[Dreams in normal and pathological aging].

Dream recall declines from early adulthood onward, not specifically in old age, and dream reports become less intense perceptually and emotionally. This decline occurs faster in men than women, with gender differences in dream content. Changes in lifestyle and attitude toward dreams in early adulthood partly explain the decline, but modifications of sleep physiology, especially the decrease and qualitative changes in REM sleep, are the main cause. Dreams hold little subjective importance for most older adults, though working with dreams can aid psychotherapy. Patients with degenerative dementia dream much less than healthy older adults; in Alzheimer's disease, this may relate to reduced REM sleep and atrophy of associative sensory cortex. REM sleep behavior disorders and nightmares induced by cholinesterase inhibitors are the most studied aspects of dreaming in cognitive disorders.

Study at a glance

Abstract

Although most of scientific knowledge in dream research is based on young adult studies, this article provides a review of the effects of normal and pathological aging on dream psychology. It starts with preliminary comments about epistemological and methodological principles of dream research, its singularities in aged persons, and the modifications of sleep physiology with age. The whole literature agrees that dream recall progressively decreases from the beginning of adulthood - not in old age - and that dream reports become less intense, perceptually and emotionally. This evolution occurs faster in men than women, with gender differences in the content of dreams. The chronological modifications could be explained partly by changes in lifestyle and attitude towards dreams in early adulthood, but mainly by modifications of sleep physiology, particularly the decrease and qualitative changes of rapid eye movement (REM) sleep. Dreams have usually little subjective importance in the mental life of aged persons. However, working with dreams can be a valuable tool for psychotherapy in the aged. According to the few existing data, patients suffering degenerative dementia dream much less than healthy aged persons. In Alzheimer's disease, this could be linked to the decrease of REM sleep, and atrophy of associative sensory areas of the cerebral cortex. Most studied aspects of dreaming in degenerative cognitive disorders are REM sleep behavior disorders, and nightmares induced by cholinesterase inhibitors. More studies are needed to better characterize the evolution of dreams with age, particularly studies performed in sleep laboratory.