DETECTION OF MILD COGNITIVE IMPAIRMENT IN OLDER INDIVIDUALS WITH OBSTRUCTIVE SLEEP APNEA.

Obstructive sleep apnea increases the risk for mild cognitive impairment and dementia. Identifying patients who will present cognitive decline is crucial in treatment decision, particularly for patients with no or mild daytime sleepiness. We aim to characterize the ability of two cognitive screening tests, the Mini-Mental State Examination and Montreal Cognitive Assessment, to detect mild cognitive impairment among older patients with obstructive sleep apnea. Mild cognitive impairment was evaluated with a comprehensive neuropsychological assessment in 67 participants with and 64 without obstructive sleep apnea (55–85 years). We used receiver operating characteristic curves to assess screening test abilities to detect mild cognitive impairment. Both screening tests showed similar discriminating abilities in participants without obstructive sleep apnea. However, among participants with obstructive sleep apnea, the Mini-Mental State Examination was not able to correctly identify those with mild cognitive impairment. The discriminant ability of the Montreal Cognitive Assessment was higher (70% sensitivity, 73% specificity, cut-off ≤26). The Mini-Mental State Examination should not be used to screen for cognitive impairment in obstructive sleep apnea patients. The Montreal Cognitive Assessment could be used in a systematic manner in clinical settings and clinicians should refer to a comprehensive neuropsychological assessment when neurodegenerative processes are suspected. This research was supported by the Canadian Institutes of Health Research and by the Fonds de Recherche du Québec - Santé.