HIGH INTENSITY LIGHT THERAPY IN ALZHEIMER'S DISEASE

描述（申请人摘要）：老年痴呆症患者的护理 疾病和相关痴呆（AD）是一种流行的、昂贵的和日益增长的问题， 特别是在长期护理环境中， AD驻留。AD中最麻烦的管理问题之一是 相关的问题-睡眠/觉醒障碍，抑郁症状和激动。 目前对这些疾病的治疗广泛依赖于精神活性药物， 这些药物的有效性有限，并且具有显著的不良反应。 一种有效的、低风险的替代治疗方法的示范可能会产生一种 对全国长期护理产生积极影响。一个有希望的替代方案，高 强度光，已被证明产生生物化学和生理 对调节这些行为的系统的影响，并产生 在试点和初步研究方面取得重大进展。 该项目是一项具有交叉性的临床试验， 强度，低眩光，环境白天光对睡眠/觉醒模式，抑郁 症状和激越在养老院居民与AD。它将在 在州立精神病医院的一个有执照的专业护理机构， 管理着45名AD患者它将采用4个疗程，12个疗程 交叉设计，治疗包括：a）早晨高强度 光，B）傍晚高强度光，c）全天高强度光，和 d）控制（预先存在的）照明。干预（单独适用于 3个病房中的每一个）将由产生均匀、无眩光的灯具组成 在设施的所有公共区域平均2500-3000勒克斯。睡眠/活动 将使用手腕运动传感器进行测量;抑郁症状将被 使用康奈尔抑郁指数和费城老年医学 中心影响评定量表;使用以下方法测量躁动 计算机辅助直接观测和科恩-曼斯菲尔德激变 库存将使用腕部光电管记录光暴露。二次 结果将包括工作人员的抑郁和据报的麻烦。数据收集 将持续一年，以便分析调整季节差异 在室外光线水平。

DESCRIPTION (APPLICANT'S ABSTRACT): The care of persons with Alzheimer's disease and related dementias (AD) is a prevalent, costly, and growing issue, particularly for long-term care settings, where nearly 1.5 million persons with AD reside. Among the most troublesome management issues in AD are a tried of interrelated problems-sleep/wake disorders, depressive symptoms, and agitation. Current management of these conditions relies extensively on psychoactive medications, which have limited effectiveness and significant adverse effects. Demonstration of an effective, low-risk alternative treatment could have a favorable impact on long-term care nationwide. One promising alternative, high intensity light, has been demonstrated to produce biochemical and physiological effects on the systems that mediate these behaviors, and to have produced significant improvement in pilot and preliminary studies. The proposed project is a clinical trial with crossover, of the effect of high intensity, low glare, ambient daytime light on sleep/wake patterns, depressive symptoms, and agitation in nursing home residents with AD. It will be conducted in a licensed skilled nursing facility within a state psychiatric hospital, which manages 45 residents with AD. It will employ a 4 treatment, 12 period crossover design, with the treatments consisting of a) morning high intensity light, b) evening high intensity light, c) full day high intensity light, and d) the control (preexisting) lighting. The intervention (applied separately to each of 3 wards) will consist of fixtures that produce even, non-glare light averaging 2500-3000 lux in all public areas of the facility. Sleep/activity will be measured using wrist motion sensors; depressive symptoms will be measured using the Cornell Depression Index and the Philadelphia Geriatric Center Affect Rating Scale; and agitation will be measured using computer-assisted direct observations and the Cohen-Mansfield Agitation Inventory. Light exposure will be documented using wrist photocells. Secondary outcomes will include staff depression and reported hassles. Data collection will continue for one year to allow analyses to adjust for seasonal differences in outdoor light levels.