Yasunobu Kabeshita1,2,3, Hiroyoshi Adachi1,2,3, Masateru Matsushita4,5, Hideki Kanemoto2, Shunsuke Sato2, Yukiko Suzuki2, Kenji Yoshiyama2, Tatsuo Shimomura6, Taku Yoshida7, Hideaki Shimizu7, Teruhisa Matsumoto7, Takaaki Mori7, Tetsuo Kashibayashi8, Hibiki Tanaka4, Yutaka Hatada4, Mamoru Hashimoto4, Yoshiyuki Nishio9, Kenjiro Komori7,10, Toshihisa Tanaka2, Kazumasa Yokoyama8, Satoshi Tanimukai11, Manabu Ikeda4, Masatoshi Takeda1,12, Etsuro Mori9, Takashi Kudo1,2, Hiroaki Kazui2. 1. Department of Psychiatry, Osaka University Health Care Center, Toyonaka, Japan. 2. Psychiatry, Department of Integrated Medicine, Division of Internal Medicine, Osaka University Graduate School of Medicine, Suita, Japan. 3. The Sleep Medical Center of Osaka University Hospital, Suita, Japan. 4. Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. 5. Center for Medical Education and Research, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. 6. Department of Rehabilitation Medicine, Akita Prefectural Centre of Rehabilitation and Psychiatric Medicine, Daisen, Japan. 7. Department of Neuropsychiatry, Graduate School of Medicine, Ehime University, Toon, Japan. 8. Departments of Neurology and Cognitive Disorders, Hyogo Prefectural Rehabilitation Center at Nishi-harima, Tatsuno, Japan. 9. Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan. 10. Zaidan-Niihama Hospital, Niihama, Japan. 11. Department of Community and Geriatric Nursing, Ehime University Graduate School of Medicine, Toon, Japan. 12. Aino University, Ibaraki, Japan.
Abstract
BACKGROUND: Sleep disturbances in Alzheimer disease (AD) may affect behavioral and psychological symptoms of dementia (BPSD). Our aim was to elucidate the associations between sleep disturbances and other BPSD at different stages of AD. METHODS: This investigation was part of a multicenter-retrospective study in Japan (J-BIRD). Eligible for final analyses were 684 AD patients. Global severity of dementia was estimated using the Clinical Dementia Rating (CDR) scale. BPSD were assessed using the Neuropsychiatric Inventory (NPI). We analyzed the relationships between sleep disturbances and BPSD at different stages of AD according to the CDR score. RESULTS: Among the 684 AD patients, 146 (21.3%) had sleep disturbances. Patients with very early AD (CDR 0.5) and sleep disturbances had significantly more BPSD than those without sleep disturbances, as indicated by the higher prevalence of the following four NPI items: anxiety, euphoria, disinhibition, and aberrant motor behavior. In AD at CDR 2, (moderate AD) only one NPI item (irritability) was affected, while none was affected at CDR 1 (mild AD) and 3 (severe AD). Multiple regression analyses were performed in those with AD having various CDR scores. At CDR 0.5, the presence of sleep disturbances was associated with a high total NPI score (β = 0.32, p < 0.001). However, other factors, including cognitive decline, age, gender, and years of education, were not significantly associated with the NPI score. At CDR 1 and 2, no factor was significantly related to BPSD. CONCLUSION: Sleep disturbances were strongly associated with other BPSD in the very early stage of AD.
BACKGROUND:Sleep disturbances in Alzheimer disease (AD) may affect behavioral and psychological symptoms of dementia (BPSD). Our aim was to elucidate the associations between sleep disturbances and other BPSD at different stages of AD. METHODS: This investigation was part of a multicenter-retrospective study in Japan (J-BIRD). Eligible for final analyses were 684 ADpatients. Global severity of dementia was estimated using the Clinical Dementia Rating (CDR) scale. BPSD were assessed using the Neuropsychiatric Inventory (NPI). We analyzed the relationships between sleep disturbances and BPSD at different stages of AD according to the CDR score. RESULTS: Among the 684 ADpatients, 146 (21.3%) had sleep disturbances. Patients with very early AD (CDR 0.5) and sleep disturbances had significantly more BPSD than those without sleep disturbances, as indicated by the higher prevalence of the following four NPI items: anxiety, euphoria, disinhibition, and aberrant motor behavior. In AD at CDR 2, (moderate AD) only one NPI item (irritability) was affected, while none was affected at CDR 1 (mild AD) and 3 (severe AD). Multiple regression analyses were performed in those with AD having various CDR scores. At CDR 0.5, the presence of sleep disturbances was associated with a high total NPI score (β = 0.32, p < 0.001). However, other factors, including cognitive decline, age, gender, and years of education, were not significantly associated with the NPI score. At CDR 1 and 2, no factor was significantly related to BPSD. CONCLUSION:Sleep disturbances were strongly associated with other BPSD in the very early stage of AD.
Authors: Daniel López-López; Marta Grela-Fariña; Marta Elena Losa-Iglesias; César Calvo-Lobo; David Rodríguez-Sanz; Patricia Palomo-López; Ricardo Becerro-de-Bengoa-Vallejo Journal: Int J Environ Res Public Health Date: 2018-02-07 Impact factor: 3.390