Sleep variables in the S‐CitAD RCT of escitalopram for agitation in Alzheimer's disease
Bibliographic record
Abstract
BACKGROUND: Sleep commonly is disturbed in Alzheimer's disease (AD) and poor sleep may accelerate AD progression. Disturbed sleep may contribute to neuropsychiatric symptoms (NPS) of AD, including agitation. We examined associations between actigraphic sleep parameters with baseline agitation and changes in agitation with escitalopram treatment among participants in the S-CitAD trial. METHOD: S-CitAD was a 12-week randomized controlled trial of escitalopram for agitation in AD. Of 173 S-CitAD participants, 32 (age = 79 +/-9.93 years, 43.7 % female, 12.5 % non-White) had actigraphic sleep data (median 13 nights at baseline). Agitation was measured with the NPI-C Agitation and Aggression (NPI-C-A+A) domains. We measured standard sleep variables (awakening length, number of awakenings, efficiency, fragmentation index, latency, total activity counts during sleep, total minutes in bed, total sleep time, wake after sleep onset). RESULT: Of the 32 participants with baseline actigraphy data, 9 had follow-up at week 12. The actigraphy subset had mean age of 79 +/-9.9 years, were 56% male, had Mini-Mental State Exam (MMSE) scores of 18.5 +/-8.2 and baseline NPI-C A/A scores of 16.0+/-6.2 (Table 1). There were no significant associations of sleep variables with baseline agitation or with change in agitation at 12 weeks. Escitalopram responders, defined by a decrease in NPI-C A/A of ≥ 4 at 12 weeks, had a smaller decline in sleep latency than placebo responders at 12 weeks (p = 0.002) Escitalopram participants (responders and nonresponders) had a smaller reduction in sleep latency (0.60 min vs. 2.81) and total minutes in bed (8 min increase vs. 35 min decrease on placebo) relative to people on placebo (Table 2). Although not significant, there was a trend for participants with worse baseline sleep efficiency to have greater 12-week improvement in agitation. (Figure 1) CONCLUSION: We observed no association of sleep variables with baseline agitation or change in agitation with treatment. Escitalopram exposure was associated with modest changes in selected sleep parameters. These findings may inform future studies of agitation in AD as well as targets for future treatments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".