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Randomized Controlled Trial
. 2012 Jan;71(1):49-56.
doi: 10.1002/ana.22655.

Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: a population-based study

Brendon P Boot  1 , Bradley F Boeve, Rosebud O Roberts, Tanis J Ferman, Yonas E Geda, V Shane Pankratz, Robert J Ivnik, Glenn E Smith, Eric McDade, Teresa J H Christianson, David S Knopman, Eric G Tangalos, Michael H Silber, Ronald C Petersen
Affiliations
Randomized Controlled Trial

Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: a population-based study

Brendon P Boot et al. Ann Neurol. 2012 Jan.

Abstract

Objective: Rapid eye movement sleep behavior disorder (RBD) is associated with neurodegenerative disease and particularly with the synucleinopathies. Convenience samples involving subjects with idiopathic RBD have suggested an increased risk of incident mild cognitive impairment (MCI), dementia (usually dementia with Lewy bodies), and Parkinson disease (PD). There are no data on such risks in a population-based sample.

Methods: Cognitively normal subjects aged 70 to 89 years in a population-based study of aging who screened positive for probable RBD using the Mayo Sleep Questionnaire were followed at 15-month intervals. In a Cox proportional hazards model, we measured the risk of developing MCI, dementia, and PD among the exposed (probable RBD [pRBD](+)) and unexposed (pRBD(-)) cohorts.

Results: Forty-four subjects with pRBD(+) status at enrollment (median duration of pRBD features was 7.5 years) and 607 pRBD(-) subjects were followed prospectively for a median of 3.8 years. Fourteen of the pRBD(+) subjects developed MCI, and 1 developed PD (15/44 = 34% developed MCI/PD); none developed dementia. After adjustment for age, sex, education, and medical comorbidity, pRBD(+) subjects were at increased risk of MCI/PD (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3-3.9; p = 0.005). Inclusion of subjects who withdrew from the study produced similar results, as did exclusion of subjects with medication-associated RBD. Duration of pRBD symptoms did not predict the development of MCI/PD (HR, 1.05 per 10 years; 95% CI, 0.84-1.3; p = 0.68).

Interpretation: In this population-based cohort study, we observed that pRBD confers a 2.2-fold increased risk of developing MCI/PD over 4 years.

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Figures

Figure One
Figure One
Study participants.
Figure Two
Figure Two
Neurodegenerative syndrome-free survival adjusted for age (a), or over time in the study (b), in subjects with (+) and without (−) probable REM sleep behavior disorder (pRBD).
Figure Two
Figure Two
Neurodegenerative syndrome-free survival adjusted for age (a), or over time in the study (b), in subjects with (+) and without (−) probable REM sleep behavior disorder (pRBD).
See this image and copyright information in PMC

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References

    1. Boeve B, Silber M, Saper C, et al. Pathophysiology of REM sleep behaviour disorder and relevance to neurodegenerative disease. Brain. 2007;130:2770–2788. - PubMed
    1. Boeve B. REM sleep behavior disorder: Updated review of the core features, the REM sleep behavior disorder-neurodegenerative disease association, evolving concepts, controversies, and future directions. Ann NY Acad Sci. 2010;1184:17–56. - PMC - PubMed
    1. Ferman T, Boeve B, Smith G, et al. Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies. Neurology. 2011 Aug 17; [Epub ahead of print] - PMC - PubMed
    1. Claassen D, Josephs K, Ahlskog J, et al. REM sleep behavior disorder preceding other aspects of synucleinopathies by up to half a century. Neurology. 2010;75:494–499. - PMC - PubMed
    1. Postuma R, Gagnon J, Vendette M, Fantini M, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology. 2009;72:1296–1300. - PMC - PubMed

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