This article reviews changes in circadian rhythms that have been reported to occur in the elderly psychiatric population. Data relating to circadian changes in normal aging are included where relevant. Information was obtained from: (1) a computerized MEDLINE search from 1975 to May 1996; (2) a review of bibliographies of papers obtained through the computerized search; and (3) texts on chronobiology. We could not locate any information relating to circadian rhythms and mania, anxiety, or paranoid disorders in old age. Disruption to the sleep/wake cycle, temperature, melatonin, and motor activity rhythms have been reported in dementia and depression, and disruption to some neuroendocrine and cardiovascular rhythms are reported in dementia. Disruption to circadian rhythmicity has implications for the management of dementia patients: for example, the sleep/wake and behavioral disturbances, and for the long-term management of mood disorders. A number of circadian markers have not been studied and several patient groups have received no research attention to date.
Get full access to this article
View all access options for this article.
References
1.
RusakBZuckerI. Neural regulation of circadian rhythms. Physiol Rev1979; 59: 449526
2.
LehmanMNSilverRGladstoneWRCircadian rhythmicity restored by neural transplant. Immunocytochemical characterization of the graft and its integration with the host brain. Neuroscience1987; 7: 16261638
3.
RefinettiRMenakerM. The circadian rhythm of body temperature. Physiol Behav1992; 51: 613637
4.
Moore-EdeMCSulzmanFMFullerCA. The clocks that time us. Cambridge: Harvard University Press, 1982
5.
CzeislerCWeitzmanEMoore-EdeMHuman sleep: its duration and organization depend on its circadian phase. Science1980; 210: 12641267
6.
WeverRA. Order and disorder in human circadian rhythmicity. Possible relations to mental disorders. In: KupferDJMonkTHBarchasJ eds. Biological rhythms and mental disorders. New York: Guildford Press, 1988
7.
CluastratBChazotGBrunJA chronobiological study of melatonin and cortisol secretion in depressed subjects: plasma melatonin, a biochemical marker in major depression. Biol Psychiatry1984; 19: 12151228
8.
SwaabDFFliersEPartimanTS. The supracahismatic nucleus of the human brain in relation to sex, age and senile dementia. Brain Res1985; 342: 3744
9.
AlexopoulosGSMeyersBSYoungRCBrain changes in geriatric depression. Int J Geriatr Psychiatry1988; 3: 157161
10.
BroadheadJJacobyR. Mania in old age: a first prospective study. Int J Geriatr Psychiatry1990; 5: 215222
11.
AlmeidaOPHowardRForstlHLate paraphrenia: a review. Int J Geriatr Psychiatry1992; 7: 543548
12.
SchulmanKITohenMSatlinAMania compared with unipolar depression in old age. Am J Psychiatry1992; 149: 341345
13.
PrinzPNVitalianoPVitielloMVSleep EEG and mental function changes in senile dementia of the Alzheimer's type. Neurobiol Aging1982; 3: 361370
14.
DoriDCasaleGSloerteSBChrono-neuroendocrinological aspects of physiological aging and senile dementia. Chronobiologia1994; 211: 1-2; 121126
15.
BjorkstenKSBasunHWetterbergL. Disorganized sleep-wake schedule associated with neuroendocrine abnormalities in dementia. A clinical study. Int J Geriatr Psychiatry1995; 10: 107113
16.
TouitouYSulonYBogdanAAdrenal circadian system in young and elderly human subjects: a comparative study. J Endocrinol1982; 93: 201210
17.
TouitouYFevreMLagogueyMAge and mental health related circadian rhythms of plasma levels of melatonin, prolactin, luteinizing hormone and follicle-stimulating hormone in man. J Endocrinol1981; 91: 467475
18.
BrockMA. Chronobiology and aging. J Am Geriatr Soc1991; 39: 7491
19.
Van GoolWAMirmiranM. Aging and circadian rhythms. Prog Brain Res1986; 70: 255277
20.
VitielloMVPocetaJSPrinzPN. Sleep in Alzheimer's disease and other dementing disorders. Can J Psychol1991; 45: 221239
21.
BliwiseDL. Sleep in normal aging and dementia. Sleep1993; 16: 4081
22.
ZepelinH. Normal age-related changes in sleep. In: ChaseMWeizmanE eds. Sleep disorders. Basic and clinical research. New York: SP Medical, 1983: 431444
23.
WilliamsRLKaracanIHurschCJ. EEG of human sleep. Clinical applications. New York: Wiley, 1974
24.
PrinzPN. Sleep patterns in healthy aged: relationships with intellectual functioning. J Gerontol1977; 32: 179186
25.
GillinJCDuncanWCMurphyDLAge-related change in sleep in depressed and normal subjects. Psychiatry Res1981: 7378
26.
SpiegelR. Sleep and sleeplessness in advanced age. New York: SP Medical, 1981
27.
BliwiseDLBevierWCBliwiseWCSystematic 24 hour behavioural observation of sleep and wakefulness in a skilled care nursing facility. Psychol Aging1990; 5: 1624
28.
CampbellSSDawsonD. Aging young sleep: a test of the phase advance hypothesis of sleep disturbance in the elderly. J Sleep Res1992; 1: 205210
29.
VitielloMVPrinzPNAveryDHSleep is undisturbed in elderly, depressed individuals who have not sought health care. Biol Psychiatry1990; 27: 431440
30.
ReynoldsCFKupferDJHouckPReliable discrimination of elderly depressed and demented patients by electroencephalographic sleep data. Arch Gen Psychiatry1988; 45: 258264
31.
ReynoldsCFKupferDJTaskaLSEEG sleep in elderly depressed, demented, and healthy subjects. Biol Psychiatry1985; 20: 431442
32.
