Clinical Interventions in Aging (Feb 2024)

Effect of Continuous Positive Airway Pressure on Incident Frailty in Elderly Patients with Obstructive Sleep Apnea: A Study Based on Propensity Score Matching

  • Xue X,
  • Zhao LB,
  • Zhao Z,
  • Xu WH,
  • Cai WM,
  • Chen SH,
  • Li TJ,
  • Nie TY,
  • Rui D,
  • Qian XS,
  • Liu L

Journal volume & issue
Vol. Volume 19
pp. 255 – 263

Abstract

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Xin Xue,1,2 Li-Bo Zhao,3 Zhe Zhao,3 Wei-Hao Xu,4 Wei-Meng Cai,1 Shao-Hua Chen,1 Tian-Jiao Li,5 Ting-Yu Nie,5 Dong Rui,1 Xiao-Shun Qian,1 Lin Liu1 1Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Department of Vasculocardiology, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 4Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, People’s Republic of China; 5Medical College, Yan’ an University, Yan’ an, People’s Republic of ChinaCorrespondence: Lin Liu; Xiao-Shun Qian, Department of Pulmonary and Critical Care Medicine, Second Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China, Tel +86 132 6318 9578 ; +86 135 2127 9287, Email [email protected]; [email protected]: The concomitant rise in the prevalence of obstructive sleep apnea (OSA) and frailty among the elderly population has been linked to an increase in mortality rates. Despite continuous positive airway pressure (CPAP) being the gold standard treatment for OSA, its impact on incident frailty remains inadequately explored.Methods: In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA.Results: During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15– 0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19– 0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14– 0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19– 0.75; P = 0.007).Conclusion: CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.Keywords: obstructive sleep apnea, frailty, continuous positive airway pressure, elderly

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