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April 05, 2016; 86 (14) Article

Risk factors for probable REM sleep behavior disorder

A community-based study

Janice C. Wong, Junjuan Li, Milena Pavlova, Shuohua Chen, Aiping Wu, Shouling Wu, Xiang Gao
First published January 27, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002414
Janice C. Wong
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Junjuan Li
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Milena Pavlova
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Shuohua Chen
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Aiping Wu
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Shouling Wu
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Xiang Gao
From the Department of Neurology (J.C.W., M.P.), Brigham and Women's Hospital, Boston; Harvard Medical School (J.C.W., M.P.), Boston; Department of Neurology (J.C.W.), Massachusetts General Hospital, Boston; Department of Internal Medicine (J.L., S.C., A.W., S.W.), Kailuan Hospital Affiliated to Hebei United University, Tangshan, China; and Department of Nutritional Science (X.G.), The Pennsylvania State University, University Park.
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Citation
Risk factors for probable REM sleep behavior disorder
A community-based study
Janice C. Wong, Junjuan Li, Milena Pavlova, Shuohua Chen, Aiping Wu, Shouling Wu, Xiang Gao
Neurology Apr 2016, 86 (14) 1306-1312; DOI: 10.1212/WNL.0000000000002414

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Abstract

Objective: To examine risk factors for REM sleep behavior disorder (RBD) in a large-scale community-based study.

Methods: This community-based study included 12,784 Chinese adults (10,556 men and 2,228 women, aged 24 years or older) who were free of Parkinson disease and dementia in 2012. Probable RBD (pRBD) status was determined by a validated questionnaire (Chinese RBD questionnaire–Hong Kong) in 2012. Potential risk factors—including age, sex, smoking, socioeconomic status, physical activity, obesity, consumption of tea (surrogate for caffeine intake) and alcohol, serum concentrations of lipids and glucose, and chronic disease status—were assessed in 2006. Logistic regression was used to calculate odds ratios and 95% confidence intervals and to test differences in prevalence of pRBD across exposures.

Results: Prevalence of pRBD was 5.9% in men and 4.1% in women. In the fully adjusted model, risk factors that were significantly associated with a higher risk of having pRBD included lower education level, coal mining and other blue collar occupation, lower physical activity level, diabetes or prediabetes, lower body mass index, head injury, higher low-density lipoprotein level, and chronic olfactory and taste dysfunction. In sensitivity analyses, restricting to pRBD cases with symptom onset within 1 year or excluding coal miners or those with history of head injury generated similar results.

Conclusion: We found several potential risk factors for pRBD, including socioeconomic status, head injury, olfactory and taste dysfunction, and various cardiovascular risk factors. Future prospective studies to establish the temporal relationship between these potential risk factors and RBD are warranted.

GLOSSARY

CI=
confidence interval;
DLB=
dementia with Lewy bodies;
HDL=
high-density lipoprotein;
LDL=
low-density lipoprotein;
OR=
odds ratio;
PD=
Parkinson disease;
pRBD=
probable REM sleep behavior disorder;
RBD=
REM sleep behavior disorder;
RBDQ-HK=
REM sleep behavior disorder questionnaire–Hong Kong

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received July 31, 2015.
  • Accepted in final form December 14, 2015.
  • © 2016 American Academy of Neurology
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