MANIPULATIONS OF EXTERNAL ZEITGEBERS IN THE ELDERLY

睡眠障碍在老年人中很常见。 暴露于 用于生物钟系统（zeitgebers）的同步剂， 光线、社会线索和身体活动在老年时大大减少。 这一点对住在院舍的老人来说尤其如此， 有助于睡眠/觉醒周期和行为的星座 这是这个群体中常见的疾病。 初步研究 表明加强透光和非透光授时标志会导致 昼夜节律和睡眠的改变以及相关的改善 在日间功能的老年居民的辅助设施。 的 本项目的具体目标是：1）检验假设， 明亮的光/黑暗或社会/身体活动时间表的时间是 对它们改变昼夜节律和睡眠的功效至关重要， 提高白天的警觉性和表现，2）为了检验假设 社会日程的强制执行， 体力活动将改善日间功能和夜间睡眠，以及3） 为了验证睡眠稳态机制的强化 通过增强慢波睡眠， 性能 辅助生活和退休设施的老年居民 将在14天干预期之前、期间和之后进行研究 无论是早晨或傍晚明亮的光线，或结构化的社会和 体育锻炼;单独的社会活动或社会与体育相结合的活动 活动计划;或药物治疗以增强慢波睡眠。 将持续监测静息-活动周期和光照 每一个协议。 温度和心脏的昼夜节律曲线 率，神经心理性能测试，夜间记录 睡眠，以及唾液中褪黑激素和皮质醇水平的测量， 在各种治疗之前、期间和之后测定。 结果 从这些研究将确定在何种程度上， 时间表可用于改变昼夜节律，改善睡眠， 老年人的警觉性和表现，以及提供必要的 这些类型的干预措施的实际应用信息， “真实的世界”的背景。

Sleep disturbances are common among older persons. Exposure to synchronizing agents for athe circadian system (zeitgebers) such as bright light, social cues and physical activity are greatly diminished in old age. This is particularly true for the institutionalized elderly and may contribute to the constellation of sleep/wake cycle and behavioral disorders which are frequently seen in this group. Preliminary studies indicate that enforcement of photic and non-photic zeitgebers results in alterations of circadian rhythmicity and sleep with associated improvements in daytime function in elderly residents of assisted facilities. The specific aims of the present project are: 1) To test the hypothesis that the timing of bright light/dark or social/physical activity schedules is critical to their efficacy to alter circadian rhythms and sleep, as well as to improve daytime alertness and performance, 2) To test the hypothesis that enforcement of a social schedule without a concomitant increase in physical activity will improve daytime function and nocturnal sleep, and 3) To test the hypothesis that reinforcement of sleep homeostatic mechanisms by enhancement of slow wave sleep will increase alertness and measures of performance. Older residents of assisted living and retirement facilities will be studies before, during and after a 14 day period of intervention will either morning or evening bright light, or structured social and physical exercise; social activity alone or combined social and physical activity programs; or pharmacological treatment to enhance slow wave sleep. Rest-activity cycles and light exposure will be monitored continuously throughout each protocol. Circadian profiles of temperature and heart rate, tests of neuropsychological performance, recording of nocturnal sleep, and measurement of melatonin and cortisol levels in saliva will be determined before, during and after athe various treatments. The results from these studies will determine the extent to which photic and non-photic zeitgebers can be used to alter circadian rhythmicity, improve sleep, alertness and performance in the elderly, as well as to provide essential practical information for th application of these types of intervention in the "real world" setting.