The prevalence of obstructive sleep apnea in mild cognitive impairment: a systematic review

Mubashir, Talha; Abrahamyan, Lusine; Niazi, Ayan; Piyasena, Deween; Arif, Abdul A.; Wong, Jean; Osorio, Ricardo S.; Ryan, Clodagh M.; Chung, Frances

doi:10.1186/s12883-019-1422-3

BMC Neurology

Table 1 Characteristics of studies included in the final review

From: The prevalence of obstructive sleep apnea in mild cognitive impairment: a systematic review

Variables	Groups	Dlugaj et al. (2014) [24]	Guarnieri et al. (2012) [26]	Kim et al. (2011) [27]	Osorio et al. (2015) [2]	Wilson et al. (2014) [28]
Referral Population	–	General population (HNR cohort); age 45–75 yrs.	Neurology clinic; age > 60 years	General practitioner clinic (Public health centre); age > 60 years	Multiple clinics (ADNI cohort); age 55–90 yrs.	Neurology clinic; age > 50 years
Study design	–	Cross-sectional	Cross-sectional	Cross-sectional	Retrospective Cohort^a	Cross-sectional
Study country	–	Germany	Italy	South Korea	USA and Canada	Australia
MCI diagnosis criteria	–	Petersen (2004) [6] Winblad (2004) [8]	Winblad (2004) [8]	Petersen (1999) [4]	Petersen (2005) [7]	Petersen (2005) [7]
OSA diagnosis method	–	ApneaLink™	History of snoring or sleep apneas & high risk on Berlin Questionnaire	PSG	“Patient reported OSA, followed by physician assessment of diagnosis based on patients’ medical history”	PSG
OSA diagnosis criteria	–	AHI ≥ 15 events/hour	NA	AHI ≥ 5 events/hour	NR	AHI ≥ 5 events/hour
OSA AHI Indices^b	–	A: ≥80%, ≥10s H: 50–80%, ≥10s OD: NR	NA	A: ≥100%, ≥10s H: ≥50%, ≥10s OD: 3% (or arousal)	NR	A: ≥100%, ≥10s H: ≥50%, ≥10s OD: 3% (or arousal)
Number of subjects	MCI	230	138	30	402	37
	aMCI	120	NR	NR	402	10
	naMCI	110	NR	NR	0	27
	Controls	676	–	30	607	37
Number of males, n (%)	MCI	919 (51%)	50%	9 (30%)	–	NR
Number of males, n (%)	Controls	919 (51%)	–	9 (30%)	–	NR
Age (years), mean ± SD	MCI	63.79 ± 7.45	73 ± 9^c	67.97 ± 4.09	–	65.5 ± 9.0
Age (years), mean ± SD	Controls	63.79 ± 7.45	–	67.37 ± 3.75	–	63.5 ± 8.7
BMI (kg/m²), mean ± SD	MCI	28.06 ± 4.38	NR	24.40 ± 3.28	–	27.6 ± 5.5
BMI (kg/m²), mean ± SD	Controls	28.06 ± 4.38	NR	24.49 ± 2.75	–	27.1 ± 4
Comorbidities (major)	–	DM (18%), HTN (36%), CAD (7%)	NR	NR	–	NR
Education (years), n (%) or mean ± SD	MCI	≤10: 167 (9%); 11–13: 1002 (56%); ≥14: 624 (35%)	8.2 ± 4.2^c	6.80 ± 4.67	–	NR
Education (years), n (%) or mean ± SD	Controls	≤10: 167 (9%); 11–13: 1002 (56%); ≥14: 624 (35%)	–	7.90 ± 5.11	–	NR
AHI (events/hour)	MCI	11.5 ± 11.43	NR	13.41 ± 11.61	NR	16.4 ± 16^d
AHI (events/hour)	Controls	11.5 ± 11.43	NR	15 ± 13.56	NR	11.9 ± 10^d
APOE positive (%)	MCI	445 (25%)	NR	NR	–	NR
APOE positive (%)	Controls	445 (25%)	NR	NR	–	NR
Mini Mental Status Exam, mean ± SD	MCI	NR	27 ± 2^c	NR	NR	28.1 ± 1.5
Mini Mental Status Exam, mean ± SD	Controls	NR	–	NR	NR	29.2 ± 1.1

Abbreviations: A apnea, ADNI Alzheimer’s disease Neuroimaging Initiative, AHI apnea-hypopnea index, APOE Apolipoprotein E, BMI body mass index, CAD coronary artery disease, DM diabetes mellitus, HNR Heinz Nixdorf Recall, HTN hypertension, H hypopnea, MCI mild cognitive impairment, NA not applicable, NR not reported, OD oxygen desaturation, OSA obstructive sleep apnea, PSG polysomnography, SD standard deviation
^aData to calculate prevalence and/or odds ratio were provided by the study authors and were taken from baseline measurements of OSA and MCI (cross-sectional)
^bThe percentage drop of airflow from baseline for 10 s or more with or without oxygen desaturation
^cValues estimated from a bar-graph
^dAHI data was available on 24 out of the 37 subjects with MCI and 25 out of the 37 control subjects

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ISSN: 1471-2377

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