Lighting and Alzheimer’s disease and related dementias: Spotlight on sleep and depression

2021 ◽  
Vol 53 (5) ◽  
pp. 405-422
Author(s):  
MG Figueiro ◽  
HC Kales
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disease ◽  
Sleep Disturbances ◽  
Well Being ◽  
Pharmacological Intervention ◽  
Negative Effects ◽  
Health And Well Being ◽  
Positive Results

Alzheimer’s disease and related dementias is the collective term for a progressive neurodegenerative disease for which there is presently no cure. This paper focuses on two symptoms of the disease, sleep disturbances and depression, and discusses how light can be used as a non-pharmacological intervention to mitigate their negative effects. Bright days and dark nights are needed for health and well-being, but the present components of the built environment, especially those places where older adults spend most of their days, are too dimly illuminated during the day and too bright at night. To be effective light needs to be correctly specified, implemented and measured. Yet, without the appropriate specification and measurement of the stimulus, researchers will not be able to successfully demonstrate positive results in the field, nor will lighting designers and specifiers have the confidence to implement lighting solutions for promoting better sleep and mood in this population.

scholarly journals Exercise interventions for older adults with Alzheimer’s disease: a systematic review and meta-analysis protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Julie M. Faieta ◽  
Hannes Devos ◽  
Prasanna Vaduvathiriyan ◽  
Michele K. York ◽  
Kirk I. Erickson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Financial Burden ◽  
Meta Analysis ◽  
Well Being ◽  
Pharmacological Intervention ◽  
Exercise Interventions ◽  
Ovid Medline

Abstract Background The growing societal and economic impact of Alzheimer’s disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations. Methods This systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol. Discussion This review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD. Systematic review registration PROSPERO CRD42020175016.

scholarly journals Terapia Ocupacional no cuidado ao idoso com demência: uma revisão integrativa/Occupational therapy in the care of the elderly with dementia: integrative review

2019 ◽  
Vol 3 (1) ◽  
pp. 117-132
Author(s):  
Vanessa Silva Lins ◽  
Marcia Queiroz de Carvalho Gomes
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Occupational Therapy ◽  
Public Health Problem ◽  
Well Being ◽  
The Elderly ◽  
Occupational Performance ◽  
Number Of Publications

A demência é uma das principais causas de incapacidade entre a população idosa, sua prevalência vem crescendo com o aumento da longevidade e vem se tornando um problema de saúde pública. O idoso acometido por demência tem as ocupações e o desempenho ocupacional bastante comprometido, necessitando da assistência do terapeuta ocupacional. O objetivo do presente estudo é analisar as contribuições da Terapia Ocupacional na atenção ao idoso com demência, descritas nas produções científicas publicadas em periódicos na área de saúde. Trata-se de uma revisão sistemática, do tipo integrativa, realizada na plataforma BIREME, nas bases de dados da LILACS, SciELO e MEDLINE, usando os descritores “Demência AND Terapia Ocupacional” e “Doença de Alzheimer AND Terapia Ocupacional”, nos idiomas português e espanhol. Foram encontrados 33 artigos, desse total foram selecionados para análise 07 artigos, que estavam dentro dos critérios de inclusão. Esta revisão permitiu constatar que, apesar da tímida produção de publicações de terapeutas ocupacionais acerca da demência, nos dois idiomas pesquisados, a Terapia Ocupacional vem ampliando seu escopo de ação, para além das tradicionais abordagens cognitivas e centradas apenas no idoso, avançou na promoção de práticas preventivas e no manejo de sintomas psicológicos e comportamentais, que envolvem tanto o ambiente físico quanto o ambiente social do idoso. A Terapia Ocupacional tem desenvolvido e utilizado instrumentos próprios da profissão, tais como a DADL-Br e a COPM, fortalecendo sua identidade e especificidade. Vem contribuindo para a qualidade de vida e bem-estar do idoso com Demência e seus cuidadores/familiares, promovendo uma atenção integral e contextualizada. Abstract Dementia is one of the leading causes of disability among the elderly population. Its prevalence has increased with longevity growth and it has become a public health problem. The older adults person affected by dementia has his/her occupations and occupational performance quite compromised, requiring Occupational Therapy assistance. The objective of the present study is to analyze Occupational Therapy assistance contributions to the elderly with dementia, described in the scientific productions published in health journals. It is a review of the integrative type, performed in BIREME platform, in the databases of LILACS, SciELO and MEDLINE, using the descriptors "Dementia AND Occupational Therapy" and "Alzheimer's Disease AND Occupational Therapy", in Portuguese and Spanish.We have found 33 articles, from which 7 articles were selected for analysis, according to the inclusion criteria.This review showed that, in spite of the small number of publications about the performance of dementia in both languages, Occupational Therapy has expanded its scope of action. Beyond cognitive approaches focused on the older adults, it has been making progress on preventing and managing psychological and behavioral symptoms, involving both the physical and social environment of the older adults. Occupational Therapy has developed and used its own tests and evaluations, such as DADL-Br and COPM, strengthening its identity and specificity. It contributes to the quality of life and well-being of the elderly with Dementia and their caregivers / family, promoting integrated and contextualized care.Keywords: Dementia, Alzheimer's Disease, Elderly; Occupational Therapy.

