Sleep/wake cycle disturbance in Alzheimer's disease: how much is due to an inherent trait?

Int Psychogeriatr. 2002 Mar;14(1):73-81. doi: 10.1017/s1041610202008293.

Abstract

Major advances in understanding the physiology and genetics of circadian rhythm in the past decade challenge the researcher of sleep/wake disorders in Alzheimer's disease (AD) to distinguish patient characteristics stable across the course of illness ("traits") from characteristics that vary with stage of illness ("states"). A components-of-variance approach with a repeated measures model was used to examine the between-subjects variance over time ("trait") vs. within-subjects ("state") variance in 42 patients with probable AD followed, on average, over 2 years on actigraphic sleep/wake measures. Mental status scores indexed stage of illness. Actigraphic measures of sleep efficiency and circadian rhythmicity appeared predominantly "trait," with between-individual differences accounting for over 55% of variance compared to the less than 5% of variance related to stage of cognitive impairment. We discuss how "state-trait" analyses can be helpful in identifying areas of assessment most likely to be fruitful objectives of physiologic and genetic research on sleep/wake disturbance in AD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / classification
  • Alzheimer Disease / complications*
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / genetics*
  • Analysis of Variance
  • Disease Progression
  • Female
  • Genetic Predisposition to Disease / genetics*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Status Schedule
  • Polysomnography
  • Severity of Illness Index
  • Sleep Stages
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / etiology*
  • Sleep Wake Disorders / physiopathology