Daytime sleepiness linked to cognitive decline.




Archives of Internal Medicine

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Cognitive function is the term used to describe a person's state of consciousness (alertness and orientation), memory, and attention span. A mental status examination (MSE) is a standard test used by healthcare professionals to measure a patient's overall mental health. Evaluating a patient's cognitive function includes, first of all, measuring their level of alertness and orientation.

Memory is a person's ability to remember information in the past and the present. Memory is considered the most common and the most important cognitive ability that can be lost. Healthcare professionals may test a patient's memory by asking questions about the history of their present illness or what they had to eat at a recent meal. Alertness measures a patient's awareness of his or her environment and situation. Abnormal states range from confusion to lethargy (tiredness), delirium (confusion), stupor (daze), or even coma. Orientation is a person's ability to describe their knowledge of person, place, and time. Asking simple questions such as the patient's name, where they live, the current date or day of the week, or season of the year can be used to evaluate orientation. Disorientation is very often linked with organic brain syndromes (for example, dementia).

In an article that was recently published in the Archives of Internal Medicine, researchers established that previous studies found that EDS (excessive daytime sleepiness) was associated with a decline in cognitive function. The purpose of this study was to measure the extent of EDS in predicting cognitive decline. This study involved 1026 individuals who were over the age of 60 years. Located in Paris, France, these individuals participated in a telephone interview using the Sleep-EVAL expert system. Out of those involved, 13.6% experienced EDS. The results were controlled for age, sex, physical activity, and occupation among others. Compared to those who did not encounter EDS, the EDS group had an increased risk of cognitive impairment. The odds ratios were increased in categories such as attention/concentration shortfalls, memory, and delayed recall. The researchers concluded that EDS is a risk factor for mental impairment in the elderly population.1


1. Ohayon M. Daytime Sleepiness and Cognitive Impairment in the Elderly Population. Arch Intern Med.Jan 2002;162:201-208.