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Effect of Continuous Positive Airway Pressure on Incident Frailty in Elderly Patients with Obstructive Sleep Apnea: A Study Based on Propensity Score Matching
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-02-16 , DOI: 10.2147/cia.s446129 Xin Xue , Li-Bo Zhao , Zhe Zhao , Wei-Hao Xu , Wei-Meng Cai , Shao-Hua Chen , Tian-Jiao Li , Ting-Yu Nie , Dong Rui , Xiao-Shun Qian , Lin Liu
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-02-16 , DOI: 10.2147/cia.s446129 Xin Xue , Li-Bo Zhao , Zhe Zhao , Wei-Hao Xu , Wei-Meng Cai , Shao-Hua Chen , Tian-Jiao Li , Ting-Yu Nie , Dong Rui , Xiao-Shun Qian , Lin Liu
Background: The concomitant rise in the prevalence of obstructive sleep apnea (OSA) and frailty among the elderly population has been linked to an increase in mortality rates. Despite continuous positive airway pressure (CPAP) being the gold standard treatment for OSA, its impact on incident frailty remains inadequately explored.
Methods: In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA.
Results: During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15– 0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19– 0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14– 0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19– 0.75; P = 0.007).
Conclusion: CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.
中文翻译：
持续气道正压通气对老年阻塞性睡眠呼吸暂停患者衰弱的影响：基于倾向评分匹配的研究
背景：老年人口中阻塞性睡眠呼吸暂停（OSA）和虚弱患病率的随之上升与死亡率的上升有关。尽管持续气道正压通气 (CPAP) 是 OSA 的黄金标准治疗方法，但其对事件衰弱的影响仍未得到充分探讨。
方法：在这项队列研究中，我们分析了 1290 名 60 岁及以上诊断为 OSA 的患者的数据。 71 名表现出对 CPAP 治疗高度依从性的患者被归类为 CPAP 组。采用倾向评分匹配（PSM）以1：4的比例，匹配年龄、性别、体重指数（BMI）、睡眠呼吸暂停低通气指数（AHI）等变量，建立非CPAP组进行比较。 FRAIL量表用于评估参与者的虚弱状况。 Logistic 回归分析检查了老年 OSA 患者中 CPAP 治疗与事件衰弱及其各个组成部分之间的关系。
结果：在 52 个月的中位随访期内，70 名患者 (19.7%) 出现虚弱症状。与未接受 CPAP 治疗的 OSA 患者相比，接受 CPAP 治疗的 OSA 患者虚弱发生率较低（11.26% vs 21.83%，P =0.045）。在多变量模型中，CPAP 治疗与衰弱事件风险降低显着相关（OR = 0.36，95% CI，0.15–0.88；P = 0.025）。子成分分析显示，CPAP 与较低的疲劳风险（OR = 0.35，95% CI，0.19–0.63；P < 0.001）、抵抗风险（OR = 0.32，95% CI，0.14–0.74；P = 0.008）、和体重减轻（OR = 0.38，95% CI，0.19–0.75；P = 0.007）。
结论： CPAP 治疗可降低老年 OSA 患者发生虚弱的风险。
更新日期：2024-02-15
Methods: In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA.
Results: During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15– 0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19– 0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14– 0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19– 0.75; P = 0.007).
Conclusion: CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.
中文翻译：
持续气道正压通气对老年阻塞性睡眠呼吸暂停患者衰弱的影响：基于倾向评分匹配的研究
背景：老年人口中阻塞性睡眠呼吸暂停（OSA）和虚弱患病率的随之上升与死亡率的上升有关。尽管持续气道正压通气 (CPAP) 是 OSA 的黄金标准治疗方法，但其对事件衰弱的影响仍未得到充分探讨。
方法：在这项队列研究中，我们分析了 1290 名 60 岁及以上诊断为 OSA 的患者的数据。 71 名表现出对 CPAP 治疗高度依从性的患者被归类为 CPAP 组。采用倾向评分匹配（PSM）以1：4的比例，匹配年龄、性别、体重指数（BMI）、睡眠呼吸暂停低通气指数（AHI）等变量，建立非CPAP组进行比较。 FRAIL量表用于评估参与者的虚弱状况。 Logistic 回归分析检查了老年 OSA 患者中 CPAP 治疗与事件衰弱及其各个组成部分之间的关系。
结果：在 52 个月的中位随访期内，70 名患者 (19.7%) 出现虚弱症状。与未接受 CPAP 治疗的 OSA 患者相比，接受 CPAP 治疗的 OSA 患者虚弱发生率较低（11.26% vs 21.83%，P =0.045）。在多变量模型中，CPAP 治疗与衰弱事件风险降低显着相关（OR = 0.36，95% CI，0.15–0.88；P = 0.025）。子成分分析显示，CPAP 与较低的疲劳风险（OR = 0.35，95% CI，0.19–0.63；P < 0.001）、抵抗风险（OR = 0.32，95% CI，0.14–0.74；P = 0.008）、和体重减轻（OR = 0.38，95% CI，0.19–0.75；P = 0.007）。
结论： CPAP 治疗可降低老年 OSA 患者发生虚弱的风险。
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