Obstructive sleep apnea risk is associated with decreased executive processing speed in older women but not in men: A longitudinal analysis of the Canadian Longitudinal Study on Aging
Bibliographic record
Abstract
Abstract Background Studies investigating the possible links between obstructive sleep apnea (OSA) and cognitive dysfunction have yet led to heterogenous results. Individual characteristics, such as sex and age, could moderate this association and explain part of this heterogeneity. Here, we characterized the sex‐ and age‐specific association between OSA risk and cognitive performance using longitudinal data from the community‐based Canadian Longitudinal Study on Aging (CLSA) comprehensive cohort. Method Our sample included 25,393 participants aged 45 to 85 years at baseline (mean = 63 years; 51% women; 78% with post‐secondary degree), recruited between 2011 and 2015 across Canada. Participants with Alzheimer’s and Parkinson’s diagnosis or with history of stroke and of traumatic brain injury were excluded. Participants’ risk for OSA was measured at baseline using the STOP‐B questionnaire, based on risk factors and symptoms of OSA. Participants scoring ³ 3/5 were classified as being at high‐risk for OSA. Neuropsychological tests assessed memory (Rey Auditory Verbal Learning Test), executive functioning (Mental Alternation, Animal Fluency, Controlled Oral Word Association and Stroop tests) and psychomotor speed (Choice Reaction Time) at baseline and at 3‐year follow‐up. We calculated changes (follow‐up – baseline) in each cognitive continuous score and conducted sex‐specific age‐stratified (45‐59; 60–69; 70–85 years) analyses of covariance (ANCOVAs) to estimate the predictive role of baseline OSA risk, adjusting for socio‐demographic, lifestyle and medical comorbidities. The level of significance was set at p<0.05, after false‐discovery rate correction. Results In the whole sample, results show a decline over time only for executive functioning (Mental Alternation, Animal Fluency and Stroop) at 3‐year follow‐up. When analyses were performed according to age and sex, being at high‐risk for OSA was associated with increased reaction times only in women aged 70–85 years (Stroop word: [F = 12.486; 95%CI ‐5.440 to ‐1.554]; Stroop color: [F = 7,870; 95%CI ‐9.843 to ‐1.738]). Conclusion Although changes in executive functioning were noted over time in the whole sample, being at high‐risk for OSA only increased the risk of slower processing speed for older women. These findings suggest that the possible detrimental effects of OSA on cognitive health depend on participants’ age and sex.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".