A Dyadic Approach to Improve Sleep and Well-Being Among Persons with Alzheimer's Disease and Their Caregivers

改善阿尔茨海默病患者及其护理人员睡眠和健康的二元方法

• 批准号: 10642774
• 负责人: Yeonsu Song
• 金额: $ 74.43万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642774
• 关键词: Address; Admission activity; Affect; Aftercare; Alzheimer' s Disease; Alzheimer' s disease related dementia; Behavior; Behavioral; Behavioral Symptoms; Biological Markers; C-reactive protein; Caregiver Burden; Caregiver support; Caregivers; Cognitive Therapy; Communities; Control Groups; Dementia; Dementia caregivers; Education; Family Caregiver; Goals; Health; Health Care Costs; Health Professional; Home; Inflammation; Inflammatory; Information Systems; Institution; Interleukin-6; Intervention; Interview; Knowledge; Light; Manuals; Measurement; Measures; Memory; Mental Depression; Mental Health; Modality; Outcome; Pathway interactions; Patient Outcomes Assessments; Patients; Personal Satisfaction; Persons; Pittsburgh Sleep Quality Index; Problem Solving; Problem behavior; Quality of Care; Quality of life; Randomized, Controlled Trials; Role; Sleep; Sleep Disorders; Sleep disturbances; Sleeplessness; Stress; TNF gene; Testing; Underrepresented Populations; Vulnerable Populations; Walking; Work; actigraphy; aged; arm; cardiovascular health; caregiving; center for epidemiological studies depression scale; cognitive benefits; cognitive function; community based service; community setting; comparison control; depressive symptoms; design; efficacy evaluation; efficacy testing; experience; follow-up; global health; health training; improved; improvement on sleep; inflammatory marker; innovation; intervention delivery; intervention effect; intervention program; loved ones; member; physical conditioning; poor sleep; post intervention; prevent; primary outcome; programs; randomized, clinical trials; secondary outcome; sleep difficulty; sleep quality; telehealth; trial design

Project Summary/Abstract Poor sleep is very common in persons with Alzheimer’s disease and related dementias (ADRD) and their caregivers. It is significantly associated with adverse mental and physical health outcomes and well-being in both members of the group. Unmanaged poor sleep will further impact the quality of care that the caregivers provide for the patients. This suggests a critical need of sleep management in this vulnerable population. Unfortunately, an intervention addressing sleep problems of both members of the dyad simultaneously is lacking, particularly using the behavioral strategies that have been effective in other groups. Effects of sleep intervention programs in different delivery modalities are also unknown in this group. The current proposal aims to examine the efficacy of a dyadic sleep intervention program for ADRD patients and their caregivers, that is built upon PI’s prior work. We propose a 3-arm randomized controlled trial design (Stage II), including both in-person (n=70 dyads) and telehealth (n=70 dyads) delivery of the intervention, compared to in-person sleep education control (n=70 dyads). The dyadic intervention is a 5-week, manual-based program, which incorporates key components of cognitive behavioral therapy for insomnia, daily light exposure and walking, and a problem-solving approach for ADRD-related problematic nighttime behaviors and other caregiving challenges. All intervention sessions will be delivered by a sleep educator. Primary outcomes include subjective and objective sleep quality of the dyads. Secondary outcomes include the patients’ dementia-related behaviors and quality of life, and the caregivers’ burden, depression, and perceived health. We will also explore effects of the dyadic sleep program on inflammatory markers among caregivers. All outcomes will be measured at baseline, post-intervention (i.e., immediately after the last session of the intervention), and 6-month after the last session. Both superior (both in-person and telehealth interventions versus control) and non-inferior effects (in-person versus telehealth intervention) will be tested. A unique aspect of the proposed work is that the program is tailored to address sleep problems of both patients and caregivers, and includes inflammatory biomarkers to evaluate a key mechanism of intervention benefits that can be further explored in future research. The knowledge gained from this study has the potential to improve the lives of ADRD patients and their caregivers. Our dyadic sleep intervention can be disseminated to multiple communities serving ADRD patients and/or caregivers, including those that lack access to traditional in-person sleep treatment. The intervention manual can also be used to train health professionals and staff in various types of community programs.

项目总结/文摘