Abstract
Objectives: To investigate the relationship between probable rapid eye movement (REM) sleep behavior disorder (pRBD) and cognitive/motor impairments in a community-dwelling population and explore the moderating effects of education.Methods: In this cross-sectional study of the Beijing Longitudinal Study of Aging II (BLSA II), 4,477 subjects (≥55 years) fulfilled the inclusion criteria. pRBD was determined by the RBD Questionnaire–Hong Kong (RBDQ-HK). Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to test the global cognitive performance. Walking speed was used to measure motor function. Logistic regression was performed to assess the relationship between pRBD and cognitive/motor impairments and the moderating effects of education.Results: There were 147 participants (3.3%) with pRBD. Participants with pRBD showed increased risks for cognitive impairment [odds ratio (OR) = 1.88, 95% CI 1.24–2.85, p = 0.003], decreased gait speed (OR = 1.43, 95% CI 1.02–2.01, p = 0.03), but not for mild cognitive impairment (MCI) (measured by MoCA: OR = 1.01, 95% CI 0.68–1.50, p = 0.95; measured by MMSE: OR = 0.90, 95% CI 0.59–1.37, p = 0.62). Education modified the effect of pRBD on MCI (measured by MoCA: p < 0.001; measured by MMSE: p = 0.061) and gait speed (p = 0.008).Conclusions: Our findings suggest that pRBD increases the risk of cognitive/motor impairments for a community-dwelling older population, and education could alleviate the negative effects. These findings implicate that education may have beneficial effects on delaying the onset of cognitive/motor decline in pRBD subjects.
Highlights
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by vivid dreams, dream-enacting behaviors, and loss of REM sleep atonia [1]
A total of 147 participants (3.3%) had probable RBD (pRBD) determined by the cutoff value of REM Sleep Behavior Disorder Questionnaire–Hong Kong (RBDQ-HK)
There was no significant difference on age, gender, educational level, hypertension, diabetes, and stroke between participants with and without pRBD
Summary
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by vivid dreams, dream-enacting behaviors, and loss of REM sleep atonia [1]. Over 70% of patients with iRBD were reported to develop parkinsonism or dementia after a 12 year follow-up [4]. Such long prodromal interval provides a unique opportunity to explore disease-modifying therapies to potentially prevent the development of much severe neurological conditions such as parkinsonism and dementia [5]. Screening for pRBD in the general population could enable early identification of RBD patients and allow us to investigate the moderating factors . Very few studies have reported an association between pRBD and impaired motor/cognitive functions in the general population [7,8,9]. The moderating factors associated with pRBD still remain to be investigated
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