Study Objectives:

Geriatric impairments and obstructive sleep apnea (OSA) are prevalent among older patients with atrial fibrillation (AF). Little is known about the association between OSA and geriatric impairments including frailty, cognitive performance, and AF-related quality of life. The objective of this study was to examine the associations of OSA with frailty, cognitive performance, and AF-related quality of life among older adults with AF.

Methods:

Data from the Systemic Assessment of Geriatrics Elements-AF study were used which included AF participants 65 years and older and with a CHA₂DS₂-VASc ≥2. The STOP-BANG questionnaire was used to assess the risk of OSA. Multivariable logistic regression models were used to examine the association between risk of OSA and geriatric impairments, adjusting for sociodemographic, geriatric, and clinical characteristics.

Results:

A total of 970 participants (mean age 75 years; 51% male) were studied. Of the 680 participants without a medical history of OSA, 26% (n=179) of participants had a low risk of OSA, 53% (n=360) had an intermediate risk, and 21% (n=141) had a high risk for OSA. Compared to those with low risk of OSA, participants with an intermediate or high risk of OSA were more likely to be frail (adjusted odds ratio [aOR]= 1.67, 95% confidence interval [CI]: 1.08–2.56; aOR= 3.00, 95% CI: 1.69-5.32, respectively) in the fully adjusted models.

Conclusions:

Our findings identify a group of patients at high risk who would benefit from early screening for OSA. Future longitudinal studies are needed to assess the effect of OSA treatment on frailty, physical functioning, and QoL among patients with AF.

中文翻译：

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患有房颤的老年人阻塞性睡眠呼吸暂停的风险与认知能力、虚弱和生活质量之间的关系

学习目标：

老年性功能障碍和阻塞性睡眠呼吸暂停 (OSA) 在患有心房颤动 (AF) 的老年患者中很普遍。对 OSA 与老年障碍（包括虚弱、认知能力和 AF 相关生活质量）之间的关联知之甚少。本研究的目的是检查 OSA 与 AF 老年人的虚弱、认知能力和 AF 相关生活质量的关联。

方法：

使用了来自老年医学要素系统评估 - AF 研究的数据，其中包括 65 岁及以上且 CHA ₂ DS ₂ -VASc ≥2 的AF 参与者。STOP-BANG 问卷用于评估 OSA 的风险。多变量逻辑回归模型用于检查 OSA 风险与老年障碍之间的关联，并根据社会人口学、老年和临床特征进行调整。

结果：

共研究了 970 名参与者（平均年龄 75 岁；51% 为男性）。在没有 OSA 病史的 680 名参与者中，26% (n=179) 的参与者有低风险，53% (n=360) 有中等风险，21% (n=141) 有高风险OSA 的风险。与 OSA 低风险者相比，OSA 中高风险参与者更可能体弱（调整后的优势比 [aOR]= 1.67，95% 置信区间 [CI]：1.08-2.56；aOR= 3.00，在完全调整的模型中，95% CI：分别为 1.69-5.32）。

结论：

我们的研究结果确定了一组高危患者，他们将从 OSA 的早期筛查中受益。未来的纵向研究需要评估 OSA 治疗对 AF 患者虚弱、身体机能和 QoL 的影响。