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. 2024 Oct 22;5(1):zpae077.
doi: 10.1093/sleepadvances/zpae077. eCollection 2024.

Sex-specific dementia risk in known or suspected obstructive sleep apnea: a 10-year longitudinal population-based study

Tiffany J Braley  1   2 , Xiru Lyu  3 , Galit Levi Dunietz  1 , Paul C Schulz  4 , Riley Bove  5 , Ronald D Chervin  1 , Henry L Paulson  6 , Kerby Shedden  3   7
Affiliations

Sex-specific dementia risk in known or suspected obstructive sleep apnea: a 10-year longitudinal population-based study

Tiffany J Braley et al. Sleep Adv. .

Abstract

Study objectives: To evaluate sex-specific associations between known or suspected obstructive sleep apnea (OSA) and dementia risk over 10 years among older women and men.

Methods: This study included 18 815 women and men age 50+ years (dementia-free at baseline) who participated in the Health and Retirement Study (HRS), a nationally representative cohort of US adults. Presence of OSA was defined by self-reported diagnosis or key HRS items that correspond to elements of a validated OSA screening tool (STOP-Bang). Incident dementia cases were identified using a validated, HRS-based algorithm derived from objective cognitive assessments. Survey-weighted regression models based on pseudo-values were utilized to estimate sex- and age-specific differences in cumulative incidence of dementia by OSA status.

Results: Data from 18 815 adults were analyzed, of which 9% of women and 8% of men (weighted proportions) met criteria for incident dementia. Known/suspected OSA was more prevalent in men than in women (weighted proportions 68% vs. 31%). Unadjusted sex-stratified analyses showed that known/suspected OSA was associated with higher cumulative incidence of dementia across ages 60-84 years for women and men. By age 80, relative to adults without known/suspected OSA, the cumulative incidence of dementia was 4.7% higher (CI 2.8%, 6.7%) for women with known/suspected OSA, and 2.5% (CI 0.5%, 4.5%) for men with known/suspected OSA, respectively. Adjusted associations between age-specific OSA and cumulative incidence of dementia attenuated for both women and men but remained statistically significant.

Conclusions: OSA contributes to dementia risk in older adults, particularly women. This study illuminates the impact of a potentially modifiable yet frequently overlooked risk factor for dementia onset.

Keywords: OSA; cognitive function; dementia; neurodegenerative disorders; neurological disorders; women’s health.

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Figures

Figure 1.
Figure 1.
Line charts of unadjusted age-specific cumulative incidence of dementia and difference in cumulative incidence of dementia by known or suspected OSA status in women and men aged 60–84 years. Left panels represent age-specific cumulative incidence (CI) of dementia by OSA status among women (top) and men (bottom). Right panels reflect age-specific differences in cumulative dementia incidence for women (top) and men (bottom) with known/suspected OSA versus no/low risk OSA. Figure 1 demonstrates that, regardless of sex, known or suspected OSA is associated with higher cumulative dementia incidence across ages. Moreover, as age advances, the increased impact of OSA on cumulative dementia incidence increases for women but decreases for men.
Figure 2.
Figure 2.
Line charts of differences in age-specific cumulative dementia incidence of known or suspected OSA status in women and men aged 60–84 years, adjusted for sociodemographic factors. Left panels represent age-specific cumulative incidence (CI) of dementia by OSA status among women (top) and men (bottom). Right panels reflect age-specific differences in cumulative dementia incidence for women (top) and men (bottom) with known/suspected OSA versus no/low risk OSA. Figure 2 demonstrates that associations between known or suspected OSA and age-specific cumulative dementia incidence for both women and men remained significant following adjustment for sociodemographic factors.
See this image and copyright information in PMC

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