Prevalence and clinical characteristics of REM sleep behavior disorder in Japanese elderly people

Abstract

Study Objectives To evaluate the prevalence and clinical characteristics of isolated REM sleep behavior disorder (iRBD) among a general population of elderly Japanese people. Methods This epidemiological study targeted 2714 elderly residents (76.0 ± 8.0 years, 52.9% female) of a rural community. Questionnaires including the REM sleep behavior disorder single question and demographic information were distributed. All respondents with the question positive were interviewed by telephone. Respondents suspected of having iRBD proceeded to face-to-face interviews and underwent video-polysomnography and neurological/neuropsychological examination. These results were compared to those of previously diagnosed clinical iRBD patients in our sleep clinic. Results Of 1464 respondents to the questionnaire, 18 respondents were diagnosed as iRBD (1.23 [0.66–1.79]%), including eight respondents who satisfied diagnostic criteria with REM sleep without atonia (RWA) above the cut-off value (0.54 [0.17–0.92]%) and 10 respondents who had clear dream enactment behaviors but not RWA above the cut-off (provisionally diagnosed iRBD; p-iRBD) (0.69 [0.26–1.11]%). Severity of RBD and RWA of the population-based iRBD were compatible with those of the clinical iRBD. Half of the population-based iRBD showed orthostatic hypotension and they showed lower olfactory function than population-based p-iRBD and non-RBD. However, their olfactory and cognitive functions were higher than those in the clinical iRBD patients. Conclusions Prevalence of iRBD in Japanese elderly people was comparable with the rate reported from other countries. Population-based iRBD/p-iRBD showed lower neurodegenerative loading than clinical iRBD in spite of comparable disease duration of RBD, that may indicate their lower risk of future neurodegeneration.

Canonical Correlation Analysis on the Association Between Sleep Quality and Nutritional Status Among Centenarians in Hainan

“…Nutritional status and sleep quality are the two cornerstone factors that comprehensively affect the physical and mental health of the elderly. Their poor condition can lead to comprehensive health consequences such as depression, anger, muscle tension, sympathetic excitement, cognitive disorders, neurological disorders, gastrointestinal, and upper respiratory tract diseases, and even cardiovascular and cerebrovascular injury (4)(5)(6). However, there are only a limited number of studies focused on nutrition and sleep status in the healthy elderly, especially centenarians.…”

Ethical Considerations in Screening for Rapid Eye Movement Sleep Behavior Disorder in the General Population

“…1 Many recent studies have used a multistep approach including questionnaires and polysomnography to detect RBD. 13,[21][22][23] Although multistep screening for RBD could lead to false negatives if participants are not aware of their RBD symptoms, 1 this approach reduces the number of required polysomnographies and increases the validity of the diagnosis. Studies using a stepwise approach have shown highly similar RBD prevalences to polysomnography studies in a random sample, supporting the accuracy of this approach.…”

“…Little is known about how previous polysomnography studies handled disclosure of RBD diagnosis or the concurrent risk of α-synucleinopathies to participants. [11][12][13][21][22][23] One study in which participants responded to a newspaper advertisement including an RBD screening question described that a study neurologist discussed the RBD diagnosis and associated risk of α-synucleinopathies in a face-to-face consultation. 22 The risk information was communicated after extensive history taking and neurological examination, and the participants were offered annual follow-up by the study neurologist.…”

“…Many recent studies have used a multistep approach including questionnaires and polysomnography to detect RBD 13,21‐23 . Although multistep screening for RBD could lead to false negatives if participants are not aware of their RBD symptoms, 1 this approach reduces the number of required polysomnographies and increases the validity of the diagnosis.…”

“…In a research setting, risk disclosure is even more challenging than in a clinical setting, as research participants may not be aware of or hindered by sleep complaints. Little is known about how previous polysomnography studies handled disclosure of RBD diagnosis or the concurrent risk of α‐synucleinopathies to participants 11‐13,21‐23 . One study in which participants responded to a newspaper advertisement including an RBD screening question described that a study neurologist discussed the RBD diagnosis and associated risk of α‐synucleinopathies in a face‐to‐face consultation 22 .…”