Association between prevalence rate of dementia with Lewy bodies and sleep characteristics in Chinese old adults

Abstract

Introduction: Few studies are available on the prevalence and sleep-related factors of dementia with Lewy bodies (DLB) in Chinese older adults, aiming to explore the associations between sleep characteristics and DLB.Methods: A cross-sectional study with 7,528 individuals aged ≥65 years in 106 communities in Northern China was conducted from April 2019 to January 2020. Questionaries (including demographic characteristics, comorbidities, lifestyles, and sleep characteristics) were administered, and neuropsychological assessments and physical examination were conducted in phase I; screening for probable DLB was done in phase II. Logistic regressions were used to assess associations.Results: A total of 919 (12.2%, 919/7,528) participants had dementia, and 101 (1.3%, 101/7,528) participants were diagnosed with DLB. The prevalence of dementia and DLB were slightly higher or equal in women, increased with age, and roughly decreased with nighttime sleep duration. Of the 101 participants, all of them (100.0%) had cognitive impairment, 46 (44.54%) displayed fluctuating cognition, 72 (71.29%) of them showed visual hallucination, 22 (21.78%) individuals reported RBD, and 27.71% showed Parkinsonism. Sleeping for <5 h (adjusted OR = 1.795, 95%CI: 1.055–3.054, p < 0.05) or having hypersomnolence (adjusted OR = 31.213, 95% CI: 17.618–55.301, p < 0.001) were significantly associated with the occurrence of DLB. Sleep duration of <5 h or >8 h had combined diagnostic value for DLB (AUC = 0.783, 95%CI: 0.734–0.831, p < 0.001).Conclusions: The current prevalence of DLB is 1.3% in Northern China. Short or long nighttime sleep duration is independently associated with the occurrence of dementia and DLB.

Neurological update: non-motor symptoms in atypical parkinsonian syndromes

“…Dementia defined as a progressive cognitive decline of sufficient magnitude to interfere with either normal social or occupational function, or with usual daily activity, is an essential criterion for diagnosing DLB. Fluctuating cognition is one of the core criteria in making the diagnosis [ 61 ], yet may not be exhibited by all patients as evidenced by one study reporting the phenomenon to occur in less than half of patients (44.5%) [ 62 ].…”

“…When the onset of NMS preceding cognitive impairments was explored among DLB patients, antecedent features of an anREM-sleep disorder were found to be common in DLB: crying or shouting in sleep preceded cognitive impairments in 77% of patients (mean duration − 4.9 ± 9.5 years); preceding abnormal limb movements sleep in 47% (− 3.9 ± 9.1 years); preceding nightmares in 38% (− 2.5 ± 8.0 years), and preceding sleep rhythm disturbances in 82% (− 0.5 ± 5.5 years) [ 66 ]. Sleep duration of less than 5 h per day or the presence of hypersomnolence have also been significantly associated with DLB amongst patients with various dementia syndromes [ 62 ].…”