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Posted: September 12, 2006

Sleep Walking and Talking May Predict Dementia Likelihood

Sleep behavior disorders, including walking and talking in one’s sleep, may be a harbinger of dementia later in life, according to ongoing research by the Mayo Clinic of Arizona.
These characteristics, called dream-enactment behavior or DEB, are symptomatic of REM sleep behavior disorder. Such behavior has been witnessed in dementia patients and can be accompanied by other defining symptoms such as hallucinations or loss of motor function.
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The REM disorder is evident in patients who yell, scream, talk or move their arms and legs during sleep in ways that distinctly act out their dreams. Researchers are especially focused on these characteristics as they are exhibited by baby boomers and how they may foretell dementia as they age.
"There are many normal people running around who talk in their sleep," Dr. Richard Caselli, the study's lead researcher and chair of neurology at Mayo Clinic, told The Arizona Republic newspaper in Phoenix. Caselli cautioned that not all sleep-walking or talking is likely to foretell dementia.
DEB is an indication of dementia with Lewy bodies, a form of mental deterioration that affects the elderly, when it is accompanied by certain brain abnormalities. This connection led Caselli and colleagues to study whether early DEB may signal later onset of dementia with Lewy bodies, which is the second most common form of dementia after Alzheimer’s disease.
His research focuses on a comparison of brain imaging with answers on a research participant survey. The brain images test for low brain metabolism, which is a sign of dementia. The questionnaires cover sleep behavior, such as walking and talking.
To date, researchers have found that while DEB in young people isn't linked to dementia, it can be among those older than age 50. In the Mayo research, 17 healthy patients over age 50 who had DEB were also found to have reduced brain metabolism.
Caselli's study makes it clearer who will later be affected by Lewy body dementia, but it offers no interventional help for the disease, which has no cure.

"If something wonderful comes up that would allow us to prevent things from getting worse, that would change things," Caselli told The Arizona Republic. For now, the research provides an early warning, said Caselli, who continues to enroll people in the study in Arizona.

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