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N/A N=68 Single-blind Treatment

Mild Cognitive Impairment and Obstructive Sleep Apnea

Obstructive Sleep Apnea · Mild Cognitive Impairment

Enrolled (actual)
68
Serious AEs
9.3%
Results posted
Jan 2019
Primary outcome: Primary: Hopkins Verbal Learning Test-Revised (HVLT-R) — 23.52; 20.04; 23.68; 20.39 score on a scale

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
CPAP adherence intervention (Behavioral); Attention control intervention (Behavioral)
Age
Adult, Older Adult · 55+ yrs
Sex
All
Sponsor
George Mason University
Primary completion
Dec 2014

Outcome Measures

OutcomeResultp-value
PRIMARY
Hopkins Verbal Learning Test-Revised (HVLT-R)
23.52; 20.04; 23.68; 20.39; 23.59; 20.82
PRIMARY
Digit Symbol Subtest (DS)
9.18; 8.06; 9.90; 8.02; 10.21; 8.09
PRIMARY
Mini Mental State Evaluation Exam (MMSE)
28.34; 28.00; 28.61; 27.48; 27.93; 26.43
PRIMARY
Stroop Color and Word Test (SCW)
47.36; 44.28; 48.22; 45.36; 50.00; 45.14
PRIMARY
The Psychomotor Vigilance Task (PVT)
3.09; 6.46; 2.58; 4.29; 2.77; 4.76
PRIMARY
Epworth Sleepiness Scale [ESS]
8.50; 9.32; 6.54; 8.00; 6.34; 7.57
SECONDARY
Functional Outcomes Sleep Questionnaire (FOSQ)
17.31; 17.34; 18.17; 18.13; 18.30; 18.63
SECONDARY
Everyday Function Outcome: Everyday Cognition (E-Cog)
1.46; 1.29; 1.35; 1.43; 1.35; 1.52
SECONDARY
Alzheimer's Disease Cooperative Study - Clinicians' Global Impression of Change Scale (ADCS-CGIC)
34; 7
SECONDARY
Clinical Dementia Rating Scale (CDR)
21; 21

Summary

Obstructive sleep apnea (OSA) has been linked to increased risk for Alzheimer's disease (AD), but little prospective evidence exists on the effects of OSA treatment in preclinical AD. The objective was to determine if CPAP treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with MCI and to determine effect sizes for a larger trial. The aim of the Mild Cognitive Impairment and Obstructive Sleep Apnea (Memories 1) trial was to determine whether CPAP treatment adherence, controlling for any baseline differences in OSA severity, ApoE4, and other previously identified demographic and patient factors, might predict cognitive and everyday function after 1 year in older adults with amnestic MCI.

Eligibility Criteria

Inclusion criteria

Participants are included in the study if all of the following criteria are met:

(1) Are able to provide written informed consent by self or legally authorized representative. MacArthur Competency Assessment Tool for Clinical Research (MacCAT-CR) will be used to assess decision making capacity; (2) OSA defined as an apnea-hypopnea index (AHI) ≥10, using either a clinical split- or whole-night polysomnography. We chose an AHI cut-off of ≥10 as opposed to ≥15, the conventional cut-off for moderate OSA because split-night studies underestimate the AHI; (3) education-adjusted scores of 28-35 on the modified Telephone Interview for Cognitive Status; (4) 0-0.5 on the Clinical Dementia Rating (CDR); (5) 24-30 on the Mini-Mental State Examination (MMSE); (6) memory impairment approximately 1.0-1.5 standard deviations below normal (adjusted for age and education), determined by scores on the Logical Memory II test; (7) performance approximately 1.0-1.5 standard deviations below normal (adjusted for age and education) in no more than one cognitive domain in addition to memory; (8) medications stable for at least 4 weeks; washout from psychoactive medications (e.g., excluded anti-depressants, neuroleptics, chronic anxiolytics, and sedative hypnotics) for 4 weeks; (9) score of ≤28 on the 21-item Beck Depression Inventory II; (10) a study partner who spends at least 10 hours per week in phone or in-person contact with participant; (11) visual and auditory acuity for testing; (12) 6 or more grades of education completed, or a history to exclude intellectual disability; and (13) English fluency.

Exclusion criteria

Patients are excluded from participating in this study if 1 or more of the following criteria are met:

(1) significant neurologic disease other than MCI; (2) MRI exclusions, e.g. metal; (3) psychiatric disorders, including uncontrolled major depression, bipolar disorder, or schizophrenia; (4) history of alcohol dependence within 6 months; (5) current significant unstable medical condition; (6) participation in studies involving neuropsychological testing; (7) currently receiving CPAP; (8) requiring oxygen during CPAP; (9) dementia indicated by impairment in 3-5 age and education adjusted cognitive domains.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01482351). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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