Sleep Disturbances in Alzheimer’s Disease Are Associated With Neuropsychiatric Symptoms and Antidementia Treatment

García‐Alberca, José María; Lara, José Pablo; Cruz, Belén; Garrido, Victoria Villena; Gris, Esther; Barbancho, Miguel Ángel

doi:10.1097/nmd.0b013e3182848d04

Cited by 35 publications

(33 citation statements)

References 42 publications

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“…Our results are consistent with previous studies that found correlations between apathy and functional status [9, 11–13] and between sleep and functional capacity [16, 17]. Apathy is commonly rated as a severe and frequent behavior on the NPI for individuals with AD [31] and strongly correlated to cognitive ability [32].…”

Section: Discussionsupporting

confidence: 92%

“…Prior studies have also associated higher frequency and severity of sleep disturbances with depression, disinhibition, or aberrant motor behavior [16]. In a previous study of AD patients with reported sleep disturbance on the NPI, better objective sleep was shown to be associated with better cognitive performance and functional status [36].…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have found anxiety and behavioral disturbances, in conjunction with cognitive status, as prodromal markers for AD [15]. Problems with sleep are also associated with declines in cognitive and functional capacities [16, 17]. The major goal of AD treatment is to improve daily living skills, so understanding the determinants of independent functional status is vitally important.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease

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Walsh

Chiodo

et al. 2015

JAD

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Background Cognitive deficits are presumed to be the primary driver of functional impairment in Alzheimer’s disease (AD); however, functional impairment is likely multifactorially determined. Objective Our objective was to determine the relative contribution of neuropsychiatric symptoms in predicting ratings of functional status. Methods A total of 223 patients received routine neurological and neuropsychological evaluations and met criteria of probable AD dementia based on the McKhann criteria. Demographic, cognitive, and neuropsychiatric variables were entered in a hierarchical linear regression analysis to predict functional status as measured by the Functional Activities Questionnaire (FAQ). Results The total model explained 29.7% of the variance (p < 0.001) in FAQ. Importantly, neuropsychiatric variables explained 12.7% of the unique variance, with apathy and sleep as significant contributors. Conclusion Two neuropsychiatric variables, apathy and changes in sleep/nighttime behaviors, predicted ratings of functional status in AD patients independent of age, global cognition, memory and executive function measures, and depressive symptoms. These results highlight the importance of neuropsychiatric symptoms in understanding and potentially treating the functional limitations so prevalent in AD.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease

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Walsh

Chiodo

et al. 2015

JAD

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“…They also had slightly lower MMSE scores than the AD group, but the clinical importance of the difference could be dubious (mean 23.8 vs. 23.0), especially since the groups had equal CDR scores. A higher total NPI score in DLB patients could also influence the severity of SD, although sleep pathology itself is an independent risk factor for the presence and severity of neuropsychiatric symptoms [24]. However, the most probable explanation is differences between DLB and AD at the neuropathophysiological level.…”

Section: Discussionmentioning

confidence: 99%

Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

et al. 2015

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Background: Sleep disturbances (SDs) are common in patients with all forms of dementia. However, most studies focus on Alzheimer's disease (AD) and less is known about the prevalence and characteristics of SD in dementia with Lewy bodies (DLB). Objective: The aims of this cross-sectional study were: (1) to examine the frequency of SD in DLB versus AD; (2) to compare patients with and without SD with regard to relevant clinical variables, and (3) to investigate the associations between SD and medication use. Methods: Patients with a first-time diagnosis of probable or possible DLB or AD were selected from the Dementia Study of Western Norway and recruited from clinics for old age psychiatry from 2010 until the end of 2013. Results: In all, 123 (55.7%) subjects with dementia suffered from at least one SD. Insomnia was present in 77 (34.8%), and 34 (20.7%) patients had probable REM-sleep behaviour disorder (RBD). All SDs were also significantly more frequent in patients with DLB than in AD, and DLB patients also more often had several co-occurring SDs. The presence of any SD was associated with more neuropsychiatric symptoms, higher morbidity, more parkinsonian symptoms and excessive daytime sleepiness. Antiparkinsonian medication was used more often in RBD, restless leg syndrome (RLS) and periodic limb movements, and benzodiazepines were also common in RLS. Conclusions: Sleep problems are more common in DLB patients compared to AD, and are associated with more clinical impairment. DLB patients frequently have several sleep problems occurring simultaneously, which suggests a need for screening and accurate assessment of sleep in DLB.

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“…In line with previous results, García‐Alberca et al . demonstrated that sleep disturbances are also significantly associated with daytime behavioural disturbances, namely aberrant motor behaviour and disinhibition . Findings suggest that night‐time sleep is important for cognitive function and for behavioural and psychological symptoms of dementia in AD, and that sleep problems should be considered when treating AD patients because their treatment might improve cognitive function as well as behavioural and psychological symptoms of dementia …”

Section: Psychopathology and Sleep Disorders In Dementiamentioning

confidence: 98%

Sleep disturbances and dementia

et al. 2014

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Sleep is a complex behavioural state, the ultimate functions of which remain poorly understood. It becomes more fragmented as we age, with more night-time awakenings and greater tendency for daytime sleep. The magnitude of disordered sleep among individuals affected by dementia has been clearly demonstrated, and disturbed sleep is a major clinical problem in dementia. Comorbid insomnia and other sleep disturbances are common in patients with neurodegenerative disorders, such Alzheimer's disease and other dementing disorders. How and when sleep problems manifest themselves can depend on the type of dementia involved as well as the stage of the dementia. However, differences in sleep pattern presentation show more variation during the initial stages of dementias than they do during the later stages. Effective, pragmatic interventions are largely anecdotal and untested.

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Sleep Disturbances in Alzheimer’s Disease Are Associated With Neuropsychiatric Symptoms and Antidementia Treatment

Cited by 35 publications

References 42 publications

Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease

Neuropsychiatric Symptoms Predict Functional Status in Alzheimer’s Disease

Higher Frequency and Complexity of Sleep Disturbances in Dementia with Lewy Bodies as Compared to Alzheimer's Disease

Sleep disturbances and dementia

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