Purpose: Obstructive sleep apnea (OSA) is linked to cognitive decline in the general older population and lower cognition in Parkinson's disease (PD) patients in clinical cohorts. This study evaluates the association between high OSA risk and cognitive function in PD individuals from a population-based cohort.
Methods: Participants with PD were identified in Canadian Longitudinal Study on Aging (CLSA) comprehensive cohort at baseline or at 3-year follow-up. High OSA risk was determined using the STOP (≥ 2). Cognitive measures included the Rey Auditory Verbal Learning Test, Animal Fluency Test, Mental Alternation Test (MAT), Controlled Oral Word Association Test (COWAT), Stroop Test, Prospective Memory Test, and Choice Reaction Time task. Linear regression assessed relationships between OSA risk and cognitive measures, adjusted for age, sex, BMI, income, and education. Sex-stratified analyses were also performed.
Results: We identified 89 PD individuals at CLSA baseline and 61 more at the 3-yr follow-up. Among them, 55 had a high OSA risk (mean age 70.9 (SD 8.8) years, 72.7% male) and 95 did not (mean age 69.5 (9.2) years, 63.2% male). High OSA risk was associated with lower MAT (ß= -3.51; 95%CI:-6.14,-0.28; p = 0.02) and COWAT (ß= -5.19;95%CI: 9.78,-0.59; p = 0.03) scores in adjusted analyses. Significant associations were observed only in females in sex-stratified analyses.
Conclusion: High OSA risk is linked to poorer executive function test results in PD participants from the CLSA cohort. The association occurring only in females suggests OSA may differentially impact cognitive health based on sex.
Keywords: Aging; CLSA; Cognition; Obstructive sleep apnea; Parkinson’s disease; Sleep-disordered breathing.
© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.