These authors contributed equally to this work.
Article first published online: 9 FEB 2012
Copyright © 2012 Movement Disorder Society
Volume 27, Issue 6, pages 720–726, May 2012
How to Cite
Postuma, R. B., Bertrand, J.-A., Montplaisir, J., Desjardins, C., Vendette, M., Rios Romenets, S., Panisset, M. and Gagnon, J.-F. (2012), Rapid eye movement sleep behavior disorder and risk of dementia in Parkinson's disease: A prospective study. Mov. Disord., 27: 720–726. doi: 10.1002/mds.24939
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 30 MAY 2012
- Article first published online: 9 FEB 2012
- Manuscript Accepted: 6 JAN 2012
- Manuscript Revised: 4 JAN 2012
- Manuscript Received: 8 SEP 2011
- Canadian Institutes of Health Research and the Fonds de recherche du Québec - Santé
- REM sleep behavior disorder;
- Parkinson's disease;
One of the most devastating nonmotor manifestations of PD is dementia. There are few established predictors of dementia in PD. In numerous cross-sectional studies, patients with rapid eye movement (REM) sleep behavior disorder (RBD) have increased cognitive impairment on neuropsychological testing, but no prospective studies have assessed whether RBD can predict Parkinson's dementia. PD patients who were free of dementia were enrolled in a prospective follow-up of a previously published cross-sectional study. All patients had a polysomnogram at baseline. Over a mean 4-year follow-up, the incidence of dementia was assessed in those with or without RBD at baseline using regression analysis, adjusting for age, sex, disease duration, and follow-up duration. Of 61 eligible patients, 45 (74%) were assessed and 42 were included in a full analysis. Twenty-seven patients had baseline RBD, and 15 did not. Four years after the initial evaluation, 48% with RBD developed dementia, compared to 0% of those without (P-adjusted = 0.014). All 13 patients who developed dementia had mild cognitive impairment on baseline examination. Baseline REM sleep atonia loss predicted development of dementia (% tonic REM = 73.2 ± 26.7 with dementia, 40.8 ± 34.5 without; P = 0.029). RBD at baseline also predicted the new development of hallucinations and cognitive fluctuations. In this prospective study, RBD was associated with increased risk of dementia. This indicates that RBD may be a marker of a relatively diffuse, complex subtype of PD. © 2012 Movement Disorder Society