0295 Tailored Lighting Intervention For Alzheimer’s Patients And Its Effects On Sleep, Mood And Agitation

Abstract

Abstract Persons with Alzheimer's disease and related dementias (ADRD) are difficult for caregivers to manage because of sleep problems, wandering, and associated daytime irritability. Light exposure during the day helps consolidate sleep and improve behavior ADRD patients, but the light levels required are high and lighting fixtures that are currently available cannot deliver the level and spectrum of lighting that maximally affects the circadian system. This study tested whether a tailored lighting intervention could improve sleep and behavior in ADRD patients living in long-term care facilities. In the context of a crossover, repeated-measures design, we exposed 42 subjects diagnosed with ADRD (Mini mental scale below 24) to an active (circadian stimulus, CS=0.3) and inactive (CS=0.1) tailored lighting intervention for successive 4-week periods, spaced by a 4-week washout period. The lighting intervention was added to spaces in which patients spent most of their waking hours and was energized from wake time until 6:00 pm. Calibrated personal light meters monitored exposures. Measures of sleep disturbances (Pittsburgh Sleep Quality Index, PSQI), mood (Cornell Scale for Depression in Dementia, CSDD) and agitation (Cohen-Mansfield Agitation Index, CMAI) were collected at baseline and during the last week of the intervention. Compared to baseline and to the inactive lighting condition, the lighting intervention significantly decreased sleep disturbances, depression and agitation. The mean ± SEM PSQI scores was 10.4 ± 0.4 and 6.4 ± 0.5 at baseline and after active intervention and 9.7 ± 0.5 and 8.0 ± 0.4 at baseline and after the inactive intervention. The mean ± SEM CSDD scores was 10.9 ± 1.1 and 7.3 ± 0.7 at baseline and after active intervention and 10.6 ± 0.9 and 9.1 ± 0.9 at baseline and after the inactive intervention. The mean ± SEM CMAI scores was 43.6 ± 2.5 and 37.5 ± 1.9 at baseline and after active intervention and 41.5 ± 1.8 and 40.4 ± 1.9 at baseline and after the inactive intervention. When carefully delivered to patients' eye and monitored with calibrated instrument, daytime light can improve sleep, mood and behavior in nursing home residents with ADRD. The NIA provided funding under grant number R01 AG034157.