title: Sleep breathing disorders and cognitive function in the elderly: an 8-year follow-up study. the proof-synapse cohort.
abstract: OBJECTIVE
  Sleep breathing disorder (SBD) may be an important factor in age-related cognitive decline. In a cohort of healthy elderly subjects, we performed an 8-y longitudinal study to assess whether changes in cognitive function occur in untreated elderly patients with SBD and without dementia and the factors implicated in these changes.
  
  
  METHODS
  A population-based longitudinal study.
  
  
  METHODS
  Clinical research settings.
  
  
  METHODS
  A total of 559 participants of the PROOF study aged 67 y at the study entry and free from neurological disorders were examined.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Abnormal breathing events were defined by an apnea-hypopnea index (AHI) > 15. The raw cognitive data and averaged Z-scores for the attentional, executive, and memory functions were collected at the baseline and follow-up. At baseline, AHI > 15 was found in 54% of subjects with 18% having an AHI > 30. At follow-up, the presence of abnormal breathing events was associated with a slight but significant decline in the attentional domain (P = 0.01), which was more evident in the subjects with an AHI > 30 (P = 0.004). No significant changes over time were observed in the executive and memory functions. Several indices of chronic hypoxemia, defined either as a cumulative peripheral oxygen saturation (SpO2) < 90% or a minimal SpO2, accounted for portions of the variance in the decline in attention. All observed effects were small, accounting for 4-7% of variance in multivariate models.
  
  
  CONCLUSIONS
  In healthy elderly subjects, various components of sleep breathing disorder at baseline were associated with small changes in selected cognitive functions specific to the attention domain after controlling for multiple comorbidities, such as sleepiness, hypertension, diabetes, anxiety, and depression.
  
  
  BACKGROUND
  ClinicalTrials.gov identifiers NCT 00759304 and NCT 00766584.
authors.affiliation: Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France.|EMC Laboratory, EA 3880, University of Lyon 2, Lyon, France.
authors.forename: Magali Saint
authors.initials: MS
authors.lastname: Martin
authors.affiliation: Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sforza
authors.affiliation: Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
authors.affiliation: Department of Clinical Physiology and Exercise, Pole NOL, CHU and Faculty of Medicine of Saint-Etienne, UJM and PRES University of Lyon, Saint-Etienne, France.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Barthélémy
authors.affiliation: EMC Laboratory, EA 3880, University of Lyon 2, Lyon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Thomas-Anterion
mesh_terms: D000368:Aged; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003704:Dementia; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology*; D012894:Sleep Stages
keywords: cognitive functions; elderly; hypoxemia; sleep breathing disorders; sleep fragmentation