TY - JOUR
T1 - Sleep disturbances are key symptoms of very early stage Alzheimer disease with behavioral and psychological symptoms
T2 - a Japan multi-center cross-sectional study (J-BIRD)
AU - Kabeshita, Yasunobu
AU - Adachi, Hiroyoshi
AU - Matsushita, Masateru
AU - Kanemoto, Hideki
AU - Sato, Shunsuke
AU - Suzuki, Yukiko
AU - Yoshiyama, Kenji
AU - Shimomura, Tatsuo
AU - Yoshida, Taku
AU - Shimizu, Hideaki
AU - Matsumoto, Teruhisa
AU - Mori, Takaaki
AU - Kashibayashi, Tetsuo
AU - Tanaka, Hibiki
AU - Hatada, Yutaka
AU - Hashimoto, Mamoru
AU - Nishio, Yoshiyuki
AU - Komori, Kenjiro
AU - Tanaka, Toshihisa
AU - Yokoyama, Kazumasa
AU - Tanimukai, Satoshi
AU - Ikeda, Manabu
AU - Takeda, Masatoshi
AU - Mori, Etsuro
AU - Kudo, Takashi
AU - Kazui, Hiroaki
N1 - Funding Information:
We thank all patients and caregivers for their participation in the J-BIRD study. The present study was undertaken with the research grants for research on dementia (H25-27 Dementia-General-003 for Kazui, H.) from the Ministry of Health, Labor, and Welfare of Japan.
Publisher Copyright:
Copyright © 2016 John Wiley & Sons, Ltd.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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.
AB - 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.
KW - Alzheimer disease
KW - Clinical Dementia Rating scale
KW - behavioral and psychological symptoms
KW - severity of dementia
KW - sleep disturbance
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U2 - 10.1002/gps.4470
DO - 10.1002/gps.4470
M3 - Article
C2 - 27001907
AN - SCOPUS:84961696249
VL - 32
SP - 222
EP - 230
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
SN - 0885-6230
IS - 2
ER -