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.