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

Simple item page
dc.contributor.authorFitzGerald, James M.
dc.contributor.authorO'Regan, Niamh
dc.contributor.authorAdamis, Dimitrios
dc.contributor.authorTimmons, Suzanne
dc.contributor.authorDunne, Colum P.
dc.contributor.authorTrzepacz, Paula T.
dc.contributor.authorMeagher, David J.
dc.contributor.funderUniversity of Limericken
dc.date.accessioned2017-03-02T12:53:59Z
dc.date.available2017-03-02T12:53:59Z
dc.date.issued2017
dc.date.updated2017-03-02T12:35:18Z
dc.description.abstractIntroduction: 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.sponsorshipUniversity of Limerick (Graduate Entry Medical School)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFitzgerald, 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.2016.12.013en
dc.identifier.doi10.1016/j.dadm.2016.12.013
dc.identifier.endpage68en
dc.identifier.issn2352-8729
dc.identifier.journaltitleAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoringen
dc.identifier.startpage61en
dc.identifier.urihttps://hdl.handle.net/10468/3729
dc.identifier.volume7en
dc.language.isoenen
dc.publisherElsevier Inc. on behalf of the Alzheimer’s Associationen
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.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectDementiaen
dc.subjectDeliriumen
dc.subjectSleep disturbance detectionen
dc.subjectElder care medicineen
dc.titleSleep-wake cycle disturbances in elderly acute general medical inpatients: longitudinal relationship to delirium and dementiaen
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
1-s2.0-S2352872916300781-main.pdf
Size:
329.64 KB
Format:
Adobe Portable Document Format
Description:
Published Version
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
2.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medicine - Journal Articles
Centre for Gerontology and Rehabilitation - Journal Articles