Original Article

Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: A population-based study

  1. Brendon P. Boot MBBS1,
  2. Bradley F. Boeve MD1,2,*,
  3. Rosebud O. Roberts MBChB3,
  4. Tanis J. Ferman PhD4,
  5. Yonas E. Geda MD, MSc3,4,
  6. V. Shane Pankratz PhD3,
  7. Robert J. Ivnik PhD4,
  8. Glenn E. Smith PhD4,
  9. Eric McDade DO1,†,
  10. Teresa J. H. Christianson BSc3,
  11. David S. Knopman MD1,
  12. Eric G. Tangalos MD5,
  13. Michael H. Silber MBChB1,2,
  14. Ronald C. Petersen PhD, MD1,3

Article first published online: 24 JAN 2012

DOI: 10.1002/ana.22655

Issue

Annals of Neurology

Annals of Neurology

Volume 71, Issue 1, pages 49–56, January 2012

Additional Information

How to Cite

Boot, B. P., Boeve, B. F., Roberts, R. O., Ferman, T. J., Geda, Y. E., Pankratz, V. S., Ivnik, R. J., Smith, G. E., McDade, E., H. Christianson, T. J., Knopman, D. S., Tangalos, E. G., Silber, M. H. and Petersen, R. C. (2012), Probable rapid eye movement sleep behavior disorder increases risk for mild cognitive impairment and Parkinson disease: A population-based study. Ann Neurol., 71: 49–56. doi: 10.1002/ana.22655

Author Information

  1. 1

    Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN and Jacksonville, FL

  2. 2

    Center for Sleep Medicine, and Mayo Clinic College of Medicine, Rochester, MN and Jacksonville, FL

  3. 3

    Departments of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN and Jacksonville, FL

  4. 4

    Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN and Jacksonville, FL

  5. 5

    Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN and Jacksonville, FL

  1. †

    Department of Neurology, University of Pittsburgh, Pittsburgh, PA

*Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905

Publication History

  1. Issue published online: 24 JAN 2012
  2. Article first published online: 24 JAN 2012
  3. Accepted manuscript online: 31 OCT 2011 06:44AM EST
  4. Manuscript Accepted: 14 OCT 2011
  5. Manuscript Revised: 5 SEP 2011
  6. Manuscript Received: 30 APR 2011

Funded by

  • NIH
  • National Institute on Aging. Grant Numbers: U01 AG06786, P50 AG016574, RO1 AG15866, K01 AG028573, K01 MH068351, R01 AR030582, R01 AG034676
  • Harold Amos Medical Faculty Development Program (RWJ foundation)
  • Robert H. and Clarice Smith and Abigail Van Buren Alzheimer's Disease Research Program

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Abstract

Objective:

Rapid eye movement sleep behavior disorder (RBD) is associated with neurodegenerative disease and particularly with the synucleinopathies. Convenience samples involving subjects with idiopathic RBD have suggested an increased risk of incident mild cognitive impairment (MCI), dementia (usually dementia with Lewy bodies), and Parkinson disease (PD). There are no data on such risks in a population-based sample.

Methods:

Cognitively normal subjects aged 70 to 89 years in a population-based study of aging who screened positive for probable RBD using the Mayo Sleep Questionnaire were followed at 15-month intervals. In a Cox proportional hazards model, we measured the risk of developing MCI, dementia, and PD among the exposed (probable RBD [pRBD]+) and unexposed (pRBD−) cohorts.

Results:

Forty-four subjects with pRBD+ status at enrollment (median duration of pRBD features was 7.5 years) and 607 pRBD− subjects were followed prospectively for a median of 3.8 years. Fourteen of the pRBD+ subjects developed MCI, and 1 developed PD (15/44 = 34% developed MCI/PD); none developed dementia. After adjustment for age, sex, education, and medical comorbidity, pRBD+ subjects were at increased risk of MCI/PD (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.3–3.9; p = 0.005). Inclusion of subjects who withdrew from the study produced similar results, as did exclusion of subjects with medication-associated RBD. Duration of pRBD symptoms did not predict the development of MCI/PD (HR, 1.05 per 10 years; 95% CI, 0.84–1.3; p = 0.68).

Interpretation:

In this population-based cohort study, we observed that pRBD confers a 2.2-fold increased risk of developing MCI/PD over 4 years. ANN NEUROL 2012;71:49–56

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