Objectives: Sleep-related injury is a serious but under-recognized condition. We examined the occurrence of sleep-related injuries and REM sleep behavior disorder (RSBD) in a community sample of elderly in Hong Kong. Design: A representative sample of elderly aged 70 years or above were interviewed with a screening question on the presence of sleep-related injuries. Those who answered affirmatively as well as a subsample of negative responders were interviewed by clinicians. Patients with suspected sleep disorders underwent physical and psychiatric assessment as well as sleep studies. Setting: NA Patients or Participants: NA Interventions: NA Results: In total, 1034 elderly were surveyed and 0.8% reported history of sleep-related injury. Four subjects were confirmed to have RSBD, giving an estimated prevalence of RSBD of 0.38% (95% CI=0.01 to 0.76%). One subject had suspected RSBD but refused investigations while 1 had history suggestive of transient RSBD but could not be confirmed by the sleep studies. The course of RSBD in these subjects was that of a waxing and waning course instead of a progressive deterioration as described in previous literature. Two patients had been hospitalized for sleep-related injury before but their sleep disorder was not recognized. Conclusions: We found that sleep-related injury and RSBD were not rare in the elderly but were frequently under-recognized. Our study calls for greater attention to elderly who had sustained injury during sleep.
Blessed-Roth Dementia Scale has been one of the most widely used rating scales in dementia. Previous studies indicated that this behavioral assessment scale is a useful tool for differentiating elderly subjects with no or minimal intellectual decline from those with cognitive deterioration. In the present study, the authors examined the validity of the Chinese version of the Blessed-Roth Dementia Scale (CDS) in Hong Kong. A total of 106 Chinese subjects were recruited from a social center, an old-age home,and psychogeriatric outpatient clinics. At a cutoff score of 3 of 4, the CDS achieved a sensitivity of 90.5% and specificity of 98.1% in differentiating demented from healthy control subjects. In the Chinese population studied, the scale was readily acceptable and considered to be an useful adjunct in screening of dementia.
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