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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)
Author(s) -
Kabeshita Yasunobu,
Adachi Hiroyoshi,
Matsushita Masateru,
Kanemoto Hideki,
Sato Shunsuke,
Suzuki Yukiko,
Yoshiyama Kenji,
Shimomura Tatsuo,
Yoshida Taku,
Shimizu Hideaki,
Matsumoto Teruhisa,
Mori Takaaki,
Kashibayashi Tetsuo,
Tanaka Hibiki,
Hatada Yutaka,
Hashimoto Mamoru,
Nishio Yoshiyuki,
Komori Kenjiro,
Tanaka Toshihisa,
Yokoyama Kazumasa,
Tanimukai Satoshi,
Ikeda Manabu,
Takeda Masatoshi,
Mori Etsuro,
Kudo Takashi,
Kazui Hiroaki
Publication year - 2017
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4470
Subject(s) - clinical dementia rating , irritability , dementia , disinhibition , anxiety , alzheimer's disease , sleep disorder , sleep (system call) , psychology , disease , cross sectional study , medicine , psychiatry , clinical psychology , cognition , pathology , computer science , operating system
Background Sleep 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. Methods This 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. Results Among 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 ( β = 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. Conclusion Sleep disturbances were strongly associated with other BPSD in the very early stage of AD. Copyright © 2016 John Wiley & Sons, Ltd.