Sleep/awake status throughout the night and circadian motor activity patterns in older nursing-home residents with or without dementia, and older community-dwelling people without dementia

Background: Sleep disturbances are commonly observed in older nursing home residents, mainly in combination with dementia. However, sleep-associated circadian motor activity patterns have not been thoroughly investigated in Japanese nursing homes. The present study aimed to respectively clarify the effect of community living and the presence of dementia on sleep disturbances and interrupted activity rhythm of older nursing-home residents with or without dementia and older community-dwelling people without dementia. Methods: Actigraph devices worn on the participants' non-dominant wrists for seven days were used to collect objective measurements of the sleep/awake status throughout the night and the circadian motor activity patterns. The presence of dementia was assessed by a trained medical doctor using the residents' records and the Clinical Dementia Rating (CDR). The functional capacity of the participants was determined using the Barthel Index (BI). Results: Fifty-one older people in Akita prefecture were included in the current study, consisting of 17 residents with dementia (mean age: 82.2 years), 17 residents without dementia (84.5 years), and 17 community-dwelling people (83.6 years). The results showed that older nursing-home residents with dementia had significantly a lower rate of sleep efficiency and a longer awake time throughout the night than the other groups. Older nursing-home residents with and without dementia had more fragmented rhythm than community-dwelling people without dementia. Conclusion: These results provide evidence of poor sleep/awake status throughout the night and interrupted circadian activity rhythms in nursing-home residents with and without dementia. However, further studies performed according to dementia classifications are needed.