Aging Well, Sleeping Efficiently: Intervention Studies

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DESCRIPTION (provided by applicant): The overall aim of this program project ("AgeWise") is to determine whether the lives, health and well-being of normal elderly people can be improved by behavioral interventions designed to enhance their sleep. Most seniors are faced with aspects of their everyday lives such as bereavement, the need to care for an ailing spouse, insomnia related to physical ill-health and progression into the final years of life; all of which can present challenges both to their sleep, and to their health, well-being, mood and ability to function. There are three cores: Administration and Subject Recruitment (Monk), Data Collection (Buysse), and Data Analysis (Mazumdar), and five component projects (see below) all using a shared battery of measures (Agebat), allowing for program-wide hypotheses to be tested. Agebat variables are divided into three broad (sometimes overlapping) categories: screening measures, predictor/outcome measures, and key moderators and mediators. Domains include: sleep, activity and circadian function, mental health, physical health, cognitive functioning, general functioning, psychosocial and stress, and demographics. Project 1 (Monk) seeks to determine whether the lives of recently widowed seniors (65y+) can be improved by Social Rhythm Therapy in which lifestyle regularity is increased and healthy sleep practices followed. Project 2 (Hall) is concerned with spousal caregivers (65y+) of early Alzheimer patients and an intervention designed to enhance their sleep and reduce the stress of caregiving. Project 3 (Buysse) aims to compare the efficacy of a brief behavioral treatment for insomnia to an information-only control condition in patients (65y+) with the usual morbidities of aging seen in primary care settings. Project 4 (Reynolds) will test the efficacy of restricting time in bed (by 30 minutes) plus education in healthy sleep practices as a means of maintaining or improving sleep quality in the very old (75y+) and thus enhancing their daytime alertness, mood, cognitive function, and well being. Project 5 (Nofzinger) seeks to identify sleep-related functional neuroanatomic changes that accompany age-related changes and intervention related changes of sleep in healthy elders (75y+). Comparisons will be made within-subjects over a 24 month span, between intervention and control seniors from Project 4, and between seniors and younger adults studied separately. All of the intervention projects will be concerned not only with the effects of the intervention on sleep per se, but also with subsequent mental health, physical health, well-being and functioning using a mediational model. Program-wide research initiatives will be concerned with the specific roles of stress (Halo, lifestyle regularity (Monk), insomnia related to physical ill-health (Buysse), and time spent in bed (Reynolds) on a mixed population of seniors. Again results will be interpreted within a conceptual model linking sleep to health, functioning and well-being.