title: REM sleep behavior disorder in the Korean elderly population: prevalence and clinical characteristics.
abstract: OBJECTIVE
  To examine the prevalence and clinical characteristics of REM sleep behavior disorder (RBD) and subclinical RBD in the Korean elderly population.
  
  
  METHODS
  A community-based Korean Longitudinal Study on Cognitive Aging and Dementia and time-synchronized video-polysomnography (vPSG) in a laboratory.
  
  
  METHODS
  Sleep laboratory in a university hospital.
  
  
  METHODS
  348 individuals aged 60 years or older.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Among 696 subjects who were invited to participate in a vPSG study, 348 completed the vPSG. RBD was diagnosed when subjects showed REM sleep without atonia (RSWA) in the vPSG, and had history of complex and vigorous behaviors during sleep or abnormal REM sleep behaviors in the vPSG. Subjects with RSWA but no abnormal REM sleep behaviors were diagnosed with subclinical RBD. Seven subjects (5 male, 2 female) had RBD, three of whom (1 male, 2 female) had Parkinson disease. Two subjects reported history of sleep-related injury. The crude prevalence of RBD and idiopathic RBD was 2.01% (95% confidence interval [CI] = 0.54% to 3.49%) and 1.15% (95% CI = 0.03% to 2.27%). An age and sex-adjusted prevalence estimate of RBD and idiopathic RBD in the Korean elderly was 2.01% and 1.34%. Eighteen subjects were diagnosed with subclinical RBD, and the prevalence of subclinical RBD was estimated to be 4.95%.
  
  
  CONCLUSIONS
  RBD and subclinical RBD are not rare in the elderly in the community with abnormal REM sleep behaviors of RBD being mild to injurious and violent. The clinical significance and long-term progression of subclinical RBD needs to be further explored, given the prevalence and its possible relation to RBD.
authors.affiliation: Department of Psychiatry, College of Medicine, Dankook University, Chungcheongnam-do, Korea.
authors.forename: Suk-Hoon
authors.initials: SH
authors.lastname: Kang
authors.forename: In-Young
authors.initials: IY
authors.lastname: Yoon
authors.forename: Sang Don
authors.initials: SD
authors.lastname: Lee
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Han
authors.forename: Tae Hui
authors.initials: TH
authors.lastname: Kim
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D020187:REM Sleep Behavior Disorder / Q000453:epidemiology* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D014741:Video Recording
keywords: REM sleep behavior disorder; prevalence; subclinical REM sleep behavior disorder
references.citation: Sleep. 2009 Dec;32(12):1629-36
references.pmid: 20041599
references.citation: Sleep Med. 2010 Jan;11(1):43-8
references.pmid: 19945912
references.citation: Sleep Med Rev. 2009 Dec;13(6):385-401
references.pmid: 19362028
references.citation: Arch Neurol. 1999 Jan;56(1):33-9
references.pmid: 9923759
references.citation: Sleep. 1994 Sep;17(6):555-8
references.pmid: 7809570
references.citation: Sleep. 2000 Jun 15;23(4):513-7
references.pmid: 10875558
references.citation: Sleep. 2008 Dec;31(12):1627
references.pmid: 19090317
references.citation: Sleep. 1992 Jun;15(3):226-35
references.pmid: 1621023
references.citation: Sleep. 2003 Aug 1;26(5):507-12
references.pmid: 12938802
references.citation: Neurology. 2011 Sep 13;77(11):1030-2
references.pmid: 21832232
references.citation: Am J Psychiatry. 1989 Sep;146(9):1166-73
references.pmid: 2764174
references.citation: Mov Disord. 2007 Dec;22(16):2386-93
references.pmid: 17894337
references.citation: J Clin Sleep Med. 2010 Dec 15;6(6):551-5
references.pmid: 21206543
references.citation: Neurology. 2009 Apr 14;72(15):1296-300
references.pmid: 19109537
references.citation: J Sleep Res. 1993 Dec;2(4):224-231
references.pmid: 10607098
references.citation: J Clin Psychiatry. 1997 Aug;58(8):369-76; quiz 377
references.pmid: 9515980
references.citation: Sleep. 2002 Mar 15;25(2):120-38
references.pmid: 11902423
references.citation: Eur J Neurol. 2010 Mar;17(3):487-92
references.pmid: 19968708
references.citation: J Neurol Neurosurg Psychiatry. 2008 Dec;79(12):1415-6
references.pmid: 19010959
references.citation: J Womens Health (Larchmt). 2009 Dec;18(12):1955-63
references.pmid: 20044857
references.citation: Ann Neurol. 2012 Jan;71(1):49-56
references.pmid: 22275251
references.citation: Sleep Med. 2009 Jan;10(1):60-5
references.pmid: 18226952
references.citation: Sleep Med. 2009 Jun;10(6):641-5
references.pmid: 19109063
references.citation: Ann Neurol. 1992 Jul;32(1):3-10
references.pmid: 1642469
references.citation: Sleep Med. 2011 Mar;12(3):278-83
references.pmid: 21317035
references.citation: Psychiatry Clin Neurosci. 2009 Aug;63(4):557-62
references.pmid: 19659561
references.citation: Brain. 2000 Feb;123 ( Pt 2):331-9
references.pmid: 10648440
references.citation: Sleep. 2008 Aug;31(8):1179-85
references.pmid: 18714790