Sleep-wake cycle disturbances in elderly acute general medical inpatients: longitudinal relationship to delirium and dementia

Show simple item record

dc.contributor.author FitzGerald, James M.
dc.contributor.author O'Regan, Niamh
dc.contributor.author Adamis, Dimitrios
dc.contributor.author Timmons, Suzanne
dc.contributor.author Dunne, Colum P.
dc.contributor.author Trzepacz, Paula T.
dc.contributor.author Meagher, David J.
dc.date.accessioned 2017-03-02T12:53:59Z
dc.date.available 2017-03-02T12:53:59Z
dc.date.issued 2017
dc.identifier.citation Fitzgerald, J. M., O'Regan, N., Adamis, D., Timmons, S., Dunne, C. P., Trzepacz, P. T. and Meagher, D. J. (2017) ‘Sleep-wake cycle disturbances in elderly acute general medical inpatients: longitudinal relationship to delirium and dementia’, Alzheimer's and Dementia: Diagnosis, Assessment & Disease Monitoring, 7, pp. 61-68. doi: 10.1016/j.dadm.2016.12.013 en
dc.identifier.volume 7 en
dc.identifier.startpage 61 en
dc.identifier.endpage 68 en
dc.identifier.issn 2352-8729
dc.identifier.uri http://hdl.handle.net/10468/3729
dc.identifier.doi 10.1016/j.dadm.2016.12.013
dc.description.abstract Introduction: Sleep disturbances in elderly medical inpatients are common, but their relationship to delirium and dementia has not been studied. Methods: Sleep and delirium status were assessed daily for a week in 145 consecutive newly admitted elderly acute general hospital patients using the Delirium Rating Scale-Revised-98 (DRS-R98), Diagnostic and Statistical Manual 5, and Richards-Campbell Sleep Quality Scale measures. The longitudinal relationship between DRS-R98 and Richards-Campbell Sleep Quality Scale sleep scores and delirium, also with dementia as a covariate, was evaluated using generalized estimating equation logistic regression. Results: The cohort was divided into delirium only, dementia only, comorbid delirium-dementia, and no-delirium/no-dementia subgroups. Mean age of total group was 80 ± 6.3, 48% were female, and 31 (21%) had dementia, 29 had delirium at admission (20%), and 27 (18.5%) experienced incident delirium. Mild sleep disturbance (DRS-R98 sleep item score ≥1) occurred for at least 1 day in all groups, whereas moderate sleep disturbance (score ≥2) occurred in significantly more of the prevalent delirium-only (81%; n = 17) cases than incident delirium-only (46%; n = 13) cases (P < .001). There were more cases with DRS-R98 sleep item scores ≥2 (P < .001) in the delirium-only group compared with the other subgroups. Severity of sleep-wake cycle disturbance over time was significantly associated with Diagnostic and Statistical Manual 5 delirium status but not with age, sex, or dementia (P < .001). Conclusions: Observer-rated more severe sleep-wake cycle disturbances are highly associated with delirium irrespective of dementia status, consistent with being a core feature of delirium. Monitoring for altered sleep-wake cycle patterns may be a simple way to improve delirium detection. en
dc.description.sponsorship University of Limerick (Graduate Entry Medical School) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier Inc. on behalf of the Alzheimer’s Association en
dc.rights © 2017, the Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Dementia en
dc.subject Delirium en
dc.subject Sleep disturbance detection en
dc.subject Elder care medicine en
dc.title Sleep-wake cycle disturbances in elderly acute general medical inpatients: longitudinal relationship to delirium and dementia en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Suzanne Timmons, Clinical Gerontology & Rehabilitation, University College Cork, Cork, Ireland. +353-21-490-3000 Email: s.timmons@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2017-03-02T12:35:18Z
dc.description.version Published Version en
dc.internal.rssid 385581297
dc.contributor.funder University of Limerick en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress s.timmons@ucc.ie en


Files in this item

This item appears in the following Collection(s)

Show simple item record

© 2017, the Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Except where otherwise noted, this item's license is described as © 2017, the Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
This website uses cookies. By using this website, you consent to the use of cookies in accordance with the UCC Privacy and Cookies Statement. For more information about cookies and how you can disable them, visit our Privacy and Cookies statement