Date of Award

12-2017

Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Frank M. Webbe

Second Advisor

Vida Tyc

Third Advisor

Mary L. Sohn

Fourth Advisor

Mary Beth Kenkel

Abstract

Objectives: To determine whether the Montreal Cognitive Assessment (MoCA) was a sensitive indicator of cognitive improvement following introduction of continuous positive airway pressure (CPAP) in community memory clinic (CMC) patients who had been diagnosed with sleep apnea (SA). Method: Twenty-six CPAP compliant CMC patients (61.5% male; 96.2% Caucasian/Non-Hispanic) with a diagnosis of SA (66-87 years (M=76.27(4.90)) completed a MoCA before initiation of treatment and again 4-9 months later. CPAP compliance was documented through CPAP machine compliance reports and/or clinical interview with patient and family member during subsequent medical visits. Twenty CPAP non-compliant CMC patients (85% male, 100% Caucasian/Non-Hispanic; 66-90 years (M=77.45 (6.88)) similarly diagnosed with SA completed MoCAs before initiation of treatment and again 4-8 months later. CMC diagnoses of the patients included: no cognitive impairment, Alzheimer’s disease, mild cognitive impairment, cognitive disorder NOS, or other dementia.

Results: Post-treatment MoCA scores for the CPAP compliant group (M= 22.27) were significantly higher than pre-treatment scores (M= 20.38; t(25)= -4.992; p<0.001). Nineteen of the 26 compliant individuals evidenced increases in MoCA, three remained the same, and four declined. The non-compliant group showed no change over time (MoCA pre- M= 19.90, MoCA post- M= 20.50; t(19)= -.798; p= .435), with seven scores decreasing, eleven increasing, and two remaining the same. There was no significant interaction between CPAP compliance groups and MoCA change scores, Wilks’ Lambda= .94, F (1, 44) = 2.67, partial eta squared= .057. Conclusions: More patients with SA who complied with CPAP recommendation demonstrated improved MoCA performance than did those who did not comply with the recommendation. Within-subject comparison of pre- and post-CPAP usage via paired t-test was significant only for the compliant group. Finding no effect on change score or interaction between MoCA test time and compliance using the mixed-model ANOVA was likely due to the relative small sample size, which did not supply sufficient power to the study. This interpretation is supported by the t-test outcome as well as the numerical difference in numbers of patients whose MoCA scores increased from the pre-test to the post-test measurement (19 versus 7).

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