Clinical Manifestations.

Background: Sleep apnea is associated with risk of objectively-measured cognitive decline and dementia, as well as with subjective cognitive decline (SCD), itself a risk factor for cognitive decline and dementia. This relationship is understudied in ethnoracially diverse groups, however, including Latinos. This study examined associations among self-reported sleep apnea risk, SCD, and cognitive performance in community-dwelling older Latino adults.

Method: Fifty-six participants (39 men, 17 women) from the Boston Latino Aging Study (BLAST) were included (M = 66.5 years [SD = 8.6]; M 10.5 years [SD = 5.2]. Participants were administered the Preclinical Alzheimer's Cognitive Composite-5 (PACC5) (z-scores), the Berlin Questionnaire to assess sleep apnea risk, in which positive scores in at least 2 categories (snoring and cessation of breathing; excessive daytime sleepiness; BMI and hypertension) indicates high risk, and the Cognitive Function Instrument (CFI) to assess SCD, in which higher scores indicate greater SCD. The Mini-Mental State Examination (MMSE) measured global cognition. Pearson or point-biserial correlations assessed associations among demographic factors (e.g., age, education), sleep apnea risk, SCD, and cognitive performance. T-tests examined demographic and cognitive differences between those at high/low risk of sleep apnea.

Result: On average, participants had intact global cognition (MMSE; M = 26.6 [3.3], range 16-30) and mild SCD (CFI; M = 4.3 [3.8]). Thirty participants were classified as high risk for sleep apnea. Older age (r = -.35, p = .037) and fewer years of education (r = .68, p<.001) correlated with worse PACC5 performance. There was a trend for an association between high sleep apnea risk and worse PACC5 performance (r = -.32, p = .058). No other associations among demographics, sleep apnea risk, and cognition were significant (p's>.16). Relative to those at low risk, those at high risk for sleep apnea had greater SCD (p = .018) and worse global cognitive performance (p = .019).

Conclusion: These findings suggest that self-reported sleep apnea risk may signal risk for cognitive decline in older Latinos. Screening for sleep apnea using a questionnaire may help identify those experiencing early cognitive decline or at risk of future decline. More work with larger sample sizes is needed to confirm these associations; BLAST data collection is ongoing.