Evidence map›Paper›PMID 30724333›Full record

Trial reportJournal of the American Geriatrics Society2019

CPAP Adherence May Slow 1-Year Cognitive Decline in Older Adults with Mild Cognitive Impairment and Apnea.

Kathy C Richards, Nalaka Gooneratne, Barry Dicicco, Alexandra Hanlon, Stephen Moelter, Fannie Onen, Yanyan Wang, Amy Sawyer, Terri Weaver, Alicia Lozano and 2 more

2 registry-linked trialsAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 71 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 8 pooled it
9.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01482351 nacompletednot on this map

Mild Cognitive Impairment and Obstructive Sleep Apnea

TypeinterventionalSponsorGeorge Mason UniversityRan2012 to 2014Enrolled54ConditionsObstructive Sleep Apnea, Mild Cognitive ImpairmentArmsCPAP adherence intervention, Attention control intervention
NCT06773416 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Treating Sleep Apnea to Improve Cognitive Function, Alzheimer's Disease Pathology, and Astrocyte Activation in Older Adults With Cognitive Impairment: A Multi-Centre Randomized Controlled Trial

TypeinterventionalSponsorSunnybrook Health Sciences CentreRan2025 to 2028Enrolled206ConditionsObstructive Sleep Apnea (OSA), Mild Cognitive Impairment (MCI), Cognitive Decline Prevention in Pre-frail Older AdultsArmsCPAP Therapy Combined with Web-Based Sleep Education for Cognitive and Sleep Health, Delayed CPAP Therapy Combined with Web-Based Sleep Education for Cognitive and Sleep Health
3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 8 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
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  3. Sleep disorders and attention: a systematic review.Arquivos de neuro-psiquiatria · 2022
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  19. Symptom subtype progression in obstructive sleep apnea over 5 years.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024
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11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 4 countries.

Kathy C RichardsSchool of Nursing, University of Texas at Austin, Texas, Austin.
Nalaka GooneratneDivision of Sleep Medicine, Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Barry DiciccoSchool of Medicine, Virginia Commonwealth University & Pulmonary and Critical Care Specialists of Northern Virginia, Richmond, Virginia.
Alexandra HanlonSchool of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Stephen MoelterDepartment of Psychology, University of the Sciences in Philadelphia, Philadelphia, Pennsylvania.
Fannie OnenDivision of Sleep Medicine, Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Yanyan WangSchool of Nursing, University of Texas at Austin, Texas, Austin.
Amy SawyerSchool of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Terri WeaverDepartment of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
Alicia LozanoSchool of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
Patricia CarterSchool of Nursing, University of Texas at Austin, Texas, Austin.
Jerry JohnsonPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
University of Pennsylvania · USThe University of Texas at Austin · USCentre de recherche en Epidémiologie et Santé des Populations · FRNeurobehavioral Systems · USSichuan University · CNUniversity of the Sciences · USVirginia Commonwealth University · US

Funding

Mild Cognitive Impairment and Obstructive Sleep ApneaR01AG034682 · NIA · GEORGE MASON UNIVERSITY · PI RICHARDS, KATHY CULPEPPER · 2011 to 2013
$1.8M
NIA NIH HHS R01 AG034682
6 · The paper itself

Abstract

BACKGROUND/

objectivesObstructive sleep apnea (OSA) has been linked to an 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 continuous positive airway pressure (CPAP) treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with mild cognitive impairment (MCI) and to determine effect sizes for a larger trial.

designQuasi-experimental pilot clinical trial with CPAP adherence defined as CPAP use 4 hours or more per night over 1 year.

settingSleep and geriatric clinics and community.

participantsOlder adults, aged 55 to 89 years, with an apnea-hypopnea index of 10 or higher participated: (1) MCI, OSA, and CPAP adherent (MCI +CPAP), n = 29; and (2) MCI, OSA, CPAP nonadherent (MCI -CPAP), n = 25.

interventionCPAP. MEASUREMENTS: The primary cognitive outcome was memory (Hopkins Verbal Learning Test-Revised), and the secondary cognitive outcome was psychomotor/cognitive processing speed (Digit Symbol subtest from the Wechsler Adult Intelligence Scale Substitution Test). Secondary function and progression measures were the Everyday Cognition, Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale, and Clinical Dementia Rating.

resultsStatistically significant improvements in psychomotor/cognitive processing speed in the MCI +CPAP group vs the MCI -CPAP group were observed at 1 year after adjustment for age, race, and marital status (parameter estimate = 1.68; standard error = 0.47; 95% confidence interval = 0.73-2.62), with a 6-month effect size (ES) of 0.46 and a 1-year ES of 1.25. There were small to moderate ESs for memory (ES 0.20, 6 mo), attention (ES 0.25, 1 y), daytime sleepiness (ES 0.33, 6 mo and ES 0.22, 1 y), and everyday function (ES 0.50, 6 mo) favoring the MCI +CPAP group vs the MCI -CPAP group.

conclusionControlling for baseline differences, 1 year of CPAP adherence in MCI +OSA significantly improved cognition, compared with a nonadherent control group, and may slow the trajectory of cognitive decline. TRIAL REGISTRATION NUMBER: Memories; NCT01482351; https://clinicaltrials.gov/ct2/show/NCT01482351?cond=MCI+and+OSA&rank=1 J Am Geriatr Soc 67:558-564, 2019.

Indexed as

Cognitive DysfunctionSleep Apnea, ObstructiveAgedAged, 80 and overContinuous Positive Airway PressureFemaleHumansMaleMemory and Learning TestsMiddle AgedNon-Randomized Controlled Trials as TopicOutcome and Process Assessment, Health CarePilot ProjectsPolysomnographyPsychomotor PerformanceTreatment Adherence and ComplianceCPAPmemoriesmild cognitive impairmentneurocognitive outcomeobstructive sleep apnea

Identifiers

PMID30724333
PMCPMC6402995
OpenAlexW2914801942

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.