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. Author manuscript; available in PMC: 2019 Nov 1.
Published in final edited form as: Geriatr Nurs. 2018 May 24;39(6):640–645. doi: 10.1016/j.gerinurse.2018.04.014

Table 1.

Summary of studies examining the association between sleep disruption and quality of life in persons with dementia

First author(s), year, country Sample Sleep assessment Quality of life measure(s) Quality of life domain(s) Results
Shin, H-Y, 2014, South Korea 32 N=117
63 AD patients & 54 age- and sex-matched cognitively normal elderly from a memory clinic		 PSQI-K

  1. Cognitive function (K-BNT; ideomotor praxis; RCFT; SVLT; COWAT; Stroop test, MMSE

  2. Depression (GDS)

  3. Behavioral symptoms

  4. Activities of daily living (B- ADL; SI-ADL

 Physical
Social
Physiological/Emotional
Cognitive		 Sleep efficiency was positively associated with cognition (K- BNT, praxis and RCFT). Sleep latency was associated with praxis, immediate recall and recognition of the RCFT.
Ownby, R.L., 2014, United States 25 N=344
344 older adults with dementia from a memory clinic		 Investigator created sleep questionnaire

  1. Cognition (MMSE)

  2. Functional status (BDS)

  3. Depression (CSDD)

  4. Caregiver mood (CES-D)

  5. Behavioral disturbances

 Cognitive
Social
Physiological/Emotional		 Sleep disruption is associated with cognition, functional status, and depression (both in person with dementia and his/her caregiver)
McCurry, S.M., 2006, United States 26 N=46
Older adults with probable or possible Alzheimer’s disease from the community		 NPI-NBS
1 week of actigraphy (percent nighttime sleep and nocturnal sleep)
ESS
PSQI

  1. Depression (GDS, CSDD)

  2. Quality of life (QOL-AD)

  3. Behavioral disturbances (RMBPC)

  4. Physical function (PSM, IADL)

  5. Health Status (SF-36)

  6. 6. Cognition (MMSE)

 Physical
Social
Physiological/Emotional
Cognition		 Higher percent sleep was associated with better patient scores on the SF-36 physical functioning subscale, higher cognition, better IADL functioning, and less daytime sleepiness reported by caregivers on the ESS. Higher percent sleep was also associated with lower depression.
Moran, M. (2005), Ireland 28 N=224
55 persons diagnosed with probable Alzheimer’s disease at a memory clinic reported sleep disturbance, 169 – did not.		 BEHAVE-AD

  1. Daytime behavioral disturbances (BEHAVE-AD, global rating)

  2. Cognition (MMSE; CAMCOG)

  3. Function (BDS; IADL)

 Social
Physiological/Emotional
Cognitive
Physical		 Sleep disruptions were strongly associated with aggressiveness (including symptoms such as verbal outbursts, physical threats, and agitation) and global rating.
Gehrman, P., 2004, United States 27 N=149
Older adults with dementia living in nursing homes		 Actigraphy (acrophase deviation and beta parameter)

  1. Survival (public death records)

 Physical Lower acrophase deviation and higher beta parameter were associated with longer survival times.
Rongve, A., 2010, Norway and United States 31 N=571
151 community- dwelling western Norway residents with dementia and 420 participants without dementia from the Mayo Clinic Study of Aging		 NPI; ESS; MSQ

  1. Behavioral disturbances (NPI)

  2. Depression (MADRS)

  3. Apathy (Starkstein apathy scale)

  4. Parkinsonism (UPDRS)

  5. Cognition (CACF or MFS)

 Social
Physiological/Emotional		 Sleep disruption was associated with greater depression, anxiety and higher total NPI score.

Abbreviations: B-ADL - Barthel Activities of Daily Living; BDS - Blessed Dementia Scale; CACF – Clinician Assessment of Cognitive Fluctuations; CAMCOG - Cambridge Examination for Mental Disorders of the Elderly; CES-D - Center for Epidemiological Studies Depression Scale; COWAT - Controlled Oral Word Association test; CSDD - Cornell Scale for Depression in Dementia; DBRS - Disruptive Behavior Rating Scale; ESS - Epworth Sleepiness Scale; GDS - Geriatric Depression Scale; IADL – Instrumental Activities of Daily Living; K-BNT - Boston Naming Test in Korean; MADRS – Montgomery-Asberg Depression Rating Scale; MFS – Mayo Fluctuation Scale; MMSE - Mini Mental Status Exam; MSQ - The Mayo Sleep Questionnaire; NPI - Neuropsychiatric Inventory; NPI-K- Neuropsychiatric Inventory in Korean; NPI-NBS - Neuropsychiatric Inventory Nighttime Behavior Scale; PSQI - Pittsburgh Sleep Quality Index; PSQI-K - Korean version of the Pittsburgh Sleep Quality Index; PSM – Physical Self-Maintenance; RAGE - Rating Scale for Aggressive Behavior in the Elderly; RCFT - Rey-Osterrieth Complex Figure Test; RMBPC - Revised Memory and Behavior Problems Checklist; SI-ADL - Seoul-Instrumental Activities of Daily Living Scale; SF-36 Health Status Survey; SVLT - Seoul Verbal Learning Test; UPDRS - Unified Parkinson’s Disease Rating Scale.