The feasibility of a tailored music intervention to reduce symptoms of sleep disruption in older adults with dementia

项目摘要 患有阿尔茨海默病和相关痴呆症（ADRD）的老年人的睡眠中断非常严重。 使人衰弱，并有助于增加制度化，降低认知功能，并加速 疾病进展。此外，睡眠中断与照顾者（CG）的不良健康结果有关，例如 生活质量差和CG负担增加。考虑到药物治疗的潜在有害副作用 治疗，非药物方法，如音乐，可以提供一个更安全的替代减少睡眠， 在这个脆弱的群体中。听音乐已被证明可以减少激动，焦虑和 ADRD疗养院居民的抑郁状况越来越多的文献表明， 音乐可以改善老年人早期记忆丧失的睡眠质量，但其功效尚未得到证实。 在大多数ADRD老年人居住的社区中，ADRD老年人中证实了这一点。如果证明 然后可以测试可行的、可接受的、定制的音乐干预在减少睡眠方面的功效 破坏这个个人国家研究服务奖（NRSA）应用程序的目的是提供 博士后研究培训的候选人获得知识和技能的独立 研究生涯。在横截面论文研究（由NIA F31 AG 055148资助）中，申请人 先前研究的与参与音乐活动和音乐相关的认知能力 轻度认知障碍的老年人的行为。申请人的长期职业目标是 使用姑息性非药物方法解决老年ADRD患者的睡眠中断问题。的 本建议的具体目的是研究：（1）可行性;（2）可接受性;（3）初步功效 在患有睡眠中断的ADRD的居家老年人中进行定制的音乐干预。六十 将对（患有ADRD的老年人及其CG）进行随机分组，接受量身定制的音乐干预 或延迟4周。音乐选择将根据患有ADRD的老年人进行个性化 并解释了已知的睡眠诱导特性。对成功执行《公约》至关重要的进程的可行性 将审查随后的研究。干预的初步有效性将使用客观 （活动记录）和主观（代理报告）睡眠质量测量。此外，定性数据将 从检查干预的可接受性和满意度的二人组中征求。为指导 在辅导团队中，申请人精心挑选了研究培训活动，以获得知识， 在五个核心领域的专业知识：1）行为干预研究，2）临床试验方法; 3）睡眠 老年人的评估措施; 4）与临床分析有关的先进统计方法 试验;和5）新颖的远程监控应用。该研究项目的成果不仅将 为未来的疗效试验提供信息，但也为申请人提供获得必要技能的机会， 开始了她的独立调查员生涯

Project Summary Sleep disruption in older adults living with Alzheimer’s disease and related dementias (ADRD) is very debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers (CGs), such as poor quality of life and increased CG burden. Given the potential harmful side effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. Listening to music has been shown to decrease agitation, anxiety and depression in nursing home residents with ADRD. A growing body of literature suggests that individualized music may improve sleep quality in older adults with early memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If proven feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. The purpose of this individual National Research Service Award (NRSA) application is to provide post-doctoral research training for a candidate to gain the knowledge and skills essential for an independent research career. In a cross-sectional dissertation study (funded by NIA F31AG055148) the applicant has previously examined cognitive abilities associated with engagement in music activities and music-related behaviors in older adults with mild cognitive impairment. The applicant’s long-term career objective is to address sleep disruption in older adults with ADRD using palliative non-pharmacologic approaches. The specific aims of this proposal are to examine the 1) feasibility; 2) acceptability; and 3) preliminary efficacy of a tailored music intervention in home-dwelling older adults with ADRD suffering from sleep disruption. Sixty dyads (older adults with ADRD and their CGs) will be randomized to receive the tailored music intervention immediately or following a four week delay. Music selections will be individualized to older adults with ADRD and account for known sleep-inducing properties. Feasibility of processes that are key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy reported) sleep quality measures. In addition, qualitative data will be solicited from the dyads examining the acceptability and satisfaction with the intervention. Under the guidance of the mentoring team, the applicant has carefully selected research training activities to gain knowledge and expertise in five core areas: 1) behavioral intervention research, 2) clinical trial methodology; 3) sleep assessment measures in older adults; 4) advanced statistical methods pertaining to the analysis of clinical trials; and 5) novel remote monitoring applications. Results from the proposed research project will not only inform a future efficacy trial, but also provide an opportunity for the applicant to gain the necessary skills to launch her career as an independent investigator.