Memory Clinic, 5 Borough Partnership NHS Trust, Brooker Centre, Halton Hospital, Runcorn, UK.
Int J Geriatr Psychiatry. 2009 Nov;24(11):1237-41. doi: 10.1002/gps.2251.
Since sleep is important for physiological memory function, sleep disturbance may contribute to subjective memory complaints and objective memory impairments independent of brain pathology. We investigated the diagnostic utility of the Pittsburgh Sleep Quality Index (PSQI) as an independent test to differentiate patients with and without dementia at the initial clinical diagnostic interview in dedicated memory clinics.
PSQI was administered to consecutive new patient referrals to two memory clinics over a 2-year period, independent of other tests (interview, neuropsychology, imaging) which were used to establish diagnoses according to standard diagnostic criteria (DSM-IV), and results were compared.
In a cohort of 310 patients, 50% fulfilling clinical diagnostic criteria for dementia, PSQI scores and subscores showed suboptimal sensitivity, specificity, positive and negative predictive values (PPV, NPV) and area under the Receiver Operating Characteristic (ROC) curve for the diagnosis of dementia, and likelihood ratios were unimportant. However, the proportion of poor sleepers was significantly larger in the non-demented as compared to the demented patient group.
PSQI scores were suboptimal for dementia diagnosis using traditional diagnostic parameters, but were pragmatically useful in identifying non-demented 'memory complainers' with poor sleep quality. This observation may have therapeutic implications for these patients.
由于睡眠对生理记忆功能很重要，因此睡眠障碍可能会导致主观记忆主诉和客观记忆障碍，而与大脑病理无关。我们研究了匹兹堡睡眠质量指数（PSQI）作为一种独立测试，用于在专门的记忆诊所的初始临床诊断访谈中区分有和无痴呆的患者的诊断效用。
在两年的时间里，对两个记忆诊所的连续新患者进行了 PSQI 评估，与其他测试（访谈、神经心理学、影像学）独立进行，这些测试根据标准诊断标准（DSM-IV）用于确定诊断，然后比较结果。
在 310 名患者的队列中，50%符合痴呆的临床诊断标准，PSQI 评分和子评分的诊断痴呆的敏感性、特异性、阳性和阴性预测值（PPV、NPV）和接收器操作特征（ROC）曲线下面积以及似然比均不理想。然而，与痴呆患者组相比，非痴呆患者组的睡眠质量差的患者比例明显更大。
PSQI 评分对于使用传统诊断参数诊断痴呆不理想，但在识别睡眠质量差的非痴呆“记忆抱怨者”方面具有实际用途。这一观察结果可能对这些患者具有治疗意义。
