Sleep disturbances are key symptoms of very early stage Alzheimer disease with behavioral and psychological symptoms: a Japan multi-center cross-sectional study (J-BIRD)

被引：38

作者：

Kabeshita, Yasunobu ^{[1
,2
,3
]}

Adachi, Hiroyoshi ^{[1
,2
,3
]}

Matsushita, Masateru ^{[10
,11
]}

Kanemoto, Hideki ^{[2
]}

Sato, Shunsuke ^{[2
]}

Suzuki, Yukiko ^{[2
]}

Yoshiyama, Kenji ^{[2
]}

Shimomura, Tatsuo ^{[5
]}

Yoshida, Taku ^{[7
]}

Shimizu, Hideaki ^{[7
]}

Matsumoto, Teruhisa ^{[7
]}

Mori, Takaaki ^{[7
]}

Kashibayashi, Tetsuo ^{[8
,9
]}

Tanaka, Hibiki ^{[10
]}

Hatada, Yutaka ^{[10
]}

Hashimoto, Mamoru ^{[10
]}

Nishio, Yoshiyuki ^{[12
]}

Komori, Kenjiro ^{[7
,13
]}

Tanaka, Toshihisa ^{[2
]}

Yokoyama, Kazumasa ^{[8
,9
]}

Tanimukai, Satoshi ^{[6
]}

Ikeda, Manabu ^{[10
]}

Takeda, Masatoshi ^{[1
,4
]}

Mori, Etsuro ^{[12
]}

Kudo, Takashi ^{[1
,2
]}

Kazui, Hiroaki ^{[2
]}

机构：

[1] Osaka Univ, Dept Psychiat, Hlth Care Ctr, Toyonaka, Osaka, Japan

[2] Osaka Univ, Div Internal Med, Dept Integrated Med, Psychiat,Grad Sch Med, Suita, Osaka, Japan

[3] Osaka Univ Hosp, Sleep Med Ctr, Suita, Osaka, Japan

[4] Aino Univ, Ibaraki, Japan

[5] Akita Prefectural Ctr Rehabil & Psychiat Med, Dept Rehabil Med, Daisen, Japan

[6] Ehime Univ, Dept Community & Geriatr Nursing, Grad Sch Med, Toon, Japan

[7] Ehime Univ, Grad Sch Med, Dept Neuropsychiat, Toon, Japan

[8] Hyogo Prefectural Rehabil Ctr Nishi Harima, Dept Neurol, Tatsuno, Japan

[9] Hyogo Prefectural Rehabil Ctr Nishi Harima, Dept Cognit Disorders, Tatsuno, Japan

[10] Kumamoto Univ, Dept Neuropsychiat, Fac Life Sci, Kumamoto, Japan

[11] Kumamoto Univ, Ctr Med Educ & Res, Fac Life Sci, Kumamoto, Japan

[12] Tohoku Univ, Grad Sch Med, Dept Behav Neurol & Cognit Neurosci, Sendai, Miyagi, Japan

[13] Zaidan Niihama Hosp, Niihama, Japan

来源：

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY | 2017年 / 32卷 / 02期

关键词：

Alzheimer disease; sleep disturbance; behavioral and psychological symptoms; severity of dementia; Clinical Dementia Rating scale; NEUROPSYCHIATRIC INVENTORY; DEMENTIA; MILD; PREVALENCE; IMPAIRMENT; DISORDERS; DIAGNOSIS; SEVERITY; APATHY; HOME;

D O I：

10.1002/gps.4470

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

BackgroundSleep disturbances in Alzheimer disease (AD) may affect behavioral and psychological symptoms of dementia (BPSD). Our aim was to elucidate the associations between sleep disturbances and other BPSD at different stages of AD. MethodsThis investigation was part of a multicenter-retrospective study in Japan (J-BIRD). Eligible for final analyses were 684 AD patients. Global severity of dementia was estimated using the Clinical Dementia Rating (CDR) scale. BPSD were assessed using the Neuropsychiatric Inventory (NPI). We analyzed the relationships between sleep disturbances and BPSD at different stages of AD according to the CDR score. ResultsAmong the 684 AD patients, 146 (21.3%) had sleep disturbances. Patients with very early AD (CDR 0.5) and sleep disturbances had significantly more BPSD than those without sleep disturbances, as indicated by the higher prevalence of the following four NPI items: anxiety, euphoria, disinhibition, and aberrant motor behavior. In AD at CDR 2, (moderate AD) only one NPI item (irritability) was affected, while none was affected at CDR 1 (mild AD) and 3 (severe AD). Multiple regression analyses were performed in those with AD having various CDR scores. At CDR 0.5, the presence of sleep disturbances was associated with a high total NPI score (=0.32, p<0.001). However, other factors, including cognitive decline, age, gender, and years of education, were not significantly associated with the NPI score. At CDR 1 and 2, no factor was significantly related to BPSD. ConclusionSleep disturbances were strongly associated with other BPSD in the very early stage of AD. Copyright (c) 2016 John Wiley & Sons, Ltd.

引用

页码：222 / 230

页数：9

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