The long-term impact of light intervention on sleep physiology and cognition in mild cognitive impairment

项目总结/摘要 数据表明，在550多万患有阿尔茨海默病（AD）的美国老年人中，约有40%患有 严重的睡眠-觉醒和昼夜节律系统功能障碍。在轻度认知障碍（MCI）患者中， 在痴呆症的”危险期“或潜在的前驱期阶段中，高达60%的患者存在明显的睡眠-觉醒障碍。睡眠至关重要 健康的认知过程。本申请旨在调查长期 照明治疗对MCI和轻度AD患者的睡眠生理和睡眠依赖性认知过程的影响。我们 假设长期（6个月）的照明干预技术（LIT），旨在促进昼夜节律夹带 会改善睡眠从而提高认知能力我们还假设LIT将改善抑郁症和生活质量（QoL）。在 一项单臂、随机、安慰剂对照（非主动比较照明干预）受试者间研究，我们 将研究6个月暴露于LIT（干预后3个月的“纯随访期”）对以下方面的影响： (1)睡眠的客观测量（EEG，活动记录），（2）睡眠的主观测量（匹兹堡睡眠质量指数），（3） 认知（工作记忆和长期记忆）;（4）抑郁和生活质量（问卷）。我们的科学前提是 睡眠纺锤波和相对于SO的纺锤波的时间，是 电生理事件，提供了一个机制解释记忆巩固在睡眠中的年轻人， 老年人来自co-PI的当前资助的数据显示，LIT改善了睡眠（通过体动记录仪测量， 问卷调查），抑郁和激动的晚期AD患者。目前的补助金是联合PI的逻辑延伸 工作：它将包括MCI和轻度AD患者，并将测量EEG和认知表现，其中没有一个是 包括在目前的赠款活动中。 除了改善患者的生活外，LIT还有可能减轻护理人员的负担。因此，一个探索性的目标是 还测量LIT对护理人员的睡眠、认知、抑郁和生活质量的影响。我们将演示 一个实用的，有效的，定制的，非药物性的LIT可以用来改善睡眠，认知和生活质量， 患有MCI和轻度AD的老年人生活在家中或独立或辅助生活设施中，因此可能 减轻重大的财政和社会负担。这项拟议的工作意义重大，因为它将是第一个 调查长期使用光疗（一种安全且易于使用的干预措施）与睡眠和 MCI和轻度AD患者的认知，以及其对照顾者的影响。有证据表明睡眠的重要性 在AD的发展中，所提出的研究可以对MCI和轻度AD的进展产生显著影响， 和照顾者的生活质量。

Project Summary/Abstract Data suggest that approximately 40% of the 5.5+ million older Americans with Alzheimer's disease (AD) suffer from severe dysfunction of sleep–wake and circadian systems. In people with mild cognitive impairment (MCI), which is an “at risk” or potential prodromal stage of dementia, sleep-wake disturbance is evident in up to 60% of patients. Sleep is critical for healthy cognitive processing in older adults. This application proposes to investigate the impact of a long-term lighting treatment on sleep physiology and sleep-dependent cognitive processes in MCI and mild AD patients. We hypothesize that a long-term (6-month) lighting intervention technology (LIT) designed to promote circadian entrainment will improve sleep and, thus cognition. We also hypothesize that LIT will improve depression and quality of life (QoL). In a single-arm, randomized, placebo-controlled (non-active comparison lighting intervention), between-subjects study, we will investigate the effect of a 6-month exposure to LIT (with a “pure follow-up period” of 3 months post-intervention) on: (1) objective measures of sleep (EEG, actigraphy), (2) subjective measures of sleep (Pittsburgh Sleep Quality Index), (3) cognition (working and long-term memory), and (4) depression and QoL (questionnaires). Our scientific premise is that sleep spindles, and timing of spindles relative to SO, are critical components of an interaction between electrophysiological events that provide a mechanistic explanation for memory consolidation during sleep in young and older adults. Data from the current grant by the co-PI shows that LIT improves sleep (measured via actigraphy and questionnaires), depression and agitation in late stages AD patients. The current grant is a logical extension of the co-PIs work: it will include MCI and mild AD patients and it will measure EEG and cognitive performance, none of which are included in the current grant activities. In addition to improving patients’ lives, LIT has the potential to reduce burden on caregivers. Thus, an exploratory goal is to also measure the impact of LIT on caregivers’ sleep, cognition, depression, and quality of life. We will demonstrate that a practical, effective, tailored, nonpharmacological LIT can be used to improve sleep, cognition, and quality of life in older adults with MCI and mild AD living at home or in independent or assisted living facilities, thereby possibly mitigating significant financial and social burdens. The proposed work is significant because it will be the first to investigate the relationship between long-term use of light therapy, a safe and easy to use intervention, and sleep and cognition in MCI and mild AD patients, as well as its impact on caretakers. Given evidence linking the sleep’s importance in the development of AD, the proposed studies can have a significant impact on the progression of MCI and mild AD, and caregivers’ quality of life.