Circadian rhythm: from preclinical to post-diagnosis dementia

Introduction

Circadian rhythm (CR) regulates body functions over the 24-hour day/night period; the sleep/wake cycle is its most visible manifestation. CR disruptions have long been observed in patients with dementia, and emerging evidence points to their presence in the preclinical period of dementia.

Significance of CR in Dementia

This suggests that certain aspects of CR could be useful in the identification of high-risk individuals and could serve as potential targets for interventions to delay dementia onset and progression. This requires an in-depth understanding of the role of CR in dementia pathogenesis.

Need for Strategies

As population ageing increases dementia burden, it is critical to find strategies to identify patients at risk of dementia with precision, prevent, and slow its progression.

Project Overview

Building on recent advances in accelerometry (to assess CR features comprehensively) and dementia biomarkers (deep-phenotyping of dementia pathogenesis), RHYTHM IN DEMENTIA will make a decisive step-change in knowledge by determining CR features involved in dementia processes along the course of the disease.

Aims of the Project

The aims are:

1. Identify core CR features that shape 10-year risk of dementia in a community-dwelling cohort of 4000 older adults.
2. Uncover specific CR disruptions that characterize major dementia subtypes and stages of Alzheimer’s disease (determined by biomarkers) in a new cohort of 1500 patients recruited from two memory clinics in Paris.
3. Ascertain how CR affects dementia prognosis in the patient cohort by examining cognitive and functional decline, hospitalization, institutionalization, and mortality.

Expected Outcomes

This project will yield new insight into the nature of the association between CR and dementia progression. These findings will ultimately inform the potential for a cost-effective and easy-to-use tool to assess CR features to facilitate both the identification of patients at risk of dementia and tailored secondary prevention interventions that address CR disruptions in dementia patients and slow the progression of dementia.