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Sleep/Wake Cycle Disturbance in Alzheimer's Disease: How Much Is Due to an Inherent Trait?

Published online by Cambridge University Press:  10 January 2005

Jerome A. Yesavage
Affiliation:
Department of Veterans Affairs Health Care System Palo Alto, California, US Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US
Joy L. Taylor
Affiliation:
Department of Veterans Affairs Health Care System Palo Alto, California, US Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US
Helena Kraemer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US
Art Noda
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US
Leah Friedman
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US
Jared R. Tinklenberg
Affiliation:
Department of Veterans Affairs Health Care System Palo Alto, California, US Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, US

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.

Type
Articles
Copyright
© 2002 International Psychogeriatric Association

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