Faculty of Medical Technique, Department of Clinical Laboratory Science, Teikyo University, Tokyo, Japan.
Department of Somnology, Tokyo Medical University, Tokyo, Japan.
Sleep. 2020 Aug 12;43(8). doi: 10.1093/sleep/zsaa024.
To evaluate the prevalence and clinical characteristics of isolated REM sleep behavior disorder (iRBD) among a general population of elderly Japanese people.
This epidemiological study targeted 2714 elderly residents (76.0 ± 8.0 years, 52.9% female) of a rural community. Questionnaires including the REM sleep behavior disorder single question and demographic information were distributed. All respondents with the question positive were interviewed by telephone. Respondents suspected of having iRBD proceeded to face-to-face interviews and underwent video-polysomnography and neurological/neuropsychological examination. These results were compared to those of previously diagnosed clinical iRBD patients in our sleep clinic.
Of 1464 respondents to the questionnaire, 18 respondents were diagnosed as iRBD (1.23 [0.66-1.79]%), including eight respondents who satisfied diagnostic criteria with REM sleep without atonia (RWA) above the cut-off value (0.54 [0.17-0.92]%) and 10 respondents who had clear dream enactment behaviors but not RWA above the cut-off (provisionally diagnosed iRBD; p-iRBD) (0.69 [0.26-1.11]%). Severity of RBD and RWA of the population-based iRBD were compatible with those of the clinical iRBD. Half of the population-based iRBD showed orthostatic hypotension and they showed lower olfactory function than population-based p-iRBD and non-RBD. However, their olfactory and cognitive functions were higher than those in the clinical iRBD patients.
Prevalence of iRBD in Japanese elderly people was comparable with the rate reported from other countries. Population-based iRBD/p-iRBD showed lower neurodegenerative loading than clinical iRBD in spite of comparable disease duration of RBD, that may indicate their lower risk of future neurodegeneration.
评估日本老年人群中 REM 睡眠行为障碍（RBD）的患病率和临床特征。
本项流行病学研究以农村地区的 2714 名老年人（76.0±8.0 岁，52.9%为女性）为研究对象。发放包含 REM 睡眠行为障碍单一问题和人口统计学信息的调查问卷。对所有问题阳性的受访者进行电话访谈。疑似 RBD 的受访者进行面对面访谈，并进行视频多导睡眠图和神经学/神经心理学检查。将这些结果与我们睡眠诊所中已确诊的临床 RBD 患者进行比较。
在回答问卷的 1464 名受访者中，有 18 名被诊断为 RBD（1.23%[0.66-1.79%]），其中 8 名满足 REM 睡眠无张力（RWA）高于截断值（0.54%[0.17-0.92%]）的诊断标准，10 名有明确的梦境行为但 RWA 未高于截断值（暂定诊断为 RBD；p-RBD）（0.69%[0.26-1.11%]）。基于人群的 RBD 和 RWA 的严重程度与临床 RBD 相符。基于人群的 RBD 中有一半存在体位性低血压，且嗅觉功能较基于人群的 p-RBD 和非-RBD 差。然而，他们的嗅觉和认知功能高于临床 RBD 患者。
日本老年人 RBD 的患病率与其他国家报道的患病率相当。基于人群的 RBD/p-RBD 尽管 RBD 持续时间相同，但神经退行性病变的负荷低于临床 RBD，这可能表明其未来神经退行性病变的风险较低。
