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Summary: Polysomnographic comparison of day-night vigilance in 8
elderly persons with vascular dementia (VD, mean age 75.3) and 14 elderly
persons with senile dementia of Alzheimer type (SDAT, mean age 76).
Activity of cholinesterase and paraoxonase in serum of these persons was
compared, as well as the activity of acetilcholinesterase and paraoxonase
in the group of 75 demented old persons (VD N=14, SDAT N=47, mixed type
N=11) was compared with the group of 45 healthy old persons.
Polysomnographic analysis showed very disturbed cyclic organization of
night sleep in all subjects, with fragmented sleep, suppression of
restitutive sleep (deep sleep - phases III and IV). Data about REM sleep
were inconsistent. Marked daily sleepiness was present in all subjects
(sleepiness index - daily sleep/daily recording = 0.5). There was no
statistically significant difference in the parameters of night sleep and
daily alertness between the two groups of demented patients (VD, SDAT).
Activity of cholinesterase and paraoxonase in serums of all the subjects,
including the polysomnographically examined group, was lower than in
the control group.
Keywords: senile dementia of Alzheimer type (SDAT), vascular dementia (VD), polysomnography, sleep, alertness, vigilance, slow-wave sleep, REM sleep, cholinesterase, paraoxonase
Research goals: Comparison of the structure of sleep and daily
alertness in elderly demented (SDAT, VD), elderly depressive patients and
control group of old persons. Comparison of polysomnographic parameters
regarding night vigilance (change of sleep phases) and parameters of daily
alertness i.e. the quality of wakefulness, with the clinical picture,
primarily the level of mental dissolution. Evaluation of the influence of
non-pharmacological methods in treating old persons as to the increase of
the level of daily alertness like for instance by means of conventional
sensory stimulation (music, TV, intensive occupational therapy etc.
Exploration of possible connection between the activity of enzymes
regulating the level of acetil cholin (cholinesterase, paraoxonase) in
serum of the patients with dementia, first of all SDAT. Evaluation of the
influence of the activity of these enzymes on day-night vigilance -
correlation of the activity of cholinesterase and paraoxonase in serum with
certain phases of night sleep or the level of daily wakefulness and/or
sleepiness. Results obtained: low level of daily alertness in SDAT and VD,
fragmented night sleep with suppression of restitutive phases of sleep;
there are no differences in parameters of daily wakefulness and night sleep
between SDAT and VD; low level of activity of cholinesterase and
paraoxonase in serum of demented patients in relation to the control group,
regardless of the type of dementia. To be done: extension of
polysomnographic recording of VD and SDAT groups for 10 more patients;
polysomnographic recording of 10 old persons with serious depression
(depression maior - DSM-III-R) and 10 persons of the control group;
correlation of the activity of certain parameters of sleep and wakefulness
with the activity of cholinesterase and paraoxonase in serums of all
subjects. Expected results: 1. low level of daily alertness in demented
persons in comparison with depressive persons and control group; 2.
negative correlation of activity of cholinesterase and paraoxonase with the
level of daily alertness and quality of night sleep.
COOPERATION - PROJECTS
Name of project
: 3-01-132 Pesticidi: Mehanizam djelovanja i
distribucije u biosferi Name of institution: Institut za medicinska istraživanja i medicinu
rada City: 10000 - Zagreb, Croatia
COOPERATION - INSTITUTIONS
Name of institution
: National Institute of Mental Health, Mental
Disorders of Aging Research Branch Type of institution: University/Faculty Type of cooperation: Occasional exchange of information City: Bethesda, USA
Name of institution
: International Psychogeriatric Association Type of institution: State administration Type of cooperation: Systematic exchange of information City: Amsterdam, Nizozemska Other information about the project.