The feasibility of a tailored music intervention to reduce symptoms of sleep disruption in older adults with dementia

项目摘要 患有阿尔茨海默病和相关痴呆(ADRD)的老年人睡眠障碍非常严重 使人衰弱，并有助于增加制度化，降低认知功能，加速 疾病的发展。此外，睡眠障碍与照顾者(CG)的健康状况不佳有关，例如 由于生活质量差，增加了CG负担。考虑到药物的潜在有害副作用 治疗，非药物方法，如音乐，可能提供一种比减少睡眠更安全的选择 对这一脆弱人群的破坏。有研究表明，听音乐可以减少焦虑、焦虑和 养老院住院患者ADRD患者的抑郁情绪。越来越多的文学作品表明，个性化 音乐可能会改善早期记忆丧失的老年人的睡眠质量，但其疗效尚未得到证实 在大多数患有ADRD的老年人居住的社区中表现为ADRD。如果经过验证 然后，可以测试可行和可接受的、量身定做的音乐干预在减少睡眠方面的效果 颠覆。个人国家研究服务奖(NRSA)申请的目的是提供 为候选人提供博士后研究培训，以获得独立工作所必需的知识和技能 研究生涯。在一项横断面论文研究(由NIA F31AG055148资助)中，申请人有 以前研究过与参与音乐活动和音乐相关的认知能力 轻度认知障碍老年人的行为。申请人的长期职业目标是 使用姑息性非药物方法解决老年ADRD患者的睡眠障碍问题。这个 这项建议的具体目标是检查1)可行性；2)可接受性；3)初步疗效 为患有ADRD睡眠障碍的居家老年人量身定做的音乐干预。六十 二人组(患有ADRD的老年人和他们的CG)将随机接受量身定做的音乐干预 立即或在四周的延迟之后。音乐选择将针对患有ADRD的老年人进行个性化 并解释了已知的诱导睡眠的特性。进程的可行性，这是成功的关键 随后的研究将会被检验。干预的初步效果将使用客观评估 (动图)和主观(代理报告)睡眠质量测量。此外，定性数据将被 向双方征求意见，检查干预措施的可接受性和满意度。在指导下 在指导团队中，申请人精心挑选了研究培训活动，以获得知识和 五个核心领域的专业知识：1)行为干预研究；2)临床试验方法学；3)睡眠 老年人的评估措施；4)与临床分析有关的高级统计方法 试验；以及5)新的远程监控应用。拟议的研究项目的结果不仅将 通知未来的疗效试验，但也为申请者提供了获得必要技能的机会 开始她作为一名独立调查员的职业生涯。

Project Summary Sleep disruption in older adults living with Alzheimer’s disease and related dementias (ADRD) is very debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers (CGs), such as poor quality of life and increased CG burden. Given the potential harmful side effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. Listening to music has been shown to decrease agitation, anxiety and depression in nursing home residents with ADRD. A growing body of literature suggests that individualized music may improve sleep quality in older adults with early memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If proven feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. The purpose of this individual National Research Service Award (NRSA) application is to provide post-doctoral research training for a candidate to gain the knowledge and skills essential for an independent research career. In a cross-sectional dissertation study (funded by NIA F31AG055148) the applicant has previously examined cognitive abilities associated with engagement in music activities and music-related behaviors in older adults with mild cognitive impairment. The applicant’s long-term career objective is to address sleep disruption in older adults with ADRD using palliative non-pharmacologic approaches. The specific aims of this proposal are to examine the 1) feasibility; 2) acceptability; and 3) preliminary efficacy of a tailored music intervention in home-dwelling older adults with ADRD suffering from sleep disruption. Sixty dyads (older adults with ADRD and their CGs) will be randomized to receive the tailored music intervention immediately or following a four week delay. Music selections will be individualized to older adults with ADRD and account for known sleep-inducing properties. Feasibility of processes that are key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy reported) sleep quality measures. In addition, qualitative data will be solicited from the dyads examining the acceptability and satisfaction with the intervention. Under the guidance of the mentoring team, the applicant has carefully selected research training activities to gain knowledge and expertise in five core areas: 1) behavioral intervention research, 2) clinical trial methodology; 3) sleep assessment measures in older adults; 4) advanced statistical methods pertaining to the analysis of clinical trials; and 5) novel remote monitoring applications. Results from the proposed research project will not only inform a future efficacy trial, but also provide an opportunity for the applicant to gain the necessary skills to launch her career as an independent investigator.