Journal Article

Effects of a Tailored Lighting Intervention on Sleep Quality, Rest–Activity, Mood, and Behavior in Older Adults With Alzheimer Disease and Related Dementias: A Randomized Clinical Trial

Figueiro, Mariana G., Plitnick, Barbara, Kalsher, Michael, Sahin, Levent, Rea, Mark S., Roohan, Charles

2019

Overview

Study Objectives: We investigated the effectiveness of a lighting intervention tailored to maximally affect the circadian system as a nonpharmacological therapy for treating problems with sleep, mood, and behavior in persons with Alzheimer disease and related dementias (ADRD). Methods: This 14-week randomized, placebo-controlled, crossover design clinical trial administered an all-day active or control lighting intervention to 46 patients with ADRD in 8 long-term care facilities for two 4-week periods (separated by a 4-week washout). The study employed wrist-worn actigraphy measures and standardized measures of sleep quality, mood, and behavior. Results: The active intervention significantly improved Pittsburgh Sleep Quality Index scores compared to the active baseline and control intervention (mean ± SEM: 6.67 ± 0.48 after active intervention, 10.30 ± 0.40 at active baseline, 8.41 ± 0.47 after control intervention). The active intervention also resulted in significantly greater active versus control differences in intradaily variability. As for secondary outcomes, the active intervention resulted in significant improvements in Cornell Scale for Depression in Dementia scores (mean ± SEM: 10.30 ± 1.02 at baseline, 7.05 ± 0.67 after active intervention) and significantly greater active versus control differences in Cohen-Mansfield Agitation Inventory scores (mean ± SEM: −5.51 ± 1.03 for the active intervention, −1.50 ± 1.24 for the control intervention). Conclusions: A lighting intervention tailored to maximally entrain the circadian system can improve sleep, mood, and behavior in patients with dementia living in controlled environments. Clinical Trial Registration: Registry: ClinicalTrials.gov , title: Methodology Issues in a Tailored Light Treatment for Persons With Dementia, URL: https://clinicaltrials.gov/ct2/show/NCT01816152 , identifier: NCT01816152. Citation: Figueiro MG, Plitnick B, Roohan C, Sahin L, Kalsher M, Rea MS. Effects of a tailored lighting intervention on sleep quality, rest–activity, mood, and behavior in older adults with Alzheimer disease and related dementias: a randomized clinical trial. J Clin Sleep Med . 2019;15(12):1757–1767.

• Publisher: Springer International Publishing,Springer Nature B.V,American Academy of Sleep Medicine
• Subject: Actigraphy / Activities of Daily Living / Aged, 80 and over / Alzheimer Disease - complications / Circadian Rhythm / Cross-Over Studies / Dementia / Dementia - complications / Female / Geriatric Assessment - methods / Humans / Intervention / Light / Light therapy / Lighting / Lighting - methods / Long term health care / Male / Melatonin / Mood Disorders - complications / Mood Disorders - therapy / Older people / Phototherapy - methods / Psychomotor Agitation - complications / Psychomotor Agitation - therapy / Quality of life / Questionnaires / Restless legs syndrome / Scientific Investigations / Sleep apnea / Sleep Wake Disorders - complications / Sleep Wake Disorders - therapy / Surveys and Questionnaires / Treatment Outcome