Effect of Personalized Blue-Enriched White Light Intervention on Rest–Activity and Light Exposure Rhythms in Mild and Moderate Alzheimer’s Disease
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Objective We aimed to examine the effectiveness of personalized light intervention using a blue-enriched light-emitting-diodes device on rest–activity rhythm (RAR) and light exposure rhythm (LER) in patients with mild and moderate Alzheimer’s disease (AD).Methods AD patients with poor sleep quality and/or insomnia symptoms were assigned into either an experimental group (EG) or control group (CG) in a single-blind design. Personalized light intervention was given at 9–10 h after individual dim light melatonin onset, lasting for 1 h every day for two weeks in the EG (77.36±5.79 years, n=14) and CG (78.10±7.98 years, n=10). Each patient of CG wore blue-attenuating sunglasses during the intervention. Actigraphy recording at home for 5 days was done at baseline (T0), immediate postintervention (T1), and at four weeks after intervention (T2). The variables of RAR and LER were derived using nonparametric analysis.Results We found a significant time effect on the intradaily variability (IV) of RAR at T2 with respect to T0 (p=0.039), indicating reduced IV of RAR at four weeks after personalized light intervention regardless of blue-enriched light intervention. There was a time effect on the IV of LER at T1 with respect to T0 (p=0.052), indicating a reduced tendency in the IV of LER immediately after intervention.Conclusion Our personalized light intervention, regardless of blue-enriched light source, could be useful in alleviating fragmentation of RAR and LER in AD patients.
Abstract
Objective We aimed to examine the effectiveness of personalized light intervention using a blue-enriched light-emitting-diodes device on rest–activity rhythm (RAR) and light exposure rhythm (LER) in patients with mild and moderate Alzheimer’s disease (AD).Methods AD patients with poor sleep quality and/or insomnia symptoms were assigned into either an experimental group (EG) or control group (CG) in a single-blind design. Personalized light intervention was given at 9–10 h after individual dim light melatonin onset, lasting for 1 h every day for two weeks in the EG (77.36±5.79 years, n=14) and CG (78.10±7.98 years, n=10). Each patient of CG wore blue-attenuating sunglasses during the intervention. Actigraphy recording at home for 5 days was done at baseline (T0), immediate postintervention (T1), and at four weeks after intervention (T2). The variables of RAR and LER were derived using nonparametric analysis.Results We found a significant time effect on the intradaily variability (IV) of RAR at T2 with respect to T0 (p=0.039), indicating reduced IV of RAR at four weeks after personalized light intervention regardless of blue-enriched light intervention. There was a time effect on the IV of LER at T1 with respect to T0 (p=0.052), indicating a reduced tendency in the IV of LER immediately after intervention.Conclusion Our personalized light intervention, regardless of blue-enriched light source, could be useful in alleviating fragmentation of RAR and LER in AD patients.
참고문헌 (68)
- Vitiello MV, "Sleep in Alzheimer’s disease and the sundown syndrome", Neurology, 42(7 Suppl 6), pp.83~93 (1992)
- Videnovic A, "Consequences of circadian disruption on neurologic health", Sleep Med Clin, 10, pp.469~480 (2015)
- Leng Y, "Association between circadian rhythms and neurodegenerative diseases", Lancet Neurol, 18, pp.307~318 (2019)
- Hatfield CF, "Disrupted daily activity", rest cycles in relation to daily cortisol rhythms of home-dwelling patients with early Alzheimer’s dementia, 2004, pp.127, 1061~1074
- Canazei M, "Actigraphy for assessing light effects on sleep and circadian activity rhythm in Alzheimer’s dementia : a narrative review", Curr Alzheimer Res, 16, pp.1084~1107 (2019)
- Carvalho-Bos SS, "Strong association of the rest–activity rhythm with well-being in demented elderly women", Am J Geriatr Psychiatry, 15, pp.92~100 (2007)
- Li P, "Circadian disturbances in Alzheimer’s disease progression : a prospective observational cohort study of community-based older adults", Lancet Healthy Longev, 1, pp.e96~e105 (2020)
- Varma VR, "Low-intensity daily walking activity is associated with hippocampal volume in older adults", Hippocampus, 25, pp.605~615 (2015)
- Musiek ES, "Circadian rest-activity pattern changes in aging and preclinical Alzheimer disease", JAMA Neurol, 75, pp.582~590 (2018)
- Musiek ES, "Mechanisms linking circadian clocks, sleep, and neurodegeneration", Science, 354, pp.1004~1008 (2016)
- Ma LZ, "Time spent in outdoor light is associated with the risk of dementia : a prospective cohort study of 362094 participants", BMC Med, 20, pp.132~ (2022)
- van Someren EJ, "Circadian rest-activity rhythm disturbances in Alzheimer’s disease", Biol Psychiatry, 40, pp.259~270 (1996)
- Mishima K, "Diminished melatonin secretion in the elderly caused by insufficient environmental illumination", J Clin Endocrinol Metab, 86, pp.129~134 (2001)
- Gandhi AV, "Melatonin is required for the circadian regulation of sleep", Neuron, 85, pp.1193~1199 (2015)
- Volicer L, "Sundowning and circadian rhythms in Alzheimer’s disease", Am J Psychiatry, 158, pp.704~711 (2001)
- Guu TW, "Light, sleep-wake rhythm, and behavioural and psychological symptoms of dementia in care home patients : revisiting the sundowning syndrome", Int J Geriatr Psychiatry, 37, pp.1~10 (2022)
- Hjetland GJ, "Light interventions and sleep, circadian, behavioral, and psychological disturbances in dementia : a systematic review of methods and outcomes", Sleep Med Rev, 52, pp.101310~ (2020)
- Liu CR, "Pilot study of the effects of bright ambient therapy on dementia symptoms and cognitive function", Front Psychol, 12, pp.782160~ (2021)
- Mitolo M, "Effects of light treatment on sleep, cognition, mood, and behavior in Alzheimer’s disease : a systematic review", Dement Geriatr Cogn Disord, 46, pp.371~384 (2019)
- Tan JSI, "Light therapy for sleep disturbances in older adults with dementia : a systematic review, metaanalysis and meta-regression", Sleep Med, 90, pp.153~166 (2022)
- Kim SJ, "Phase-shifting response to light in older adults", J Physiol, 592, pp.189~202 (2014)
- Harper DG, "Disturbance of endogenous circadian rhythm in aging and Alzheimer disease", Am J Geriatr Psychiatry, 13, pp.359~368 (2005)
- Satlin A, "Circadian locomotor activity and core-body temperature rhythms in Alzheimer’s disease", Neurobiol Aging, 16, pp.765~771 (1995)
- Kim SJ, "Positive effect of timed blue-enriched white light on sleep and cognition in patients with mild and moderate Alzheimer’s disease", Sci Rep, 11, pp.10174~ (2021)
- Van Someren EJ, "Bright light therapy : improved sensitivity to its effects on rest-activity rhythms in Alzheimer patients by application of nonparametric methods", Chronobiol Int, 16, pp.505~518 (1999)
- Hooghiemstra AM, "The rest-activity rhythm and physical activity in early-onset dementia", Alzheimer Dis Assoc Disord, 29, pp.45~49 (2015)
- Yamadera H, "Effects of bright light on cognitive and sleep-wake(circadian)rhythm disturbances in Alzheimer-type dementia", Psychiatry Clin Neurosci, 54, pp.352~353 (2000)
- Bauer M, "Association between polarity of first episode and solar insolation in bipolar I disorder", J Psychosom Res, 160, pp.110982~ (2022)
- Kim SJ, "Association of a nonsynonymous polymorphism in PER 1 with diurnal preference in Korean adults", Biol Rhythm Res, 50, pp.593~602 (2019)
- Pan ST, "A transition-constrained discrete hidden Markov model for automatic sleep staging", Biomed Eng Online, 11, pp.52~ (2012)
- Sletten TL, "Age-related changes in acute and phase-advancing responses to monochromatic light", J Biol Rhythms, 24, pp.73~84 (2009)
- Figueiro MG, "Light, sleep and circadian rhythms in older adults with Alzheimer’s disease and related dementias", Neurodegener Dis Manag, 7, pp.119~145 (2017)
- Association Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
- Hughes CP, "A new clinical scale for the staging of dementia", Br J Psychiatry, 140, pp.566~572 (1982)
- Buysse DJ, "The Pittsburgh Sleep Quality Index : a new instrument for psychiatric practice and research", Psychiatry Res, 28, pp.193~213 (1989)
- Cho YW, "The reliability and validity of the Korean version of the Epworth sleepiness scale", Sleep Breath, 15, pp.377~384 (2011)
- Jung IK, "A reliability and validity study of geriatric depression scale", J Korean Neuropsychiatr Assoc, 36, pp.103~112 (1997)
- Lee JH, "Development of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet(CERAD-K)clinical and neuropsychological assessment batteries", J Gerontol B Psychol Sci Soc Sci, 57, pp.P47~P53 (2002)
- Kim SJ, "Disrupted sleep maintenance is associated with altered circadian phase and phase angle in communitydwelling adults", Sleep Med, 73, pp.250~256 (2020)
- Revell VL, "Human phase response curve to intermittent blue light using a commercially available device", J Physiol, 590, pp.4859~4868 (2012)
- Kim SJ, "Association of rest–activity and light exposure rhythms with sleep quality in insomnia patients", Chronobiol Int, 37, pp.403~413 (2020)
- Blume C, "‘nparACT’ package for R : a free software tool for the non-parametric analysis of actigraphy data", MethodsX, 3, pp.430~435 (2016)
- Neikrug AB, "Characterizing behavioral activity rhythms in older adults using actigraphy", Sensors(Basel), 20, pp.549~ (2020)
- Sloane P, "Effect of home-based light treatment on persons with dementia and their caregivers", Light Res Technol, 47, pp.161~176 (2015)
- Dowling GA, "Effect of morning bright light treatment for rest–activity disruption in institutionalized patients with severe Alzheimer’s disease", Int Psychogeriatr, 17, pp.221~236 (2005)
- Satlin A, "Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer’s disease", Am J Psychiatry, 149, pp.1028~1032 (1992)
- Fontana Gasio P, "Dawn–dusk simulation light therapy of disturbed circadian rest–activity cycles in demented elderly", Exp Gerontol, 38, pp.207~216 (2003)
- Skjerve A, "Improvement in behavioral symptoms and advance of activity acrophase after short-term bright light treatment in severe dementia", Psychiatry Clin Neurosci, 58, pp.343~347 (2004)
- Cremascoli R, "Effects of circadian phase tailored light therapy on sleep, mood, and cognition in Alzheimer’s disease : preliminary findings in a pivotal study", Front Physiol, 12, pp.755322~ (2022)
- Rosenwasser AM, "Neurobiology of circadian rhythm regulation", Sleep Med Clin, 10, pp.403~412 (2015)
- Duffy JF, "Decreased sensitivity to phase-delaying effects of moderate intensity light in older subjects", Neurobiol Aging, 28, pp.799~807 (2007)
- Benloucif S, "Responsiveness of the aging circadian clock to light", Neurobiol Aging, 27, pp.1870~1879 (2006)
- Sloane PD, "High-intensity environmental light in dementia : effect on sleep and activity", J Am Geriatr Soc, 55, pp.1524~1533 (2007)
- Figueiro MG, "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", J Clin Sleep Med, 15, pp.1757~1767 (2019)
- Figueiro MG, "Long-term, allday exposure to circadian-effective light improves sleep, mood, and behavior in persons with dementia", J Alzheimers Dis Rep, 4, pp.297~312 (2020)
- Figueiro MG, "Measuring dose in a tailored lighting intervention to improve sleep and mood in Alzheimer’s disease patients : psychosocial factors and environmental design : technology and interventions", Alzheimers Dem, 16, pp.e037168~ (2020)
- Sagud M, "Personalized treatment interventions : nonpharmacological and natural treatment strategies in Alzheimer’s disease", Expert Rev Neurother, 21, pp.571~589 (2021)
- Tsai SY, "Light is beneficial for infant circadian entrainment : an actigraphic study", J Adv Nurs, 68, pp.1738~1747 (2012)
- Martinez-Nicolas A, "Crosstalk between environmental light and internal time in humans", Chronobiol Int, 28, pp.617~629 (2011)
- Campbell SS, "Exposure to light in healthy elderly subjects and Alzheimer’s patients", Physiol Behav, 42, pp.141~144 (1988)
- Uchida K, "Daily rhythm of serum melatonin in patients with dementia of the degenerate type", Brain Res, 717, pp.154~159 (1996)
- Mishima K, "Melatonin secretion rhythm disorders in patients with senile dementia of Alzheimer’s type with disturbed sleep-waking", Biol Psychiatry, 45, pp.417~421 (1999)
- Obayashi K, "Positive effect of daylight exposure on nocturnal urinary melatonin excretion in the elderly : a cross-sectional analysis of the HEIJO-KYO study", J Clin Endocrinol Metab, 97, pp.4166~4173 (2012)
- Obayashi K, "Association between light exposure at night and insomnia in the general elderly population : the HEIJO-KYO cohort", Chronobiol Int, 31, pp.976~982 (2014)
- Coogan AN, "The circadian system in Alzheimer’s disease : disturbances, mechanisms, and opportunities", Biol Psychiatry, 74, pp.333~339 (2013)
- Phan TX, "Sleep and circadian rhythm disruption and stress intersect in Alzheimer’s disease", Neurobiol Stress, 10, pp.100133~ (2019)
- Burns A, "Bright light therapy for agitation in dementia : a randomized controlled trial", Int Psychogeriatr, 21, pp.711~721 (2009)
- Riemersma-van Der Lek RF, "Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities : a randomized controlled trial", JAMA, 299, pp.2642~2655 (2008)
