Progression of Dementia Assessed by Temporal Correlations of Physical Activity: Results From a 3.5-Year, Longitudinal Randomized Controlled Trial.
Progression of Dementia Assessed by Temporal Correlations of Physical Activity: Results From a 3.5-Year, Longitudinal Randomized Controlled Trial.
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DOI：
10.1038/srep27742
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发表时间：
2016-06-13
影响因子：
4.6
通讯作者：
Van Someren EJ
中科院分区：
文献类型：
--
作者：
Hu K;Riemersma-van der Lek RF;Patxot M;Li P;Shea SA;Scheer FA;Van Someren EJ
横断面研究表明，健康年轻人的活动波动具有强大的时间相关性，随着年龄的增长，以及痴呆和抑郁症的变化。本研究旨在测试活动相关性的受试者内变化是否（i）跟踪痴呆症的临床进展，（ii）反映痴呆症患者抑郁症状的变化，以及（iii）可以通过旨在稳定昼夜节律和改善痴呆症睡眠的临床干预措施（即定时强光治疗和褪黑激素补充剂）进行操纵。我们在一项为期3.5年的双盲随机临床试验中检查了144例痴呆患者（70-96岁），这些患者被分配到每天接受明亮的灯光，睡前褪黑激素，两者或安慰剂治疗。我们发现，在时间尺度<~2小时的活动相关性显着下降，随着时间的推移，光处理减弱了约73%的下降。此外，时间活动相关性的降低与认知功能下降和情绪恶化的程度呈正相关，但相关性相对较弱。这些结果表明，在痴呆患者的多尺度活动调节和昼夜节律/睡眠功能之间的机械联系。时间活动模式是否允许不引人注目的，长期监测痴呆症的进展和情绪变化值得进一步研究。
Cross-sectional studies show that activity fluctuations in healthy young adults possess robust temporal correlations that become altered with aging, and in dementia and depression. This study was designed to test whether or not within-subject changes of activity correlations (i) track the clinical progression of dementia, (ii) reflect the alterations of depression symptoms in patients with dementia, and (iii) can be manipulated by clinical interventions aimed at stabilizing circadian rhythmicity and improving sleep in dementia, namely timed bright light therapy and melatonin supplementation. We examined 144 patients with dementia (70–96 years old) who were assigned to daily treatment with bright light, bedtime melatonin, both or placebos only in a 3.5-year double-blinded randomized clinical trial. We found that activity correlations at temporal scales <~2 hours significantly decreased over time and that light treatment attenuated the decrease by ~73%. Moreover, the decrease of temporal activity correlations positively correlated with the degrees of cognitive decline and worsening of mood though the associations were relatively weak. These results suggest a mechanistic link between multiscale activity regulation and circadian/sleep function in dementia patients. Whether temporal activity patterns allow unobtrusive, long-term monitoring of dementia progression and mood changes is worth further investigation.