%0 Journal Article
%T Screening for Sleep Apnoea in Mild Cognitive Impairment: The Utility of the Multivariable Apnoea Prediction Index
%A Georgina Wilson
%A Zoe Terpening
%A Keith Wong
%A Ron Grunstein
%A Louisa Norrie
%A Simon J. G. Lewis
%A Sharon L. Naismith
%J Sleep Disorders
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/945287
%X Purpose. Mild cognitive impairment (MCI) is considered an ¡°at risk¡± state for dementia and efforts are needed to target modifiable risk factors, of which Obstructive sleep apnoea (OSA) is one. This study aims to evaluate the predictive utility of the multivariate apnoea prediction index (MAPI), a patient self-report survey, to assess OSA in MCI. Methods. Thirty-seven participants with MCI and 37 age-matched controls completed the MAPI and underwent polysomnography (PSG). Correlations were used to compare the MAPI and PSG measures including oxygen desaturation index and apnoea-hypopnoea index (AHI). Receiver-operating characteristics (ROC) curve analyses were performed using various cut-off scores for apnoea severity. Results. In controls, there was a significant moderate correlation between higher MAPI scores and more severe apnoea (AHI: , ). However, this relationship was not significant in the MCI sample. ROC curve analysis indicated much lower area under the curve (AUC) in the MCI sample compared to the controls across all AHI severity cut-off scores. Conclusions. In older people, the MAPI moderately correlates with AHI severity but only in those who are cognitively intact. Development of further screening tools is required in order to accurately screen for OSA in MCI. 1. Introduction Mild cognitive impairment (MCI) is a syndrome defining a transitional stage between normal ageing and dementia. Clinically, it is defined as cognitive decline greater than expected for an individual¡¯s age and education, but with preservation of daily functioning [1]. Since there is a conversion rate to dementia of around 50% in five years, MCI is often considered an ¡°at risk¡± state. Importantly, in this critical period, there is opportunity to implement secondary prevention strategies targeting modifiable risk factors. Research to date has identified that a range of cardiovascular, psychological, and lifestyle factors are associated with an increased conversion to dementia. However, there has been a paucity of research addressing sleep. This is despite the fact that sleep disturbance is a common symptom of dementia [2], associated with decreased cognitive and daily functioning, reduced quality of life, and increased carer burden [3]. Sleep disturbance in older people is multifaceted and includes age-related changes to sleep macro- and microarchitecture, medical comorbidity, mood disturbance, and alterations in circadian rhythm [3, 4]. In addition, the prevalence of nocturnal respiratory disturbance increases with age, and, in particular, obstructive sleep apnoea (OSA)
%U http://www.hindawi.com/journals/sd/2014/945287/