GillinCDuncanWCMurphyDLAge-related changes in sleep in depressed and normal subjects. Psychiatry Res1981; 4: 7378
33.
WetterbergLAperiaBGorelickDAAge, alcoholism and depression are associated with low levels of urinary melatonin. J Psychiatry Neurosci1992; 17: 215224
34.
ZulleyJWeverRAschfffJ. The dependence of onset and duration of sleep on the circadian rhythm of rectal temperature. Pflugers Arch1981; 314318
35.
TouitouYReinbergABogdanA. Age related changes in both circadian and seasonal rhythms of rectal temperature with special reference to senile dementia of Alzheimer type. Gerontology1986; 32: 110118
36.
VitielloMVSmallwoodRGAveryDHCircadian temperature rhythms in young adult and aged men. Neurobiol Aging1986; 7: 97100
37.
PrinzPNMoeKEVitielloMVEntrained body temperature rhythms are similar in mild Alzheimer's disease, geriatric onset depression, and normal aging. J Geriatr Psychiatry Neurol1992; 5: 6571
38.
PrinzPNChristieCSmallwoodRCircadian temperature variation in healthy aged and in Alzheimer's disease. J Gerontol1984; 39: 3035
39.
OkawaMMishimaYHozumiSCircadian waking disorders in sleep-waking and body temperature in elderly patients with dementia and their treatment. Sleep1991; 14: 478485
40.
Van de NesJAPKamphorstWDavidRThe distribution of Alz-50 immunoreactivity in the hypothalamus and adjoining areas of Alzheimer's disease patients. Brain1993; 116: 103115
41.
FordDEKamerowDB. Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention?J Am Med Assoc1989; 262: 14791484
42.
LewyAJAhmedSJacksonJM. Melatonin shifts human circadian rhythms according to a phase-response curve. Chronobiol Int1992; 9: 380392
43.
DollinsABZhdanovaIVWurtmanRJ. Effect of inducing nocturnal serum melatonin concentrations in daytime on sleep, mood, body temperature, and performance. Proc Natl Acad Sci U S A1994; 91: 18241828
44.
LewyAJWehrTAGoodwinF. Light suppresses melatonin secretion in humans. Science1980; 210: 12671268
45.
IguchiHKatoKIIbayashiH. Age-dependent reduction in serum melatonin concentrations in healthy elderly subjects. J Clin Endocrinol Metab1982; 55: 2729
46.
Van CoevordenAMockelJLaurentENeuroendocrine rhythms and sleep in aging men. Am J Physiol1991; 260: E651661
47.
HaimovILaudonMZisapelNSleep disorders and melatonin rhythms in elderly people. Br Med J1994; 309: 167
48.
CarnazzoGPatterno-RaddusaFTravaliS. Variations of melatonin incretion in elderly patients affected by cerebral deterioration. Arch Gerontol Geriatrics1991; 12 (suppl 2): 123126
49.
ArendtJWirz-JusticeABradtkeKronemarkM. Long term studies on immunoreactive human melatonin. Ann Clin Biochem1979; 16: 307312
50.
TouitouYFevreMBogdanAPatterns of plasma melatonin with aging and mental conditions: stability of nyctohemeral rhythms and differences in seasonal variations. Acta Endocrinol1984; 106: 145151
51.
SkeneDJVivien-RoelsBSparksDLDaily variation in the concentration of melatonin and 5-methoxytryptophol in the human pineal gland: effect of age and Alzheimer's disease. Brain Res1990; 528: 170174
52.
MurialdoGCostelliPFonziSCircadian secretion of melatonin and thyrotropin in hospitalized aged patients. Aging Clin Exper Res1993; 5: 3946
53.
TouitouYSulonJBogdanAAdrenocortical hormones, aging and mental condition: seasonal and circadian rhythms of plasma 18-hydroxy-11-deoxycorticosterone, total and free cortisol and urinary corticosteroids. J Endocrinol1983; 96: 5364
54.
FranceschiMAiraghiLGramignaCACTH and cortisol secretion in patients with Alzheimer's disease. J Neurol Neurosurg Psychiatry1991; 54: 836837
WittingWKwaIHEikelenbloomPAlterations in the circadian rest-activity rhythm in aging and Alzheimer's disease. Biol Psychiatry1990; 27: 563572
57.
SatlinATeicherMHLiebermanHRCircadian locomotor activity in Alzheimer's disease. Neuropsychopharmacology1991; 5: 115126
58.
CampbellSGillinJCKripkeDF. Ambulatory recording of rest/activity, body temperature and light exposure in normal elderly and Alzheimer's disease. Sleep Res1986; 15: 264
59.
TeicherMHLawrenceJMBarberNIIncreased activity and phase delay in circadian motility rhythms in geriatric depression. Arch Gen Psychiatry1988; 45: 913917
60.
KupferDJWeissBLFosterFGPsychomotor activity in affective states. Arch Gen Psychiatry1974; 132: 928931
61.
WehrTAMuscettolaGGoodwinFK. Urinary 3-methoxy-4-hydroxy phenylglycol circadian rhythms: early timing (phase-advance) in manic-depressives compared with normal subjects. Arch Gen Psychiatry1980; 37: 257263
62.
OtsukaAMikamiHKatahiraKAbsence of nocturnal fall in blood pressure in elderly persons with Alzheimer-type dementia. J Am Geriatr Soc1990; 38: 973978
63.
Van SomerenEJWHagebeukESwaabDFCircadian rest-activity rhythm disturbances in Alzheimer's disease. Sleep Wake Res Neth1983; 4: 189191
64.
HintonDRSadunAABlanksJCMillerCA. Optic-nerve degeneration in Alzheimer's disease. N Engl J Med1986; 315: 485487
