Aging Well, Sleeping Efficiently: Intervention Studies

描述（由申请人提供）：本项目（“AgeWise”）的总体目标是确定是否可以通过旨在改善睡眠的行为干预来改善正常老年人的生活，健康和福祉。大多数老年人都面临着日常生活的各个方面，如丧亲之痛、需要照顾生病的配偶、与身体不健康有关的失眠以及进入生命的最后几年；所有这些都会给他们的睡眠、健康、幸福感、情绪和功能带来挑战。有三个核心：管理和受试者招募（Monk）、数据收集（Buysse）和数据分析（Mazumdar），以及五个组成部分项目（见下），所有这些项目都使用一套共享的测量方法（Agebat），允许对整个项目的假设进行测试。Agebat变量分为三大类（有时重叠）：筛选措施，预测/结果措施，关键调节和中介。领域包括：睡眠、活动和昼夜节律功能、心理健康、身体健康、认知功能、一般功能、社会心理和压力以及人口统计学。项目1 （Monk）旨在确定最近丧偶的老年人（65岁以上）的生活是否可以通过社会节奏疗法得到改善，在这种疗法中，生活方式的规律性得到加强，健康的睡眠习惯得到遵循。项目2 （Hall）关注的是早期阿尔茨海默病患者的配偶照顾者（65岁以上），以及旨在改善他们的睡眠和减少照顾压力的干预。项目3 （Buysse）的目的是比较65岁以上患者的失眠短期行为治疗与仅提供信息的对照条件的疗效，这些患者在初级保健机构中常见的老年发病率。项目4 （Reynolds）将测试限制床上时间（30分钟）以及健康睡眠习惯教育作为维持或改善老年人（75岁以上）睡眠质量的手段的有效性，从而提高他们白天的警觉性、情绪、认知功能和幸福感。Project 5 （Nofzinger）旨在识别健康老年人（75岁以上）睡眠相关的功能神经解剖学变化，这些变化伴随着年龄相关的变化和干预相关的睡眠变化。在24个月的时间里，将在受试者内部进行比较，在项目4的干预组和对照组老年人之间进行比较，在单独研究的老年人和年轻人之间进行比较。所有的干预项目将不仅关注干预对睡眠本身的影响，而且还关注随后的心理健康，身体健康，福祉和使用中介模型的功能。项目范围内的研究计划将关注压力（Halo）、生活方式规律（Monk）、与身体不健康相关的失眠（Buysse）和卧床时间（Reynolds）在老年人群体中的具体作用。同样，结果将在将睡眠与健康、功能和幸福联系起来的概念模型中进行解释。

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.