Changes in Sleep Predict Changes in Affect in Older Caregivers of Individuals with Alzheimer’s Dementia: A Multilevel Model Approach: Table 1.

McCrae, Christina S.; Dzierzewski, Joseph M.; McNamara, Joseph P. H.; Vatthauer, Karlyn E.; Roth, Alicia J.; Rowe, Meredeth A.

doi:10.1093/geronb/gbu162

Cited by 34 publications

(20 citation statements)

References 15 publications

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“…Impaired melatonin production occurs in AD and other dementias because of Suprachiasmatic Nucleus neuronal loss (469;470), leading to a decreased regularity of sleep, impaired sleep initiation and continuity, and difficulty maintaining wakefulness during daylight. Sleep disturbance predicts family carer depressive symptoms, increases care burden and leads to care home admission, significantly elevating care costs (471). A Cochrane review found no definitive evidence from trials of pharmacological treatments for sleep in older people with dementia (ChEIs, donepezil and galantamine; antidepressants, trazodone and mirtazapine; or melatonin and ramelteon) and there were no RCTs of benzodiazepines or non-benzodiazepine hypnotics (472).There was some suggestion that trazodone 50mg may be useful but no large trials.…”

Section: Sleepmentioning

confidence: 99%

Dementia prevention, intervention, and care

et al. 2017

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People with dementia are usually older, often have co-morbidities and may need help in coping with these illnesses. A third of older people now die with dementia and all professionals working in endof-life care need to make this a central part of their planning and communication. In this commission, we have detailed evidence-based approaches to dementia and its symptoms. Services should be available, scalable and give value. As there are limited resources, professionals and services need to use what works, not use what is ineffective, and be aware of the difference. Overall, there is good potential for prevention and, once someone develops dementia, for care to be high-quality, accessible, and give value to an under-served, growing population. Effective dementia prevention and care could transform the future for society and vastly improve living and dying for individuals with dementia and their families. Acting now on what we already know can make this difference happen. Key Messages 1 There are increasing numbers of people with dementia globally although incidence in some countries has decreased. 2 Be ambitious about prevention: We recommend energetically treating hypertension in middle aged and older people without dementia to reduce dementia incidence. Interventions for other risk factors, including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes and obesity; may have the potential of delaying or preventing a third of dementias. 3 Treat cognitive symptoms: To maximise cognition, people with Alzheimer's dementia or Dementia with Lewy Bodies should be offered Cholinesterase Inhibitors (ChEIs)at all stages, or memantine for severe dementia. ChEIs are not effective in Mild Cognitive Impairment. 4 Individualise dementia care: Good dementia care spans medical, social and supportive care, should be tailored to unique individual and cultural needs, preferences, priorities, and should incorporate support for the family carers 5 Care for family carers. Family carers are at high risk of depression. Effective interventions reduce the risk and treat the symptoms, include START (Strategies for Relatives) or REACH (Resources for Enhancing Alzheimer's Caregiver Health intervention) and should be made available. 6 Plan for the future. People with dementia and their families value discussions about the future and decisions about possible attorneys to make decisions. Clinicians should consider capacity to make different types of decisions at diagnosis. 7 Protect people with dementia. People with dementia and society require protection from possible risks of the condition, including self-neglect, vulnerability including to exploitation, managing money, driving or using weapons. Risk assessment and management at all stages of the disease is essential but it should be balanced against the persons' right to autonomy. 8 Manage neuropsychiatric symptoms. Management of the neuropsychiatric symptoms of dementia including agitation, low mood or psyc...

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Section: Sleepmentioning

confidence: 99%

Dementia prevention, intervention, and care

et al. 2017

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“…This affects sleep regardless of whether a person has assistance at home or is in a hospital intensive care unit . For those who have assistance at home, there are genuine concerns that their caregiver's sleep is also affected …”

Section: Sleep and Physical Disabilitymentioning

confidence: 99%

Sleep disorders in the elderly: a growing challenge

2018

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In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.

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“…Technological strategies that might help reduce the unpredictability of dealing with care-receivers at night could be particularly helpful as there is evidence that caregiver perceptions about the inconsistency in their sleep may have as much impact on caregiver mood and burden as the actual sleep quality itself [40].…”

Section: Caregiver Sleep Interventionsmentioning

confidence: 99%

Sleep in caregivers

McCurry

Song

Martin

2015

Current Opinion in Psychiatry

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There is a growing literature describing the general determinants of sleep disturbances in caregivers, the health consequences of these disturbances, and intervention strategies for treating them. Identifying effective sleep treatments suited to more specialized caregiving situations and increasing intervention access will help caregivers continue to provide quality care while protecting their own health and well-being.

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Changes in Sleep Predict Changes in Affect in Older Caregivers of Individuals with Alzheimer’s Dementia: A Multilevel Model Approach: Table 1.

Cited by 34 publications

References 15 publications

Dementia prevention, intervention, and care

Dementia prevention, intervention, and care

Sleep disorders in the elderly: a growing challenge

Sleep in caregivers

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