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Obstructive sleep apnea treatment and dementia risk in older adults
Dunietz GL, Chervin RD, Burke JF, Conceicao AS, Braley TJ.. Sleep, 2021-09-01
Topic: Risk, prevention and care in population studies
Plain-language summary
Study objectives To examine associations between positive airway pressure (PAP) therapy, adherence and incident diagnoses of Alzheimer's disease (AD), mild cognitive impairment (MCI), and dementia not otherwise specified (DNOS) in older adults. Methods This retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65 and older, with an obstructive sleep apnea (OSA) diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes (AD [n = 1,057], DNOS [n = 378], and MCI [n = 443]) that were newly identified between 2011 and 2013. PAP treatment was defined as the presence of at least one durable medical equipment (Healthcare Common Procedure Coding System [HCPCS]) code for PAP supplies. PAP adherence was defined as at least two HCPCS codes for PAP equipment, separated by at least 1 month. Logistic regression models, adjusted for demographic and health characteristics, were used to estimate associations between PAP treatment or adherence and new AD, DNOS, and MCI diagnoses. Results In this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75 years. The majority (78%) of beneficiaries with OSA were prescribed PAP (treated), and 74% showed evidence of adherent PAP use. In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (odds ratio [OR] = 0.78, 95% confidence interval [95% CI]: 0.69 to 0.89; and OR = 0.69, 95% CI: 0.55 to 0.85). Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR = 0.82, 95% CI: 0.66 to 1.02). PAP adherence was associated with lower odds of incident diagnoses of AD (OR = 0.65, 95% CI: 0.56 to 0.76). Conclusions PAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults. Results suggest that treatment of OSA may reduce the risk of subsequent dementia.
What this study adds
Evidence grade: Low
The record lists 1,057 participants. In this study of Medicare beneficiaries with obstructive sleep apnea, treatment with positive airway pressure was associated with lower odds of being diagnosed with Alzheimer's disease and dementia not otherwise specified. Reported effect size: OR = 0.69; OR = 0.82; OR = 0.65.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Dunietz, G. L., Chervin, R. D., Burke, J. F., Conceicao, A. S., & Braley, T. J. (2021). Obstructive sleep apnea treatment and dementia risk in older adults. Sleep. https://doi.org/10.1093/sleep/zsab076
Vancouver
Dunietz GL, Chervin RD, Burke JF, Conceicao AS, Braley TJ. Obstructive sleep apnea treatment and dementia risk in older adults. Sleep. 2021. doi:10.1093/sleep/zsab076. PMID: 33769542.
BibTeX
@article{dunietz2021-33769542,
author = {Dunietz, G. L. and Chervin, R. D. and Burke, J. F. and Conceicao, A. S. and Braley, T. J.},
title = {{Obstructive sleep apnea treatment and dementia risk in older adults}},
journal = {Sleep},
year = {2021},
doi = {10.1093/sleep/zsab076},
pmid = {33769542},
url = {https://doi.org/10.1093/sleep/zsab076}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results In this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75 years.
- In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (odds ratio [OR] = 0.78, 95% confidence interval [95% CI]: 0.69 to 0.89; and OR = 0.69, 95% CI: 0.55 to 0.85).
- Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR = 0.82, 95% CI: 0.66 to 1.02).
- PAP adherence was associated with lower odds of incident diagnoses of AD (OR = 0.65, 95% CI: 0.56 to 0.76).
- Conclusions PAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults.
Why it matters
In this study of Medicare beneficiaries with obstructive sleep apnea, treatment with positive airway pressure was associated with lower odds of being diagnosed with Alzheimer's disease and dementia not otherwise specified. Because it is a retrospective study based on claims data, it can show an association but cannot prove that the treatment prevents dementia.
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Study details
- Participants1,057
- Effect sizeOR = 0.69; OR = 0.82; OR = 0.65
- Evidence strengthLow
How this study scored 57/100
Published in a peer-reviewed journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Sleep) |
| Journal's citation record | 3 / 4 | SLEEP: journal h-index 308 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,057 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 132 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 18.9 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 4 / 6 | Cited 11.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 3 / 4 | Cited 68 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Tiffany J. Braley: h-index 26 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33769542) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 57 / 100 | — |
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