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Latest News on Family Medicine on January 2, 2019 (1 of 3)



Alcohol use and psychological stress are newly identified risk factors for possible REM sleep and behavior disorders (pRBD), according to Canadian Longitudinal Study of Aging (CLSA).

RBD is the strongest known prodromal symptom of neurodegenerative sinukleinopathy. Most patients (about 80%) with confirmed RBD will develop Parkinson's Disease (PD), Dementia with Lewy's Bodies (DLB), or multiple atrophy of the system. The risk factors for water areas remain poorly defined.

"The vast majority of people with RBD do not represent the sleep of doctors (or any physician)," said Dr Ronald B. Post, from McGill University, Montreal, Canada. "Doctors have to be on guard – if someone describes a clear case of sleep, they may be in the early stages of Parkinson's disease."

Dr. Post's team has used CLSA data from more than 30,000 participants between 2012 and 2015 to evaluate sociodemographic, socioeconomic and clinical correlations of pRBD.

After removing potential fake RBD mimics, 3.2% of the total group was considered to have pRBD, the researchers reported that Neurology, online December 26.

Age and ethnicity did not differ significantly between the participants in the pRBD and the controls, but those with pRBD had twice the likelihood that they would be men, had lower education, and were more likely to be smokers than controls. These risk factors were recorded in previous studies.

Newly identified risk factors for pRBD included higher levels of alcohol consumption, antidepressant use, higher levels of psychological disturbance, medical anxiety diagnosis and depressive disorder, and a positive screening for posttraumatic stress disorder (PTSP).

Participants with pRBD were rated on average lower than life satisfaction and social status and are more likely to report retirement due to health problems compared to controls.

"One of the most insightful things about the risk factors for REM sleep and behavior is that they only partially resemble PDs," Dr. Postman said. "If all patients receive PD or a related disorder, should they not be the same risk factors? For example, smoking, which is consistently associated with a lower risk of PD in the general population, has the opposite relationship in the water area (people with the water area are more likely to smoke ).

"It suggests that PD is not one thing, and that subtype diseases may have different relationships with risky factors," he said.

Unfortunately, Dr Postum said, even if the water area is diagnosed, little can be done to prevent the development of one of the related neurodegenerative diseases.

– Will Boggs MD

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