Notice bibliographique
Résumé
Obstructive sleep apnea (OSA) is a treatable disorder with a multifaceted pathophysiology. There has been increasing concern in the effects of OSA on brain, particularly in the elderly and in patients with neurodegenerative diseases such has Parkinson’s disease (PD), Alzheimer’s disease (AD) and stroke. OSA has the potential to exacerbate PD-related symptoms and the underlying neuropathology. While increasing data on OSA supports its role in higher risk of cognitive decline and Alzheimer-type dementia, a knowledge gap continues to exist regarding relationships between OSA and PD, particularly from prospective cohort studies. Questionnaires that identify OSA, in lieu of polysomnography (PSG), could be helpful in studying larger groups. Despite the validation of several questionnaires for OSA screening in the general population, there is a scarcity of studies evaluating the diagnostic precision of these tools in PD populations. My first objective of this thesis was to validate self-reported sleep questionnaires for OSA detection in PD individuals. My second objective was to evaluate the prevalence of questionnaire-based OSA risk in individuals with PD, and with other frequent neurological conditions in a population-based cohort. My last objective was to determine whether OSA is associated with greater dysfunction in specific cognitive domains in individuals with PD from a population cohort. These aims have led to three research articles. My first article allowed to assess the diagnostic precision of four OSA screening tools to identify OSA in PD patients selected from the McGill Movement Disorder Clinic. Both STOP-B28 and STOP questionnaires exhibited the most favorable qualities for detecting PSG-defined OSA in patients with PD and showed the strongest association with clinical outcomes related to OSA. The second article examined the prevalence of high risk of OSA, as determined by commonly used questionnaires, and self-reported OSA diagnosis among individuals with stroke, Alzheimer's disease, PD, and the general population (GP) in the Canadian Longitudinal Study on Aging (CLSA). This is a national, long-term population-based study on healthy aging that recruited individuals between the ages of 45 and 85 without any major cognitive impairment. There were extensive variations in the prevalence of high-risk of OSA depending on which of the screening questionnaires were used, emphasizing the need to validate these tools in older adults with neurological conditions. Self-reported OSA rates were notably low across all groups, hinting at a potential underdiagnosis or patient underreporting. The third article assessed the association between high risk of OSA and cognitive function in patients with PD from the CLSA . A strong association emerged between high risk of OSA and reduced executive function in individuals with PD, especially in females. The impact of OSA on cognitive health can vary depending on the sex of the individuals. The work presented in this thesis enhances our understanding of the relationship between OSA and neurological diseases of aging, particularly PD. It shows that different OSA screening tools show highly variable prevalence of OSA in neurological diseases of aging. This emphasizes the need to validate OSA diagnostic tools specifically in these populations. My work has defined the accuracy of OSA screening tools in PD, which will help with further work in this field. Furthermore, I have found that OSA is associated with reduced cognitive function in PD in a population cohort. Results support wider screening for OSA in PD patients and additional research on OSA therapies. Amelioration of OSA could not only improve PD patient symptoms and well-being but also slow the progression of the neurodegenerative process. OSA treatment trials will be required to evaluate whether OSA-related effects are indeed modifiable.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».