| Title: | Circadian Rest-Activity Rhythms, Delirium Risk, and Progression to Dementia |
| Journal: | Annals of Neurology |
| Published: | 3 Mar 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36808743/ |
| DOI: | https://doi.org/10.1002/ana.26617 |
| URL: | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ana.26617 |
Publication 11165
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
OBJECTIVE: Delirium is a complex neurocognitive syndrome suspected to be bidirectionally linked to dementia. Circadian rhythm disturbances likely contribute to dementia pathogenesis, but whether these disturbances are related to delirium risk and progression to all-cause dementia is unknown.</p>
METHODS: We analyzed continuous actigraphy data from 53,417 middle-aged or older UK Biobank participants during a median 5 years of follow-up. Four measures were used to characterize the 24-hour daily rest-activity rhythms (RARs): normalized amplitude, acrophase representing the peak activity time, interdaily stability, and intradaily variability (IV) for fragmentation of the rhythm. Cox proportional hazards models examined whether RARs predicted incident delirium (n = 551) and progression to dementia (n = 61).</p>
RESULTS: Suppressed 24-hour amplitude, lowest (Q1) versus highest (Q4) quartile (hazard ratio [HR]Q1 vs Q4 = 1.94, 95% confidence interval [CI] = 1.53-2.46, p < 0.001), and more fragmented (higher IV: HRQ4 vs Q1 = 1.49, 95% CI = 1.18-1.88, p < 0.001) rhythms predicted higher delirium risk, after adjusting for age, sex, education, cognitive performance, sleep duration/disturbances, and comorbidities. In those free from dementia, each hour of delayed acrophase was associated with delirium risk (HR = 1.13, 95% CI = 1.04-1.23, p = 0.003). Suppressed 24-hour amplitude was associated with increased risk of progression from delirium to new onset dementia (HR = 1.31, 95% CI = 1.03-1.67, p = 0.03 for each 1-standard deviation decrease).</p>
INTERPRETATION: Twenty-four-hour daily RAR suppression, fragmentation, and potentially delayed acrophase were associated with delirium risk. Subsequent progression to dementia was more likely in delirium cases with suppressed rhythms. The presence of RAR disturbances before delirium and prior to progression to dementia suggests that these disturbances may predict higher risk and be involved in early disease pathogenesis. ANN NEUROL 2023;93:1145-1157.</p>
11 Authors
- Lei Gao
- Peng Li
- Nicole Gaykova
- Xi Zheng
- Chenlu Gao
- Jacqueline M. Lane
- Richa Saxena
- Frank A. J. L. Scheer
- Martin K. Rutter
- Oluwaseun Akeju
- Kun Hu
1 Application
| Application ID | Title |
|---|---|
| 33883 | Multiscale regulation of motor activity and the risk for Alzheimer's disease |
Enabling scientific discoveries that improve human health