Obstructive Sleep Apnea and the Risk of Cognitive Decline in Older Adults

作者：Nadia Gosselin, Andrée‐Ann Baril, Ricardo S. Osorio, Marta Kamińska, Julie Carrier · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2018 · DOI：10.1164/rccm.201801-0204pp · 被引用次数：164 · 研究领域：Obstructive Sleep Apnea Research、Neuroscience of respiration and sleep、Sleep and Wakefulness Research

Obstructive sleep apnea causes intermittent hypoxia and sleep fragmentation and affects at least 20% of individuals after the age of 65. There is accumulating evidence that obstructive sleep apnea may impact brain structure and function. Recent cohort studies suggest that it is a risk factor for stroke, mild cognitive impairment and Alzheimer’s disease. Because prevention through treatment of risk factors is currently the main intervention for reducing the incidence of dementia, how obstructive sleep apnea affects brain health and whether its treatment can slow neurodegeneration are relevant questions. This Perspective Article presents the most recent findings on the neurocognitive consequences of obstructive sleep apnea in the elderly. We focus on the aging brain and the link between obstructive sleep apnea, brain health, cognitive decline and dementia. We present how new discoveries from animal models, human sleep experiments, and Alzheimer’s disease biomarkers point to an active role of disturbed sleep in dementia pathogenesis. We show preliminary data on how sex, genetics, physical exercise and cognitive reserve can strengthen or weaken the association between obstructive sleep apnea and dementia. We present preliminary results of obstructive sleep apnea treatment, which can slow, stop or reverse neurodegenerative processes accentuated by obstructive sleep apnea, even in individuals already affected by a neurodegenerative disease. We propose future research directions tha...