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

• Published in: Journal of clinical sleep medicine Vol. 15; no. 12; pp. 1757 - 1767
• Main Authors: Figueiro, Mariana G, Plitnick, Barbara, Roohan, Charles, Sahin, Levent, Kalsher, Michael, Rea, Mark S
• Format: Journal Article
• Language: English
• Published: United States American Academy of Sleep Medicine 15-12-2019
• Subjects: Actigraphy; Activities of Daily Living; Aged, 80 and over; Alzheimer Disease - complications; Circadian Rhythm; Cross-Over Studies; Dementia - complications; Female; Geriatric Assessment - methods; Humans; Lighting - methods; Male; Mood Disorders - complications; Mood Disorders - therapy; Phototherapy - methods; Psychomotor Agitation - complications; Psychomotor Agitation - therapy; Scientific Investigations; Sleep Wake Disorders - complications; Sleep Wake Disorders - therapy; Surveys and Questionnaires; Treatment Outcome; sleep; Alzheimer’s disease; mood; dementia; circadian system; lighting intervention; rest–activity
• ISSN: 1550-9389; 1550-9397
• DOI: 10.5664/jcsm.8078

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).
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.
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).
A lighting intervention tailored to maximally entrain the circadian system can improve sleep, mood, and behavior in patients with dementia living in controlled environments.
Registry: ClinicalTrials.gov, title: Methodology Issues in a Tailored Light Treatment for Persons With Dementia, URL: https://clinicaltrials.gov/ct2/show/NCT01816152, identifier: NCT01816152.