Phenoconversion in Women and Men With Isolated REM Sleep Behavior Disorder: A Retrospective Cohort Study.
Christina A Alexandres1, Stuart J McCarter1, Grace M Tabatabai1
1From the Mayo Center for Sleep Medicine (C.A.A., S.J.M., G.M.T., L.L.-V., J.C.F., T.R.G., E.P.S., J.T.J., M.R.K., T.F., E.J.O., D.J.S., T.J.M., M.J., M.L., J.L.M., M.T.-P., D.Z.C., M.H.S., E.K.S.L.), Department of Neurology; Mayo Center for Sleep Medicine (S.J.M., G.M.T., L.L.-V., J.C.F., T.R.G., E.P.S., J.T.J., M.R.K., T.F., D.J.S., T.J.M., M.J., M.L., J.L.M., M.T.-P., D.Z.C., M.H.S., E.K.S.L.),; Department of Neurology (F.A., H.B., J.G.-R., R.S., W.S., B.F.B.); Department of Radiology (K.K.); Department of Cardiovascular Medicine (N.C., V.K.S.); Department of Medicine (J.L.K.); and Mayo Center for Sleep Medicine (C.A.M.), Department of Pediatrics, Mayo Clinic.
Neurology
|October 25, 2024
Summary
Age at diagnosis is a key factor for predicting neurodegenerative disease conversion in isolated REM sleep behavior disorder (iRBD) patients. This finding is crucial for understanding disease progression in both men and women with iRBD.
Area of Science:
- Neurology
- Sleep Medicine
- Neurodegenerative Diseases
Background:
- Isolated REM sleep behavior disorder (iRBD) is a significant predictor of synucleinopathies.
- Existing research on iRBD cohorts predominantly features older males, leaving a gap in understanding phenoconversion risks for women and younger individuals.
- The clinical characteristics influencing neurodegenerative conversion in diverse iRBD populations require further investigation.
Purpose of the Study:
- To identify clinical features associated with phenoconversion to a defined neurodegenerative disorder in men and women diagnosed with iRBD.
- To compare phenoconversion rates and associated factors between sexes and age groups within an iRBD cohort.
- To clarify the role of specific comorbidities and treatments in the neurodegenerative progression of iRBD.
Main Methods:
- A cohort study involving 186 women and 186 men with iRBD, matched by polysomnography date.
- Chart review was used to abstract baseline clinical data and subsequent neurodegenerative outcomes.
- Kaplan-Meier survival analysis and Cox proportional hazards modeling were employed to assess conversion rates and identify risk factors.
Main Results:
- The average age of iRBD diagnosis was lower in women (54.9 years) than in men (62.5 years).
- Over a median follow-up of 6.0 years, 12.9% of patients (48 total) phenoconverted.
- Age at diagnosis emerged as the sole independent predictor of phenoconversion (HR 1.09), after adjusting for symptom duration, sex, and comorbidities.
Conclusions:
- Age at diagnosis is a critical and independent factor influencing the risk of phenoconversion in individuals with isolated REM sleep behavior disorder.
- These findings highlight the importance of age in predicting neurodegenerative disease development following an iRBD diagnosis.
- Further research should explore sex-specific differences and the impact of comorbidities on iRBD progression.
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