Sleep Problems Associated with Behavioral and Psychological Symptoms as Well as Cognitive Functions in Alzheimer’s Disease
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Background and Purpose It has been shown that sleep problems in Alzheimer’s disease (AD)are associated with cognitive impairment and behavioral problems. In fact, most of studies havefounded that daytime sleepiness is significantly correlated with cognitive decline in AD. However, a few studies have also shown that nighttime sleep problems are associated with cognitivefunction and behavioral symptoms in AD. Accordingly, the aim of this study was to evaluate theeffects of nighttime sleep on cognition and behavioral and psychological symptoms of dementia(BPSD) in AD. Methods The study population comprised 117 subjects: 63 AD patients and 54 age- and sexmatched non-demented elderly subjects. Detailed cognitive functions and behavioral symptomswere measured using the Seoul Neuropsychological Screening Battery (SNSB) and the Koreanversion of the Neuropsychiatric Inventory (NPI-K). Sleep characteristics were evaluated usingthe Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). The correlations betweenPSQI-K and SNSB scores and between PSQI-K and NPI-K scores were analyzed. Results In AD patients, sleep latency was found to be negatively correlated with praxis (p=0.041), Rey-Osterrieth Complex Figure Test (RCFT) immediate recall (p=0.041), and RCFTrecognition (p=0.008) after controlling for age and education, while sleep duration and sleep efficiency were positively correlated with praxis (p=0.034 and p=0.025, respectively). Althoughno significant correlation was found between PSQI-K and NPI-K scores, sleep disturbance andtotal PSQI-K scores were found to be significantly associated with apathy/indifference in AD. Conclusions Sleep problems such as prolonged sleep duration, sleep latency, and poor sleepefficiency in AD patients were correlated with cognitive dysfunction, and especially frontal executive and visuospatial functions, and BPSD. These findings suggest that treatment of nighttime sleep problems might improve cognition and behavioral symptoms in AD patients.
Abstract
Background and Purpose It has been shown that sleep problems in Alzheimer’s disease (AD)are associated with cognitive impairment and behavioral problems. In fact, most of studies havefounded that daytime sleepiness is significantly correlated with cognitive decline in AD. However, a few studies have also shown that nighttime sleep problems are associated with cognitivefunction and behavioral symptoms in AD. Accordingly, the aim of this study was to evaluate theeffects of nighttime sleep on cognition and behavioral and psychological symptoms of dementia(BPSD) in AD. Methods The study population comprised 117 subjects: 63 AD patients and 54 age- and sexmatched non-demented elderly subjects. Detailed cognitive functions and behavioral symptomswere measured using the Seoul Neuropsychological Screening Battery (SNSB) and the Koreanversion of the Neuropsychiatric Inventory (NPI-K). Sleep characteristics were evaluated usingthe Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). The correlations betweenPSQI-K and SNSB scores and between PSQI-K and NPI-K scores were analyzed. Results In AD patients, sleep latency was found to be negatively correlated with praxis (p=0.041), Rey-Osterrieth Complex Figure Test (RCFT) immediate recall (p=0.041), and RCFTrecognition (p=0.008) after controlling for age and education, while sleep duration and sleep efficiency were positively correlated with praxis (p=0.034 and p=0.025, respectively). Althoughno significant correlation was found between PSQI-K and NPI-K scores, sleep disturbance andtotal PSQI-K scores were found to be significantly associated with apathy/indifference in AD. Conclusions Sleep problems such as prolonged sleep duration, sleep latency, and poor sleepefficiency in AD patients were correlated with cognitive dysfunction, and especially frontal executive and visuospatial functions, and BPSD. These findings suggest that treatment of nighttime sleep problems might improve cognition and behavioral symptoms in AD patients.
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