HIGH INTENSITY LIGHT THERAPY IN ALZHEIMER'S DISEASE

描述(申请人摘要)：阿尔茨海默氏症患者的护理 疾病及相关痴呆症(AD)是一个普遍、昂贵且日益严重的问题， 特别是对于长期护理环境，在那里有近150万人患有 广告居留。在AD中最麻烦的管理问题包括 相互关联的问题--睡眠/清醒障碍、抑郁症状和烦躁不安。 目前对这些疾病的治疗广泛依赖于精神药物 药物疗效有限，不良反应严重。 展示一种有效的、低风险的替代疗法可能会产生 在全国范围内对长期护理产生有利影响。一个很有希望的替代方案，High 强光，已被证明可以产生生化和生理 对调节这些行为的系统的影响，并产生了 试点和初步研究取得重大进展。 建议的项目是一项交叉的临床试验，目的是观察HIGH 强度、低眩光、白天环境光线对睡眠/醒来模式的影响、抑郁 阿尔茨海默病疗养院住院患者的症状、情绪变化。它将被执行 在一家州立精神病院的有执照的熟练护理机构里， 它管理着45名患有AD的居民。它将采用4个疗程，12个疗程 交叉设计，治疗包括)上午高强度 光，b)傍晚高强度光，c)全天高强度光，以及 D)控制(预先存在的)照明。干预措施(单独应用于 3个病房中的每一个)将由产生均匀、非眩光的照明装置组成 在设施的所有公共区域，平均为2500-3000勒克斯。睡眠/活动 将使用腕部运动传感器进行测量；抑郁症状将 使用康奈尔抑郁指数和费城老年人指数进行测量 中心影响评定量表；激动感将使用 计算机辅助直接观测与科恩-曼斯菲尔德激荡 库存。将使用腕部光电池记录光暴露。次要的 结果将包括员工抑郁和报告的麻烦。数据收集 将持续一年，以允许分析根据季节性差异进行调整 在室外光线水平上。

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.