Effects of a Tailored Lighting Intervention on Sleep Quality, Rest–Activity, Mood, and Behavior in Older Adults With Alzheimer Disease and Related Dementias: A Randomized Clinical Trial

Dec 20, 2019Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

Tailored Lighting’s effects on sleep, daily activity, mood, and behavior in older adults with Alzheimer’s and related dementias

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Abstract

The active lighting intervention improved Pittsburgh Sleep Quality Index scores from 10.30 at baseline to 6.67 after treatment.

The lighting intervention resulted in significantly lower scores for sleep quality compared to both the baseline and control interventions.
Improvements in intradaily variability were greater with the active lighting intervention than with the control.
The active intervention led to significant reductions in depression symptoms as measured by the Cornell Scale for Depression in Dementia.
There were notable decreases in agitation, as indicated by the Cohen-Mansfield Agitation Inventory scores, with the active intervention showing more improvement than the control.

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STUDY OBJECTIVES: We investigated the effectiveness of a lighting intervention tailored to maximally affect the circadian system as a nonpharmacological therapy for treating problems with sleep, mood, and behavior in persons with Alzheimer disease and related dementias (ADRD).

METHODS: This 14-week randomized, placebo-controlled, crossover design clinical trial administered an all-day active or control lighting intervention to 46 patients with ADRD in 8 long-term care facilities for two 4-week periods (separated by a 4-week washout). The study employed wrist-worn actigraphy measures and standardized measures of sleep quality, mood, and behavior.

RESULTS: The active intervention significantly improved Pittsburgh Sleep Quality Index scores compared to the active baseline and control intervention (mean ± SEM: 6.67 ± 0.48 after active intervention, 10.30 ± 0.40 at active baseline, 8.41 ± 0.47 after control intervention). The active intervention also resulted in significantly greater active versus control differences in intradaily variability. As for secondary outcomes, the active intervention resulted in significant improvements in Cornell Scale for Depression in Dementia scores (mean ± SEM: 10.30 ± 1.02 at baseline, 7.05 ± 0.67 after active intervention) and significantly greater active versus control differences in Cohen-Mansfield Agitation Inventory scores (mean ± SEM: -5.51 ± 1.03 for the active intervention, -1.50 ± 1.24 for the control intervention).

CONCLUSIONS: A lighting intervention tailored to maximally entrain the circadian system can improve sleep, mood, and behavior in patients with dementia living in controlled environments.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov, title: Methodology Issues in a Tailored Light Treatment for Persons With Dementia, URL: https://clinicaltrials.gov/ct2/show/NCT01816152, identifier: NCT01816152.

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Effects of a Tailored Lighting Intervention on Sleep Quality, Rest–Activity, Mood, and Behavior in Older Adults With Alzheimer Disease and Related Dementias: A Randomized Clinical Trial

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