title: Protective Effect of Long-Term CPAP Therapy on Cognitive Performance in Elderly Patients with Severe OSA: The PROOF Study.
abstract: OBJECTIVE
  Obstructive sleep apnea syndrome (OSA) leads to a deterioration in cognitive functions, with regard to memory and executive functions. However, few studies have investigated the impact of treatment on these cognitive functions in elderly subjects.
  
  
  METHODS
  The study was conducted in a large cohort of subjects aged 65 years or older (the PROOF cohort). Subjects were not diagnosed or treated for OSA. Subjects underwent a polygraphic recording. Cognitive performance was assessed in all OSA subjects at baseline and 10 years later, whether or not they were receiving continuous positive airway pressure (CPAP) therapy.
  
  
  RESULTS
  A group of 126 patients were analyzed. Only 26% of them were treated, with therapy initiated at the discretion of the primary care physician. Among treated subjects, self-reported compliance with therapy was good (> 6 h/night on average), and 66% of them reported an improvement in their quality of life. Patients receiving CPAP treatment had a higher apneahypopnea index (p = 0.006), a higher oxygen desaturation index (p < 0.001), and experienced more pronounced daytime repercussions (p = 0.004). These patients showed a statistically significant improvement in mental agility (similarities test; p < 0.0001) and memory performance (Grober and Buschke delayed free recall; p = 0.02).
  
  
  CONCLUSIONS
  CPAP treatment is associated with the maintenance of memory performance over time.
authors.affiliation: Laboratoire de Physiologie de l'exercice, Equipe SNA Epis EA 4607, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital universitaire, Saint-Etienne, France.|Département de Gérontologie clinique, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital universitaire, Saint-Etienne, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Crawford-Achour
authors.affiliation: Centre Mémoire de Ressources et de Recherche de Lyon, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Dauphinot
authors.affiliation: Centre VISA, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital général, Saint-Chamond, France.
authors.forename: Magali Saint
authors.initials: MS
authors.lastname: Martin
authors.affiliation: Département de Gérontologie clinique, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital général, Saint-Chamond, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Tardy
authors.affiliation: Département de Gérontologie clinique, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital universitaire, Saint-Etienne, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Gonthier
authors.affiliation: Laboratoire de Physiologie de l'exercice, Equipe SNA Epis EA 4607, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital universitaire, Saint-Etienne, France.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Barthelemy
authors.affiliation: Laboratoire de Physiologie de l'exercice, Equipe SNA Epis EA 4607, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital universitaire, Saint-Etienne, France.|Centre VISA, Université Jean Monnet, Faculté de médecine J. Lisfranc, Hôpital général, Saint-Chamond, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
mesh_terms: D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications* / Q000517:prevention & control; D015331:Cohort Studies; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008568:Memory; D008569:Memory Disorders / Q000150:complications / Q000517:prevention & control; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy*; D011795:Surveys and Questionnaires; D013995:Time
keywords: CPAP treatment; cognitive impairment; elderly; sleep apnea