Indian Journal of Sleep Medicine

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VOLUME 16 , ISSUE 3 ( July-September, 2021 ) > List of Articles


Assessing Cognitive Impairment in Patients with Sleep-disordered Breathing Using Mini-mental State Score and Addenbrooke's Cognitive Examination—Revised

Priya Ramachandran, Kimberley D Souza, Uma Devaraj, Uma Maheshwari, George D Souza

Keywords : Addenbrooke's cognitive examination—revised, Mild cognitive impairment, Mini-mental state score, Obstructive sleep apnea

Citation Information : Ramachandran P, Souza KD, Devaraj U, Maheshwari U, Souza GD. Assessing Cognitive Impairment in Patients with Sleep-disordered Breathing Using Mini-mental State Score and Addenbrooke's Cognitive Examination—Revised. Indian Sleep Med 2021; 16 (3):65-68.

DOI: 10.5005/jp-journals-10069-0082

License: CC BY-NC 4.0

Published Online: 13-10-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aims and objectives: Obstructive sleep apnea (OSA), which is by far the most common form of sleep-disordered breathing, is associated with many other adverse health consequences including cognitive impairment. The screening methods for cognitive impairment in subjects with OSA are not well recognized. Mini-mental state score (MMSE) is the most widely used screening tool. This study was done to evaluate the utility of Addenbrooke's cognitive examination—revised (ACE-R) in comparison to MMSE. Methodology and results: Thirty-six cases and controls [Epworth sleepiness score (ESS<10)] were recruited. They were administered using MMSE and ACE-R along with the online simulation test. The average age of both cases and controls was 49.2. Fourteen (58%) subjects had an MMSE score of less than 24, and 30 (81%) subjects had an ACE-R score of less than 82 thus qualifying for mild cognitive impairment (MCI). None of the controls had MCI. All subjects had severe OSA. The sleep parameters like apnea–hypopnea index (AHI), oxygen desaturation index (ODI), lowest saturation, and ESS had a negative correlation though not significant. Reaction time on the online simulator was increased in OSA as compared to controls. Conclusion: The ACE-R can be used for screening for the presence of MCI in subjects with OSA and is a better screening tool than MMSE.

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