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Use of Positive Airway Pressure in Mild Cognitive Impairment to Delay Progression to Dementia.

STUDY OBJECTIVES
To assess the relationship between continuous positive airway pressure (CPAP) therapy and cognitive function in patients with mild cognitive impairment (MCI) and obstructive sleep apnea (OSA).


METHODS
This was a retrospective chart review of patients with MCI and OSA. CPAP compliance was defined as average use of CPAP for at least 4 hours a night. Kaplan-Meier estimates, logrank tests and Cox proportional hazards regression were done to compare the compliance groups in terms of progression to dementia, defined as Clinical Dementia Rating (CDR) of 1 or greater. Linear mixed models were used to assess the relationships between CPAP compliance and neurological cognitive function outcomes over time.


RESULTS
Ninety-six patients were included with mean age at MCI diagnosis of 70.4 years, mean Apnea Hypopnea Index of 25.9 and mean duration of neurology follow-up of 2.8 years. Forty-two were CPAP compliant, 30 were non-compliant and 24 had no CPAP use. No overall difference among the groups was detected for progression to dementia (p = 0.928, logrank test). Patients with amnestic MCI had better CPAP use (p = 0.016) and shorter progression time to dementia (p = 0.042), but this difference was not significant after adjusting for age, education and race (p = 0.32).


CONCLUSIONS
CPAP use in MCI patients with OSA was not associated with delay in progression to dementia or cognitive decline.