Low-Dose Atypical Antipsychotic Risperidone Improves the 5-Year Outcome in Alzheimer's Disease Patients with Sleep Disturbances.
Sleep disturbances (SD) accelerate the progression of Alzheimer's disease (AD) and increase the stress of caregivers. However, the long-term outcome of disturbed nocturnal sleep/wake patterns in AD and on increased stress of spousal caregivers is unclear. This study assessed the 5-year effect of nocturnal SD on the long-term outcome in AD patients. A total of 156 donepezil-treated mild-moderate AD patients (93 AD + SD and 63 AD - SD as a control group) were recruited. The AD + SD patients were formed into 4 subgroups according to the preferences of spousal caregivers for treatment with atypical antipsychotics (0.5-1 mg risperidone, n = 22), non-benzodiazepine hypnotic (5-10 mg zolpidem tartrate, n = 33), melatonin (2.55 mg, n = 9), or no-drug treatment (n = 29). SD were evaluated by polysomnography, sleep scale, and cognitive scale examinations. Moreover, all spousal caregivers of AD patients were assessed using a series of scales, including sleep, anxiety, mood, and treatment attitude scales. Our data showed that nocturnal sleep/wake disturbances were significantly associated with lower 5-year outcomes for AD patients, earlier nursing home placement, and more negative emotions of spousal caregivers. Treatment with low-dose atypical antipsychotic risperidone improved the 5-year outcome in AD + SD patients. In conclusion, low-dose atypical antipsychotic risperidone improves the 5-year outcome in AD patients with SD. Moreover, improvement of nocturnal sleep problems in AD patients will also bring better emotional stability for AD caregivers.
Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
You
Y
Yin
Yan
Y
Liu
Jianhua
J
Zhuang
Xiao
X
Pan
Peng
P
Li
Yuechang
Y
Yang
Yan-Peng
YP
Li
Zheng-Qing
ZQ
Zhao
Liu-Qing
LQ
Huang
Zhong-Xin
ZX
Zhao
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017028:Caregivers / Q000523:psychology; D000077265:Donepezil; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007189:Indans / Q000627:therapeutic use; D008297:Male; D008550:Melatonin / Q000627:therapeutic use; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use; D009735:Nursing Homes; D010880:Piperidines / Q000627:therapeutic use; D017286:Polysomnography; D011725:Pyridines / Q000627:therapeutic use; D018967:Risperidone / Q000008:administration & dosage / Q000627:therapeutic use*; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D016896:Treatment Outcome; D000077334:Zolpidem
D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D011725:Pyridines; D000077334:Zolpidem; D000077265:Donepezil; D008550:Melatonin; D018967:Risperidone