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Previous studies showed circadian rhythm disturbances in patients with Alzheimer's
disease. Rest-activity rhythm disturbances manifest themselves through a fragmentation
of the rhythm, a weak coupling with Zeitgebers, and high levels of activity during
the night. The aim of the present study was to investigate which factors contribute
to the presence of these disturbances. Therefore, several rest-activity rhythm, constitutional,
and environmental variables were assessed in a heterogeneous group of 34 patients
with Alzheimer's disease, including presenile and senile patients living at home or
in a nursing home, as well as in 11 healthy controls. Circadian rest-activity rhythm
disturbances were most prominent in institutionalized patients. Regression analyses
showed the involvement of the following variables. First stability of the rest-activity
rhythm is associated with high levels of daytime activity and high levels of environmental
light resulting from seasonal effects as well as from indoor illumination. Presenile
onset contributed to instability of the rhythm. Second, fragmentation of periods of
activity and rest is associated with low levels of daytime activity, and is most prominent
in moderately severe dementia. Third, night-time activity level is higher during the
times of the year when the days are getting shorter and lower when the days are growing
longer. These findings indicate that rest-activity rhythm disturbances may improve
by increasing environmental light and daytime activity, an assumption for which empirical
evidence has recently been published.
Keywords
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Article info
Publication history
Received in revised form:
April 12,
1995
Received:
February 18,
1994
Identification
Copyright
© 1996 Society of Biological Psychiatry. Published by Elsevier Inc.
