The relationship between dementia severity and rest/activity circadian rhythms.
The relationship between dementia severity and rest/activity circadian rhythms.
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DOI：
10.2147/nedt.1.2.155.61043
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发表时间：
2005-06-01
影响因子：
3.2
通讯作者：
Ancoli-Israel, Sonia
中科院分区：
文献类型：
--
作者：
Gehrman, Phil;Marler, Matthew;Ancoli-Israel, Sonia
患有痴呆症的患者已被证明具有紊乱的睡眠/觉醒节律。有证据表明该人群的内源性节律发生受损且环境线索不足。这项研究试图检查休息/活动节律的模式，因为它们与痴呆的严重程度有关。收集了150名老年痴呆患者的三天腕动记录，并用于计算节律参数。痴呆的严重程度估计与简易精神状态检查（MMSE）。研究节律参数与痴呆严重程度之间的关系。节奏参数与痴呆症的样本作为一个整体，但出现的关系时，样本被划分的基础上，整体节奏的鲁棒性（F-统计）。在节奏不太强的那组中，节奏较强的那组痴呆症的严重程度较低。在节律更强的组中，轻度痴呆与较早的acrophase（节律峰值的时间）和较窄的节律峰值（峰值活动的持续时间较短）有关。这些结果表明，痴呆症患者的休息/活动节律变化的三阶段模型，其中痴呆症患者的节律性迅速下降，随后略微恢复到较强的节律。在痴呆症的后期，节奏甚至进一步下降。
Patients with dementia have been shown to have disturbed sleep/wake rhythms. There is evidence of impairment in endogenous generation of rhythms and deficient environmental cues in this population. This study sought to examine patterns of rest/activity rhythms as they relate to dementia severity. Three days of actigraphy were collected from 150 nursing-home patients with dementia and used to compute rhythm parameters. Dementia severity was estimated with the Mini-Mental State Examination (MMSE). The relationship between rhythm parameters and dementia severity was examined. Rhythm parameters were not associated with dementia in the sample as a whole, but relationships emerged when the sample was divided on the basis of overall rhythm robustness (F-statistic). Within the group with less robust rhythms, those with stronger rhythms had less severe dementia. In the group with more robust rhythms, milder dementia was associated with having an earlier acrophase (timing of the peak of the rhythm) and narrower peak of the rhythm (shorter duration of peak activity). These results suggested a three-stage model of rest/activity rhythm changes in dementia in which dementia patients have a rapid decline in rhythmicity followed by a slight return to stronger rhythms. In the later stages of dementia, rhythms decline even further.