Sleep-disordered breathing in healthy aged persons: two- and three-year follow-up.

We report the results of a study of the effects of sleep-disordered breathing in a cohort of healthy elderly subjects followed longitudinally for 3 years. In a comprehensive evaluation of daytime functioning, including medical history and physical examination, pulmonary function testing and neuropsychiatric testing, we found very little difference in the neuropsychiatric or medical sequelae between those subjects with moderate [apnea+hypopnea index (AHI) > or = 5] and low (AHI < 5) levels of sleep-disordered breathing at baseline. Although there were no differences in the electrocardiogram, pulse rate or cardiac history data, a mild association was found between indices of sleep-disordered breathing and pulmonary function. We conclude that moderate levels of sleep-disordered breathing in an otherwise asymptomatic healthy geriatric patient should probably not be considered pathologic in the short term.

Sleep-disordered breathing in healthy, aged persons. Fifth and final year follow-up.

The frequency of sleep-disordered breathing (SDB) events increases dramatically with age, although the clinical significance of this phenomenon is uncertain. We report herein on data from the fifth follow-up observation of a cohort of healthy elderly which we selected, evaluated, and followed up in an effort to address this issue. Baseline observations on this group of 95 normal older persons medically screened for good health included standard nocturnal polysomnograms and daytime assessment of medical, sleep/wake, and psychological variables. At fifth-year follow-up, 42 subjects returned for assessment. Comparison of returning vs nonreturning subjects indicated no significant differences in baseline characteristics between these groups. Division of returning subjects into moderate (apnea-hypopnea index [AHI] > or = 5) vs low (AHI < 5) SDB at baseline resulted in 10 subjects in the moderate group and 32 subjects in the low group. The two groups were comparable with regard to sex, weight, and education, although the moderate SDB group was significantly older (70.4 years) than the low SDB group (64.8 years). Follow-up medical, sleep/wake, and psychological data were contrasted for the two groups using a mixed design multivariate analysis of variance (repeated measures factor-time-6 observations; between-subjects factor SDB level, 2 groups). There were no statistically significant effects of SDB or interactions of SDB and time across this 5-year follow-up. These results confirm observations from the third-year follow-up. We conclude that observation of a moderate level of SDB in an otherwise healthy older person is apparently not a significant risk across a 5-year follow-up period and therefore does not seem to warrant investigation beyond a thorough medical history and physical examination to rule out other disorders.

The New Adult Reading Test-Revised: accuracy in estimating WAIS-R IQ scores obtained 3.5 years earlier from normal older persons.

Scores on the New Adult Reading Test-Revised (NART-R) were used to estimate WA1S-R IQ scores obtained approximately 3.5 years earlier from 54 normal older persons (M = 68 y; SD = 8.6). NART-R estimated IQ scores correlated reliably with earlier obtained IQ scores: FS1Q r = 0.70; VIQ r = 0.68; PIQ r = 0.61 (all p's < 0.05). NART-R estimated FSIQs underpredicted obtained FSIQs by an average of 3.8 points (SD = 9.3). The correlation between estimated and obtained FSIQ is fairly high and estimated FSIQ is reasonably close to obtained IQ, despite the considerable length of time passing between WAIS-R and NART-R administration. These results represent the first confirmation of the retrospective accuracy of the NART-R in estimating WAIS-R scores across time, a previously untested but critical assumption for clinical application of this approach. These results also apparently represent the first cross-validation of the NART-R in a sample of older Americans. These results suggest that further research on the clinical utility of the NART-R is warranted.