Dementia in Institutionalized Elderly: Relation to Sleep Apnea

Ancoli‐Israel, Sonia; Klauber, Melville R.; Butters, Nelson; Parker, Lawrence N.; Kripke, Daniel F.

doi:10.1111/j.1532-5415.1991.tb01647.x

Cited by 201 publications

(136 citation statements)

References 26 publications

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“…Such findings are not surprising as associations between OSA and some cognitive impairment are well established in multiple studies including sleep disorders clinic patients, older adults, patients with Alzheimer disease, and nursing home patients. [71][72][73][74][75][76][77][78][79] We also found that OSA treatment improves nighttime sleep in PD. 80 OSA treatment is therefore clinically indicated, as it may also reduce NMS impairment and improve quality of life.…”

mentioning

confidence: 56%

Effects of Sleep Disorders on the Non-Motor Symptoms of Parkinson Disease

Neikrug

Maglione

Liu³

et al. 2013

Journal of Clinical Sleep Medicine

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106

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Study Objectives: To evaluate the impact of sleep disorders on non-motor symptoms in patients with Parkinson disease (PD). Design: This was a cross-sectional study. Patients with PD were evaluated for obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and REM sleep behavior disorder (RBD). Cognition was assessed with the Montreal Cognitive Assessment and patients completed self-reported questionnaires assessing non-motor symptoms including depressive symptoms, fatigue, sleep complaints, daytime sleepiness, and quality of life. Setting: Sleep laboratory. Participants: 86 patients with PD (mean age = 67.4 ± 8.8 years; range: 47-89; 29 women). Interventions: N/A. Measurements and Results: Having sleep disorders was a predictor of overall non-motor symptoms in PD (R 2 = 0.33, p < 0.001) while controlling for age, PD severity, and dopaminergic therapy. These analyses revealed that RBD (p = 0.006) and RLS (p = 0.014) were signifi cant predictors of increased non-motor symptoms, but OSA was not. More specifi cally, having a sleep disorder signifi cantly predicted sleep complaints (ΔR 2 = 0.13, p = 0.006), depressive symptoms (ΔR 2 = 0.01, p = 0.03), fatigue (ΔR 2 = 0.12, p = 0.007), poor quality of life (ΔR 2 = 0.13, p = 0.002), and cognitive decline (ΔR 2 = 0.09, p = 0.036). Additionally, increasing number of sleep disorders (0, 1, or ≥ 2 sleep disorders) was a signifi cant contributor to non-motor symptom impairment (R 2 = 0.28, p < 0.001). Conclusion: In this study of PD patients, presence of comorbid sleep disorders predicted more non-motor symptoms including increased sleep complaints, more depressive symptoms, lower quality of life, poorer cognition, and more fatigue. RBD and RLS were factors of overall increased non-motor symptoms, but OSA was not. S C I E N T I F I C I N V E S T I G A T I O N SP arkinson disease (PD) is a progressive neurodegenerative disorder primarily characterized by motor symptoms and increasing motor-related disability, including bradykinesia, rigidity, and tremor.1 Non-motor symptoms (NMS) such as sleep dysfunction, sleepiness, fatigue, pain, and depressive symptoms, are common in PD. In a large multicenter study, NMS were reported by 99% of 1072 PD patients.2 The presentation of NMS in PD is highly variable, and the understanding of such heterogeneity in PD is limited and incomplete.3,4 Chaudhuri et al. 4 suggested that NMS dominate the clinical picture in patients with PD and contribute to the severe disability these patients experience, impair quality of life, and even shorten life expectancy. Studies have suggested that NMS, more than motor symptoms, may impact caregiver distress, quality of life, institutionalization rates, and overall costs related to PD .4-6 A 15-year follow-up study of patients with PD reported that the NMS that did not respond to dopamine therapy (e.g., dementia, sleep disruption) were "more disabling than endof-dose failure or dyskinesia" and were the major cause of morbidity and mortality. Sixty to 98% of pati...

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mentioning

confidence: 56%

Effects of Sleep Disorders on the Non-Motor Symptoms of Parkinson Disease

Neikrug

Maglione

Liu³

et al. 2013

Journal of Clinical Sleep Medicine

Self Cite

106

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“…Besides sleep disruption, clinical sleep disorders are strongly comorbid with mild cognitive impairment (MCI) and AD. Over 60% of persons with MCI and AD have one or more sleep disturbances (Ancoli‐Israel, Klauber, Butters, Parker, & Kripke, 1991; Guarnieri et al, 2012), with sleep apnea and insomnia being most common.…”

Section: Lifestyle Associations and Interventions For Aging And Admentioning

confidence: 99%

Aging and Alzheimer’s disease: Comparison and associations from molecular to system level

et al. 2018

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Alzheimer's disease is the most prevalent cause of dementia, which is defined by the combined presence of amyloid and tau, but researchers are gradually moving away from the simple assumption of linear causality proposed by the original amyloid hypothesis. Aging is the main risk factor for Alzheimer's disease that cannot be explained by amyloid hypothesis. To evaluate how aging and Alzheimer's disease are intrinsically interwoven with each other, we review and summarize evidence from molecular, cellular, and system level. In particular, we focus on study designs, treatments, or interventions in Alzheimer's disease that could also be insightful in aging and vice versa.

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“…This degeneration may place the patient at an increased risk of developing SRBD. For example, Ancoli-Israel et al 62 found that those institutionalized elderly with severe dementia had more severe SRBD compared to those with mild-moderate or no dementia. Furthermore, those with more severe SRBD performed worse on the dementia rating scales, suggesting that more severe SRBD was associated with more severe dementia.…”

Section: Sleep-related Breathing Disordermentioning

confidence: 99%