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09, P?=?0.0045), CESD-4 (fully adjusted F1,2788?=?13.21, P?=?0.0003), HRQoL MCS-12 (fully adjusted F1,2788?=?5.47, P?=?0.0194) and HRQoL PCS-12 (fully adjusted F1,2788?=?20.79, P? performance (fully adjusted F1,2788?=?1.62, P?=?0.20) and marginally predicted delayed recall performance (fully adjusted F1,2788?=?3.77, P?=?0.052), although adjustment for demographics resulted only in significant differences in delayed recall by OSA risk (F1,2916?=?4.41, P?=?0.036). There was a significant OSA risk?��?age interaction affecting several of the outcome variables: specifically, animal fluency (fully adjusted F1,2788 for interaction term?=?8.18, P?=?0.004), CESD-4 (fully adjusted F1,2788 for interaction?=?9.32, P?=?0.002) and HRQoL PCS-12 (fully adjusted F1,2788 for interaction?=?13.84, P?=?0.0002). Individuals at high risk for OSA had lower animal fluency scores than their low-risk peers at younger ages (Fig.?1). However, the trend for lower animal fluency scores at older ages was steeper for those with low OSA risk than for those with high risk, resulting in a cross-over at approximately age 70. Younger high-risk individuals reported more depressive symptoms than their low-risk counterparts (Fig.?2); however, at older ages, high-risk individuals�� report of depressive symptoms did not differ from those of low-risk participants. A similar trend was found for physical wellbeing (Fig.?3) and mental wellbeing, although for the latter index the age?��?OSA risk interaction was not statistically significant. Physical wellbeing was perceived more negatively among younger individuals at high risk for OSA versus older individuals at high risk. In sensitivity analyses restricted to those at highest and lowest OSA risk, the fully adjusted models including gender, education, race, diabetes and dyslipidaemia underscored the primary study results with respect to the main and interactive effects of OSA risk and age on both cognitive and quality of life outcomes (manova P-values for OSA risk?=?0.007 and 0.0001 for cognition and quality of life, respectively; for age, P-values?=?0.0001 for both outcomes; and for the interaction of OSA risk and age, P-values?=?0.007 and 0.03, respectively). Univariate parameter estimates indicated that those at highest OSA risk scored on average 16.12 points lower than those at no risk on the animal fluency measure; 3.15 points higher on the CES-D-4, indicating more depressive symptoms; and 23.86 and 23.31 points lower on the SF-12 PCS and MCS scores, respectively, indicating markedly lower HRQoL. These effects were pronounced at younger ages and were diminished to no difference or virtually no difference at older ages, with older age conferring modest but statistically significant protective effects in those at high OSA risk (i.e.