Summary: Among older adults with obstructive sleep apnea, those who used positive airway pressure therapy showed a lower likelihood of receiving a dementia diagnosis over three years.
Source: University of Michigan
New research indicates that positive airway pressure (PAP) therapy prescribed for obstructive sleep apnea (OSA) in older adults is associated with a reduced risk of developing Alzheimer’s disease and other forms of dementia.
Investigators from Michigan Medicine’s Sleep Disorders Centers examined Medicare claims for more than 50,000 beneficiaries aged 65 and older who had been diagnosed with OSA. Using nationally representative fee-for-service data, the team compared those who received PAP therapy with those who did not, tracking new diagnoses of dementia and mild cognitive impairment (MCI) over a three-year follow-up period.
The study found a statistically significant association between PAP use and lower risk of Alzheimer’s disease and other dementia diagnoses over three years. “Our results suggest that PAP therapy may offer protective benefits against dementia risk for people with OSA,” says lead author Galit Levi Dunietz, Ph.D., M.P.H., an assistant professor of neurology and a sleep epidemiologist.
Study co-investigator Tiffany J. Braley, M.D., M.S., an associate professor of neurology, highlights the clinical implications: “If a causal pathway exists between treating OSA and reduced dementia risk, as our findings suggest, then timely diagnosis and effective PAP treatment could play an important role in maintaining cognitive health in older adults.”
Obstructive sleep apnea is a disorder in which the upper airway collapses repeatedly during sleep, interrupting normal breathing. OSA has been linked to a range of neurological and cardiovascular problems, and its prevalence increases with age. Dementia—affecting millions of Americans—is a major public health challenge, and identifying modifiable risk factors or treatments that could lower dementia risk remains a priority for clinicians and researchers.
About this OSA and dementia research news
Source: University of Michigan
Contact: Press Office – University of Michigan
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Original Research: Closed access.
“Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults” by G L Dunietz et al. Sleep
Abstract
Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults
Study Objectives
This study evaluated whether PAP therapy and adherence to PAP are associated with incident diagnoses of Alzheimer’s disease (AD), mild cognitive impairment (MCI), and dementia not-otherwise-specified (DNOS) among older adults with OSA.
Methods
Researchers conducted a retrospective analysis of Medicare 5% fee-for-service claims data, identifying 53,321 beneficiaries aged 65 and older who had an OSA diagnosis before 2011. Newly identified neurocognitive diagnoses—AD (n=1,057), DNOS (n=378), and MCI (n=443)—were captured between 2011 and 2013 using ICD-9 codes. PAP treatment was defined by the presence of one or more durable medical equipment codes for PAP supplies, while PAP adherence was conservatively defined as at least two durable equipment claims for PAP separated by one month or more. Logistic regression models adjusted for demographic and health variables were used to estimate associations between PAP treatment or adherence and new diagnoses of AD, DNOS, and MCI.
Results
Participants were predominantly male (59%), largely non-Hispanic white (90%), and most (62%) were younger than 75 years. The majority (78%) of beneficiaries with OSA had evidence of PAP treatment, and 74% met the study criteria for adherent PAP use. After adjusting for potential confounders, PAP treatment was associated with lower odds of incident AD and DNOS (odds ratio [OR]=0.78, 95% CI: 0.69–0.89; and OR=0.69, 95% CI: 0.55–0.85, respectively). A reduction in odds of MCI among PAP users approached statistical significance (OR=0.82, 95% CI: 0.66–1.02). Stronger protective associations were observed for PAP adherence and incident AD (OR=0.65, 95% CI: 0.56–0.76).
Conclusions
In this large national sample of older adults with OSA, both receiving PAP treatment and demonstrating adherence were independently associated with lower odds of receiving a new Alzheimer’s disease diagnosis. These findings support the possibility that effective treatment of obstructive sleep apnea may reduce the risk of subsequent dementia, underscoring the potential value of diagnosing OSA and promoting PAP adherence as part of strategies to protect cognitive health in aging populations.