename: Art
authors.initials: A
authors.lastname: Noda
authors.forename: Booil
authors.initials: B
authors.lastname: Jo
authors.forename: Beatriz
authors.initials: B
authors.lastname: Hernandez
authors.forename: Joy
authors.initials: J
authors.lastname: Taylor
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Zeitzer
authors.forename: Leah
authors.initials: L
authors.lastname: Friedman
authors.forename: J Kaci
authors.initials: JK
authors.lastname: Fairchild
authors.forename: Jauhtai
authors.initials: J
authors.lastname: Cheng
authors.forename: Ware
authors.initials: W
authors.lastname: Kuschner
authors.forename: Ruth
authors.initials: R
authors.lastname: O'Hara
authors.forename: Jon-Erik C
authors.initials: JE
authors.lastname: Holty
authors.forename: Blake K
authors.initials: BK
authors.lastname: Scanlon
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017286:Polysomnography; D011594:Psychometrics; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict