Effect of morning bright light treatment for rest–activity disruption in institutionalized patients with severe Alzheimer's disease

Dowling, Glenna A.; Hubbard, Erin; Mastick, Judy; Luxenberg, Jay S.; Burr, Robert L.; Someren, Eus J.W. Van

doi:10.1017/s1041610205001584

Cited by 155 publications

(135 citation statements)

References 26 publications

Supporting

Mentioning

118

Contrasting

Order By: Relevance

“…If aging reduces visual inputs to the pineal gland or SCN, bright-light therapy might also rescue the disruption of circadian rhythm. Indeed, bright-light treatment improves circadian rhythms or sleep-wake cycles in both SAMP8 and humans with Alzheimer's disease (Dowling et al 2005;Miyamoto et al 1998;Yamadera et al 2000).…”

Section: Discussionmentioning

confidence: 99%

Age-related disruptions of circadian rhythm and memory in the senescence-accelerated mouse (SAMP8)

Pang

Miller

Fortress

et al. 2006

AGE

View full text Add to dashboard Cite

Common complaints of the elderly involve impaired cognitive abilities, such as loss of memory and inability to attend. Although much research has been devoted to these cognitive impairments, other factors such as disrupted sleep patterns and increased daytime drowsiness may contribute indirectly to impaired cognitive abilities. Disrupted sleep-wake cycles may be the result of age-related changes to the internal (circadian) clock. In this article, we review recent research on aging and circadian rhythms with a focus on the senescence-accelerated mouse (SAM) as a model of aging. We explore some of the neurobiological mechanisms that appear to be responsible for our aging clock, and consider implications of this work for age-related changes in cognition.Key words aging . C-Fos . circadian rhythms . mouse . running wheel . SAMP8 . suprachiasmatic nucleus Cognitive impairments are well-known complaints of the elderly. Despite their obvious clinical importance, many questions remain unanswered. One important issue concerns whether cognitive impairments are due to direct alterations in the cognitive function, or to other difficulties that may in turn result in cognitive deficits. For example, the elderly often report poor night-time sleep quality, daytime sleepiness, lack of energy, and difficulty adjusting to a time shift (increased "jet lag"). Could these effects contribute to cognitive impairments?Although a confluence of factors may lead to poor sleep quality, etc., it is likely that one general culprit is aging of the internal (circadian) clock that regulates these behaviors (Munch et al. 2005;Turek et al. 1995;Weitzman et al. 1982). Moreover, evidence suggests that our internal clock may also mediate cognitive functioning (Antoniadis et al. 2000;Brock 1991, Stone 1989van Gool 1986;van Someren et al. 1993a). In this article, we review recent research on aging and circadian rhythms, with a focus on the senescence-accelerated mouse line. We explore some of the neurobiological mechanisms that appear to be responsible for our aging clock, and consider implications of this work for the study of age-related changes in cognition.Circadian rhythms are predictable and regularly occurring daily changes in behavior and physiological states. The term circadian, literally meaning "around a day," has its origins in two Latin words: Circa (around) and dies (day). Two defining characteristics AGE (2006) of circadian rhythms are their continued persistence in the absence of external cues in the environment and their ability to be entrained (synchronized) by environmental cues. With respect to the former property, it is the endogenous (self-sustaining) nature of circadian rhythms that engenders an internal clock. With respect to the latter property, the major external cue that serves to synchronize the circadian rhythms of humans and other mammals is light, but almost any periodic event can act as a Zeitgeber ("time-giver").Research on the biological basis of circadian rhythms in humans and other mammals implicates the s...

show abstract

Section: Discussionmentioning

confidence: 99%

Age-related disruptions of circadian rhythm and memory in the senescence-accelerated mouse (SAMP8)

Pang

Miller

Fortress

et al. 2006

AGE

View full text Add to dashboard Cite

show abstract

“…Even in severe dementia morning light therapy might lead to phase advances of circadian rhythms and improve behavioral symptoms (75), and both morning and evening light therapy improves circadian parameters and leads to consolidation of sleep (74). Dowling et al (76) did not report beneficial effects of light therapy on sleep parameters in institutionalized AD patients, but the light therapy did lead to a more stable circadian phase, and it has been suggested that those AD patients with the most severe circadian abnormality are most likely to respond to light therapy (77). Efficacy of light therapy might also be enhanced significantly in combination with melatonin treatment (78).…”

Section: Chronotherapeutics In Admentioning

confidence: 99%

The Circadian System in Alzheimer’s Disease: Disturbances, Mechanisms, and Opportunities