scholarly journals Plasma Total Tau and Neurobehavioral Symptoms of Cognitive Decline in Cognitively Normal Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
James R. Hall ◽  
Melissa Petersen ◽  
Leigh Johnson ◽  
Sid E. O’Bryant
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Significant Relationship ◽  
Sleep Disturbances ◽  
Cognitively Normal ◽  
Total Tau ◽  
Neurobehavioral Symptoms ◽  
The Impact

Depression and related neurobehavioral symptoms are common features of Alzheimer’s disease and other dementias. The presence of these potentially modifiable neurobehavioral symptoms in cognitively intact older adults may represent an early indication of pathophysiological processes in the brain. Tau pathology is a key feature of a number of dementias. A number of studies have found an association between tau and neurobehavioral symptoms. The current study investigated the relationship of a blood-based biomarker of tau and symptoms of depression, anxiety, worry, and sleep disturbances in 538 community based, cognitively normal older adults. Logistic regression revealed no significant relationship between plasma total tau and any measures of neurobehavioral symptoms. To assess the impact of level of tau on these relationships, participants were divided into those in the highest quintile of tau and those in the lower four quintiles. Regression analyses showed a significant relationship between level of plasma total tau and measures of depression, apathy, anxiety, worry and sleep. The presence of higher levels of plasma tau and elevated neurobehavioral symptoms may be an early indicator of cognitive decline and prodromal Alzheimer’s disease. Longitudinal research is needed to evaluate the impact of these factors on the development of dementia and may suggest areas for early intervention.

scholarly journals OBJECTIVELY MEASURED SLEEP CHARACTERISTICS OF OLDER ADULTS WITH AND WITHOUT ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S1-S2
Author(s):  
Alex Laffer ◽  
Hilary J Hicks ◽  
Genna Losinski ◽  
Amber Watts
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Living Environment ◽  
Sleep Onset Latency ◽  
Significant Group ◽  
Time In Bed ◽  
Increased Risk

Abstract Older adults commonly experience disturbed sleep such as difficulty initiating or maintaining sleep. Older adults who experience impaired sleep are at increased risk for cognitive decline or developing Alzheimer’s disease (AD). Research has shown that people with AD experience changes in sleep patterns, however, these changes are not well characterized. To better understand sleep in an older adult population with and without AD, the present study aimed to describe and compare objective sleep characteristics in both. Participants were older adults (126 with and 41 without AD) who wore an ActiGraph GT9X monitor on their non-dominant wrist for 7 days in a free-living environment. Results suggest that, compared to those without AD, participants with AD spent significantly more time in bed, t (165) = -4.37, p = .001), slept for longer durations, t (165) = -2.39, p = .044), and had less efficient sleep, t (165) = 2.71, p = .007. Participants with AD also had significantly greater sleep onset latency, more time awake after sleep onset, longer awakening lengths, and tended to arise later in the morning (all p ≤ .016). No differences were found between the groups in age, bedtime, or the number of awakenings during the night. These findings add to our understanding of the sleep disturbances experienced by older adults with and without AD. Significant group differences suggest that interventions may be necessary in treating sleep disturbances for older adults with and without AD. Future studies should examine sleep longitudinally to understand risk factors related to AD.

