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Is Obstructive Sleep Apnoea Related to Neuropsychological Function in Healthy Older Adults? A Systematic Review and Meta-Analysis
Neuropsychology Review ( IF 5.8 ) Pub Date : 2017-05-08 , DOI: 10.1007/s11065-017-9344-6
Nathan Cross , Amit Lampit , Jonathon Pye , Ronald R. Grunstein , Nathaniel Marshall , Sharon L. Naismith

Previous systematic reviews and meta-analyses have identified cognitive deficits in adults with obstructive sleep apnoea (OSA). However, quantitative analysis of the association between OSA and neuropsychological performance has not been conducted specifically in older adults, for whom there is a greater risk of cognitive decline. We searched Medline, Embase and PsycINFO through August 2016 for studies describing associations between OSA and neuropsychological outcomes in people aged>50 years. Meta-analyses were performed on these studies for overall cognition and within cognitive domains. Subgroup analyses were performed taking into account risk of bias and moderating differences in study design. 13 studies met eligibility criteria for analysis. A small negative association was found between OSA and all neuropsychological outcomes combined, g=0.18(95% CI 0.04–0.32), and in memory and processing speed domains. Small case-control studies from sleep clinic populations observed the greatest associations, while larger cohort studies from community samples illustrated no association. Analysis accounting for publication bias resulted in a null overall association, g=0.02 (95%CI -0.12 to 0.16). Associations between OSA and cognition in later life are highly variable and the findings differ based on the type and setting of study. It appears some older adults may be at risk of cognitive impairments attributable to OSA; however, the risk of bias renders the evidence inconclusive. High quality research is warranted in clinically diagnosed OSA patients as well as those already experiencing neuropsychological impairment and who may be regarded at higher risk of further cognitive decline.

中文翻译:

健康老年人阻塞性睡眠呼吸暂停与神经心理功能有关吗?系统评价和荟萃分析

先前的系统评价和荟萃分析已经确定了成人阻塞性睡眠呼吸暂停(OSA)的认知功能障碍。但是,尚未专门针对老年人进行OSA与神经心理性能之间关系的定量分析,因为老年人的认知能力下降风险更大。我们在2016年8月之前对Medline,Embase和PsycINFO进行了搜索,以研究描述50岁以上的OSA与神经心理学结果之间的关联的研究。对这些研究进行了荟萃分析,以了解整体认知并在认知领域内进行。进行亚组分析时要考虑偏倚风险和缓和研究设计中的差异。13个研究符合分析的资格标准。发现OSA与所有神经心理学结果相加之间存在较小的负相关关系,G= 0.18(95%CI 0.04-0.32),并且在内存和处理速度域中。来自睡眠诊所人群的小型病例对照研究观察到最大的关联,而来自社区样本的较大队列研究表明没有关联。解释发布偏倚的分析导致无效总体关联,g = 0.02(95%CI -0.12至0.16)。OSA和以后的认知之间的关联是高度可变的,并且根据研究的类型和背景,发现也有所不同。似乎某些老年人可能会因OSA引起认知障碍的风险;但是,存在偏见的风险使证据没有定论。临床上确诊的OSA患者以及已经遭受神经心理学障碍并且可能被认为具有更高的进一步认知衰退风险的患者,需要进行高质量的研究。
更新日期:2017-05-08
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