Coogan

Schutová

Husung

et al. 2013

Biological Psychiatry

146

131

View full text Add to dashboard Cite

Alzheimer's disease (AD) is a devastating neurodegenerative condition associated with severe cognitive and behavioral impairments. Circadian rhythms are recurring cycles that display periods of approximately 24 hours and are driven by an endogenous circadian timekeeping system centered on the suprachiasmatic nucleus of the hypothalamus. We review the compelling evidence that circadian rhythms are significantly disturbed in AD and that such disturbance is of significant clinical importance in terms of behavioral symptoms. We also detail findings from neuropathological studies of brain areas associated with the circadian system in postmortem studies, the use of animal models of AD in the investigation of circadian processes, and the evidence that chronotherapeutic approaches aimed at bolstering weakened circadian rhythms in AD produce beneficial outcomes. We argue that further investigation in such areas is warranted and highlight areas for future research that might prove fruitful in ultimately providing new treatment options for this most serious and intractable of conditions.

show abstract

“…It is known that with the progression of neurodegenerative dementias, sleep is disrupted; therefore maintaining the sleep/wake cycle is a biologically plausible intervention. The variation in the intensity of light used across studies as well as the timing were critical to the outcomes observed (Dowling 2005), and likely account for the differences in study results.…”

Section: Light Therapymentioning

confidence: 99%

Psychosocial interventions for dementia: from evidence to practice

Patel¹,

Perera²,

J³

et al. 2014

Adv. psychiatr. treat

View full text Add to dashboard Cite

ARTICLEThis article is an update to the overview in Advances by Douglas et al (2004). We summarise the most well-researched psychosocial approaches for dementia by focusing on those with goodquality evidence, and acknowledge some of the newer and less-researched interventions listed in Box 1.The recurrent theme throughout the literature regarding the efficacy of non-pharmacological interventions for dementia is the need for more robust evidence. Reasons for this include that research funding is largely targeted at biomedical approaches and that study designs are not always a good fit for the outcomes measured. Kitwood (1997) proposed that a person-centred approach should be the bedrock for supporting people with dementia. The essential tenet is that personhood remains throughout the experience of dementia and it is the caregiver's responsibility to ensure that it is maintained. Person-centred practice recognises the underlying needs of the individual, often expressed through behaviour. The paradigm shift from 'managing' behavioural and psychological symptoms of dementia (BPSD) towards improving well-being, engagement and quality of life represents a significant change. These goals are more hopeful, leaving therapeutic nihilism in the past. Reducing antipsychotic prescribing (Banerjee 2009) presents another opportunity to exploit these approaches. A review of 26 non-pharmacological intervention categories concluded that non-pharmacological therapies are useful, versatile and potentially cost-effective in improving outcomes and quality of life (Olazarán 2010); however, they necessitate staff time, raising issues regarding priorities and risk (Lawrence 2012).The essential component is the belief that distress and behaviour are expressions of unmet need -all behaviour having meaning -and are a response to the challenges dementia presents (Kitwood 1997). The key appears to be formulation or behavioural analysis (Moniz-Cook 2012) to understand the behaviour and its function for each person. is not yet robust enough to clearly suggest which interventions are most suited for which environment. However, from our literature review there appears to be reason to use music therapy, aromatherapy, life story work, animal-assisted therapy and post-diagnosis/carer support work. We focus on both the traditional outcome measures of behavioural and psychological symptoms of dementia (BPSD) and the more difficult to measure, but equally important, person-centred outcomes of non-pharmacological interventions, as their properties are distinctly different from those of pharmacological agents. LEARNING OBJECTIVES•• Be aware of the range of psychosocial interventions.•• Have a better understanding of the possible outcomes from given interventions.•• Be aware of the paradigm shift from managing BPSD to a person-centred approach that focuses on the patient's well-being and quality of life. DECLARATION OF INTERESTNone.BOX 1 Psychosocial approaches for dementia that are in use but research is ongoing

show abstract

Effect of morning bright light treatment for rest–activity disruption in institutionalized patients with severe Alzheimer's disease

Cited by 155 publications

References 26 publications

Age-related disruptions of circadian rhythm and memory in the senescence-accelerated mouse (SAMP8)

Age-related disruptions of circadian rhythm and memory in the senescence-accelerated mouse (SAMP8)

The Circadian System in Alzheimer’s Disease: Disturbances, Mechanisms, and Opportunities

Psychosocial interventions for dementia: from evidence to practice

Contact Info

Product

Resources

About