Regular Research ArticlesComparison Between Informant-Observed and Actigraphic Assessments of Sleep–Wake Rhythm Disturbances in Demented Residents of Homes for the Elderly
Section snippets
Subjects
Elderly (N = 78; 73 female) were recruited from group care facilities of 12 homes for the elderly. Mean age was 85 ± 6 years (range: 70–97 years). The average Mini Mental State Examination (MMSE) was 14.8 ± 6.8.23 The clinical diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for dementia and dementia subtypes24 and the NINCDS-ADRDA criteria for probable or possible AD.25 Subjects were diagnosed with probable AD (N = 52),
RESULTS
CSINAPS item and subscale averages are summarized in Table 1. None of the items was completed for all 78 subjects, indicating that the caregivers could not answer all questions. The items about snoring and combative or violent behavior during the night were not answered confirmatively in any of the subjects. Table 1 shows the averages of all actigraphy parameters used for comparison with the CSINAPS scores.
DISCUSSION
There was good agreement between scores on the habitual sleep timing items and corresponding actigraphy parameters as indicated by strong correlations between the CSINAPS items Bed Time and Get Up Time with the respective actigraphic variables Sleep Start and Sleep End. However, whereas caregivers adequately reported the timing of the major sleep period, they overestimated the amount actually slept by more than 30 minutes. Actigraphy may provide a more reliable estimate of actual sleep time. At
CONCLUSION
This article compared the use of a questionnaire and actigraphy to quantify circadian and sleep disturbances in demented elderly. The CSINAPS is one of the few questionnaires available that is specifically designed to measure these disturbances in demented elderly (see also 29). Our results should therefore be used with caution, and our study was primarily intended to evaluate the crossvalidity. To summarize, the main findings were as follows. First, caregivers should be given additional
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Funding for this study was provided by ZON-MW the Hague (project 28–3003), NWO the Hague (Innovation Grant), Stichting Centraal Fonds RVVZ.
Prof. S. Ancoli-Israel (University of California, San Diego, CA) is acknowledged for helpful comments on the text.