MANIPULATIONS OF EXTERNAL ZEITGEBERS IN THE ELDERLY

睡眠障碍在老年人中很常见。暴露于 昼夜节律系统的同步剂(如BREAT) 光、社交暗示和体力活动在老年时会大大减少。 这对住院老人来说尤其如此，并可能 对睡眠/清醒周期和行为的影响 在这一群体中常见的疾病。初步研究 表明执行光学和非光学计时器会导致 昼夜节律性和睡眠的改变及其相关改善 在日间功能上对老年居民进行辅助设施。这个 本项目的具体目标是：1)检验假设 亮/暗或社交/体力活动时间表的时间安排是 对它们改变昼夜节律和睡眠的有效性至关重要，以及 为了提高白天的警觉性和表现，2)检验假设 在没有随之而来增加的情况下执行社交时间表 体育锻炼将改善白天的功能和夜间的睡眠，以及3) 来检验这样一种假设，即睡眠平衡机制的加强 通过加强慢波睡眠将提高警觉性和措施 性能。辅助生活和退休设施的老年居民 将在14天干预之前、期间和之后进行研究 无论是早晨还是晚上明亮的灯光，还是结构化的社交和 体育锻炼；单独的社会活动或社会和身体相结合的活动 活动计划；或加强慢波睡眠的药物治疗。 将持续监测休息-活动周期和光照 在每个协议中。体温和心脏的昼夜节律 心率、神经心理功能测试、夜间活动记录 睡眠，唾液中褪黑激素和皮质醇水平的测量 在各种治疗前、治疗中和治疗后测定。结果是 从这些研究中将确定光和非光的程度 时代诱因可以用来改变昼夜节律，改善睡眠， 在老年人的警觉性和表现上，以及提供必要的 应用这些类型的干预措施的实用信息 “真实世界”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.