The relationship between dementia severity and rest/activity circadian rhythms
Open accessAbstract
Patients with dementia have been shown to have disturbed sleep/wake rhythms. There is evidence of impairment in endogenous generation of rhythms and deficient environmental cues in this population. This study sought to examine patterns of rest/activity rhythms as they relate to dementia severity. Three days of actigraphy were collected from 150 nursing-home patients with dementia and used to compute rhythm parameters. Dementia severity was estimated with the Mini-Mental State Examination (MMSE). The relationship between rhythm parameters and dementia severity was examined. Rhythm parameters were not associated with dementia in the sample as a whole, but relationships emerged when the sample was divided on the basis of overall rhythm robustness (F-statistic). Within the group with less robust rhythms, those with stronger rhythms had less severe dementia. In the group with more robust rhythms, milder dementia was associated with having an earlier acrophase (timing of the peak of the rhythm) and narrower peak of the rhythm (shorter duration of peak activity). These results suggested a three-stage model of rest/activity rhythm changes in dementia in which dementia patients have a rapid decline in rhythmicity followed by a slight return to stronger rhythms. In the later stages of dementia, rhythms decline even further.
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Fragmentation in sleep-wake patterns and behavioural dysregulation are widely prevalent in people with dementia due to impaired circadian function and degeneration of the suprachiasmatic nuclei with this disease.
“Fragmentation in sleep‐wake patterns and behavioural dysregulation are also widely prevalent in people with dementia due to impaired circadian function and degeneration of the suprachiasmatic nuclei with this disease [42].”
From Ocular light exposure interventions for sleep, circadian rhythms, rest-activity cycles, mood, and cognitive function in older adults: An Overview of Cochrane and non-Cochrane Systematic Reviews (2025) · cites this paper as [42]
The Introduction (page unavailable) says people with dementia often have fragmented sleep–wake patterns and describes SCN degeneration, particularly in Alzheimer’s disease. But it says the cause of sleep fragmentation remains unclear, and the Discussion (page unavailable) cannot determine whether disturbed rhythms result from reduced SCN activity, environmental cues, or both. The cited passages do not establish the claim’s behavioural dysregulation component. (LLM, conf=0.88)
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- Authors
- Gehrman, P., Marler, M., Martin, J. L., Shochat, T., Corey-Bloom, J., & Ancoli-Israel, S.
- Affiliations
- San Diego State University (US)
- University of California San Diego (US)
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2005
- Volume
- 1
- Issue
- 2
- Pages
- 155-163
- ISSN
- 1176-6328 (ISSN-L)
- PMC
- PMC2413196
- OpenAlex
- W1986412485
- Cited by
- 82
- References
- 33
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 9 · 2021: 10 · 2020: 6 · 2019: 5 · 2017: 3 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 7
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- University of California, San Diego
- Veterans Affairs San Diego Healthcare System
- National Institute on Aging (R01AG015301, R01AG008415, AG 15301, AG 08415, RF1AG015301)
- National Cancer Institute (R01CA085264)
- NIH Clinical Center
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- dementia severity, rest-activity rhythm, circadian rhythm, actigraphy, nursing home residents, acrophase, Mini-Mental State Examination
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