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Sleep problems more common in LBD than AD
There's nothing new in this recently-published abstract for join Norwegian and Minnesotan research into sleep disturbances ("defined as complaints rather than formally diagnosed disorders") in the elderly, both with and without dementia. Those with dementia in this study had "mild dementia, as reflected by the mean MMSE score (just <24)..."
Sleep issues are common in the elderly whether you have dementia or not. "Aging is associated with sleep structure changes such as advanced circadian phase with earlier sleep onset and earlier morning awakening, less total amount of time asleep, and greater sleepâwake instability. Diseases common to older persons may be associated with changes in sleep, in particular brain diseases such as Alzheimer's disease (AD)."
The research showed that there "were more sleep-related problems reported in participants with Lewy body dementias (LBD) (dementia with Lewy bodies and Parkinson's disease dementia) than in those with Alzheimer's disease. Having any sleep disorder correlated with depression and anxiety."
"Sleep disturbances negatively affect patients' quality of life and functional and cognitive abilities and are associated with greater risk of psychiatric symptoms. Thus, it is not surprising that they pose greater burden on caregivers, including sleep disturbance, which can contribute to caregiver decisions on institutionalization."
This phrase in the article was funny: "caregivers who tended to use criticism as a behavioral management strategy were more likely to make discrepant reports about their patient's sleep." (I assume a "discrepant report" is one where the caregiver and patient don't have the same view of the patient's sleep.)
The abstract is copied below.
Journal of the American Geriatrics Society. 2010 Mar;58(3):480-6.
Frequency and correlates of caregiver-reported sleep disturbances in a sample of persons with early dementia.
Rongve A, Boeve BF, Aarsland D.
Research Department, Psychiatric Clinic, Helse-Fonna HF Haugesund Hospital, Haugesund, Norway.
OBJECTIVES: To identify sleep disturbances in participants with subtypes of dementia and explore clinical correlates.
SETTING: Outpatient clinics in western Norway and the Mayo Clinic Study of Aging, Olmsted County, Minnesota.
PARTICIPANTS: One hundred fifty-one community-dwelling western Norway residents referred for geriatric medicine, geriatric psychiatry or neurology evaluation and 420 participants without dementia from the Mayo Clinic Study of Aging.
MEASUREMENTS: Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria.
The Mayo Sleep Questionnaire, an interview to detect sleep disturbances, was administered to diagnose probable rapid eye movement (REM) sleep behavior disorder, probable periodic leg movements during sleep, probable restless legs syndrome, probable sleepwalking, probable sleep-related leg cramps, probable obstructive sleep apnea, and excessive daytime sleepiness.
Insomnia was assessed using the Neuropsychiatric Inventory, an interview to detect neuropsychiatric symptoms in dementia.
RESULTS: Seventy-one percent of the participants with dementia and 55.7% of control participants had sleep disturbances (P=.001).
Most frequently reported in the mild dementia participants were insomnia (29.9%), probable sleep-related leg cramps (24.1%), excessive daytime sleepiness (22.6%), probable restless legs syndrome (20.7%), and probable REM sleep behavior disorder (18.5%).
There were more sleep-related problems reported in participants with Lewy body dementias (LBD) (dementia with Lewy bodies and Parkinson's disease dementia) than in those with Alzheimer's disease (P=.008).
Having any sleep disorder correlated with depression (P=.03) and anxiety (P=.02).
CONCLUSION: Sleep problems are common in dementia, particularly in subjects with LBD, and are associated with psychiatric symptoms. Further research is needed to understand these associations and identify treatment strategies.
PubMed ID#: 20398116 (see pubmed.gov for abstract only)