Ethical dilemmas in neurodegenerative disease: Respecting patients at the twilight of agency

2017 ◽  
Author(s):  
Agnieszka Jaworska
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disease ◽  
Ethical Dilemmas ◽  
Well Being

This chapter focuses on dilemmas faced by caregivers of Alzheimer’s patients in cases in which current preferences of such patients come into conflict with the attitudes and values the person held during better health. To which set of preferences should conscientious caregivers give priority? The chapter argues that many Alzheimer’s patients, at least up to the middle stages of the disease, are still capable of rudimentary autonomy and that they still have authority concerning their well-being. The capacity to value is often not completely lost in dementia, and insofar as it is not, respect for the immediate interests of a demented person compromises neither their well-being nor the respect for their autonomy. In the postscript, emerging neuroscience evidence is discussed that may suggest that, for a time, the capacity to value is not only preserved but even enhanced in the progression of Alzheimer’s disease.

scholarly journals Beyond the sleep-amyloid interactions in Alzheimer’s disease pathogenesis

2019 ◽  
Vol 122 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Shen Ning ◽  
Mehdi Jorfi
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Circadian Rhythm ◽  
Cognitive Impairment ◽  
Circadian Rhythms ◽  
Sleep Disturbances ◽  
Amyloid Β ◽  
Disease Pathogenesis ◽  
Previous Evidence

Cognitive impairment in older adults is associated with sleep and circadian rhythm disturbances. Numerous studies have linked disrupted sleep and circadian rhythms with amyloid-β (Aβ), a key pathological hallmark in Alzheimer’s disease (AD). While previous evidence suggests that Aβ initiates AD pathogenesis, tau, another major hallmark of AD, seems to drive neurodegeneration. Recent studies imply that sleep-wake cycles affect brain tau more significantly than Aβ levels, leading to accelerated AD progression and cognitive decline. The study of sleep disturbances in AD is shedding light on our understanding of the mechanism underlying sleep disturbances in AD and dementia.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Partner-Specific Communication Deficits in Individuals With Alzheimer's Disease

2020 ◽  
pp. 1-15
Author(s):  
Eun Jin Paek ◽  
Si On Yoon
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Referential Communication ◽  
Sorting Task ◽  
Audience Design ◽  
Healthy Older Adults ◽  
Communication Task ◽  
Design Skills ◽  
Referential Expressions

Purpose Speakers adjust referential expressions to the listeners' knowledge while communicating, a phenomenon called “audience design.” While individuals with Alzheimer's disease (AD) show difficulties in discourse production, it is unclear whether they exhibit preserved partner-specific audience design. The current study examined if individuals with AD demonstrate partner-specific audience design skills. Method Ten adults with mild-to-moderate AD and 12 healthy older adults performed a referential communication task with two experimenters (E1 and E2). At first, E1 and participants completed an image-sorting task, allowing them to establish shared labels. Then, during testing, both experimenters were present in the room, and participants described images to either E1 or E2 (randomly alternating). Analyses focused on the number of words participants used to describe each image and whether they reused shared labels. Results During testing, participants in both groups produced shorter descriptions when describing familiar images versus new images, demonstrating their ability to learn novel knowledge. When they described familiar images, healthy older adults modified their expressions depending on the current partner's knowledge, producing shorter expressions and more established labels for the knowledgeable partner (E1) versus the naïve partner (E2), but individuals with AD were less likely to do so. Conclusions The current study revealed that both individuals with AD and the control participants were able to acquire novel knowledge, but individuals with AD tended not to flexibly adjust expressions depending on the partner's knowledge state. Conversational inefficiency and difficulties observed in AD may, in part, stem from disrupted audience design skills.

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