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

项目摘要/摘要 数据显示，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 睡眠-觉醒和昼夜节律系统严重失调。在患有轻度认知障碍(MCI)的人中，这是一种 在痴呆症的“风险”或潜在前驱阶段，高达60%的患者明显存在睡眠-觉醒障碍。睡眠是至关重要的 对于老年人健康的认知过程。这项申请建议调查一项长期 照明治疗对轻度认知障碍和轻度阿尔茨海默病患者睡眠生理和睡眠依赖认知过程的影响。我们 假设旨在促进昼夜节律夹带的长期(6个月)照明干预技术(LIT) 会改善睡眠，从而改善认知能力。我们还假设LIT将改善抑郁症和生活质量(QOL)。在……里面 一项单臂、随机、安慰剂对照(非主动比较照明干预)的受试者间研究，我们 将调查暴露于LIT 6个月(干预后3个月的“纯随访期”)对以下方面的影响： (1)客观睡眠测量(脑电、活动描记)，(2)主观睡眠测量(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 睡眠主轴和主轴相对于SO的计时是相互作用的关键组件 电生理事件为青少年和青少年睡眠期间记忆巩固提供了机制解释 上了年纪的人。来自co-PI的当前授权的数据显示，LIT改善了睡眠(通过活动记录仪和 问卷)、抑郁和激越对晚期AD患者的影响。目前的赠款是合作绩效指标的逻辑延伸 工作：它将包括MCI和轻度AD患者，并将测量脑电和认知表现，这些都不是 包括在当前的赠款活动中。 除了改善患者的生活外，LIT还有可能减轻照顾者的负担。因此，探索性目标是 同时测量LIT对照顾者的睡眠、认知、抑郁和生活质量的影响。我们将演示 一种实用的、有效的、量身定做的、非药理的LIGN可以用来改善睡眠、认知和生活质量 患有MCI和轻度AD的老年人住在家里或在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。拟议中的工作意义重大，因为它将是第一个 调查长期使用光疗法，一种安全和易于使用的干预措施，与睡眠和 轻度认知障碍和轻度阿尔茨海默病患者的认知及其对照顾者的影响有证据表明睡眠的重要性 在AD的发展过程中，拟议的研究可以对MCI和轻度AD的进展产生重大影响， 以及照顾者的生活质量。

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.