The association between circadian rest-activity patterns and the behavioral and psychological symptoms depending on the cognitive status in Japanese nursing-home residents

Saito, Yuma; Kume, Yu; Kodama, Atsuko; Sato, Kotaro; Yasuba, Megumi

doi:10.1080/07420528.2018.1505752

Cited by 18 publications

(13 citation statements)

References 26 publications

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“…Cross-sectional studies( Table 1 ): Consistent evidence demonstrated that people with dementia had less stable rhythms (5/6 studies 3–8). For example, the recent work by Saito et al (5) demonstrated that, among nursing home residents, those with dementia had lower IS values (reflecting less stability across days). The one study (8) that failed to detect an overall statistically significant overall association between dementia and RAR stability did find stability was lower among people with dementia who were living in institutional settings (compared with community dwelling people with dementia and healthy controls); the sample of people with Alzheimer’s disease living independently in this study was small (n = 8).…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Evidence for a Role of Rest-Activity Rhythms in Dementia

et al. 2019

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Background: Rest-activity rhythm (RAR) disruption may be a risk factor for dementia that can be objectively measured with wearable accelerometers. It is possible that risk monitoring and preventive interventions could be developed targeting RARs. To evaluate whether current evidence supports these applications, we systematically reviewed published studies linking RARs with dementia, its course, and mechanisms.Methods: Entering pre-defined search terms in PsycINFO, MEDLINE, and PubMed databases returned 192 unique titles. We identified 32 articles that met our primary inclusion criteria, namely, that they examined objective RAR measures in the context of dementia, cognition, or brain biomarkers.Results: Cross-sectional studies consistently found that people with dementia had less stable (5/6 studies), more fragmented (4/6 studies), lower amplitude rhythms (5/5 studies), that had a worse fit to 24-h models (3/3 studies). Findings from studies relating RARs to cognitive test performance (rather than diagnostic status) were more nuanced. RAR fragmentation was associated with neurodegeneration biomarkers in 2/2 studies; and 1/1 study found 24-h model fit related to hippocampal hyperactivation. Although 2/2 studies found RARs related to markers of cerebrovascular disease, the specific RARs and cerebrovascular disease measures were not consistent. Longitudinal studies (3/3 articles) reported that lower amplitude and worse 24-h rhythm fit predicted future cognitive impairment and executive function. However, interventions aimed at modifying RARs had mixed effects (e.g., 0/4 studies demonstrated effects of morning light on 24-h model fit; evening light was associated with improved 24-h fit in 2/2 studies reporting); these effects may be more evident in subgroups.Conclusions: Consistent evidence shows that dementia is associated with disrupted RARs. Importantly, recent studies have shown that RAR disruption is associated with dementia biomarkers and, prospectively, with the risk of cognitive impairment. Interventions mostly tried using bright light to modify RARs in people who already have dementia; these studies produced modest effects on RARs and did not show modification of dementia’s course. Altogether, these findings suggest studies are needed to understand how RARs relate to changes in brain health earlier in the disease process. Better understanding of the biopsychosocial mechanisms linking RARs with future dementia risk can help further target intervention development.

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Section: Resultsmentioning

confidence: 99%

“…In addition, 4/6 studies (positive studies (3, 4, 7, 9 and nonsignificant studies 5, 8) found that cognitive impairment was related to higher RAR fragmentation. For example, the early work by Wittin et al (3) demonstrated that Alzheimer disease patients had higher intra-daily variability, reflecting more fragmented (less consistent) rhythms.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Evidence for a Role of Rest-Activity Rhythms in Dementia

et al. 2019

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“…These disruptions predominantly include fragmentation and a reduced amplitude of the 24-h activity rhythm, and behaviors such as "sun-downing" [27] and frequent daytime napping [28]. Recent cross-sectional studies report a lower amplitude [28][29][30], a lower stability [29,31], and more fragmentation [29] in patients with dementia. More fragmented 24-h activity rhythms were also found in persons with earlyonset dementia [32].…”

Section: -H Activity Rhythms and Neurodegenerative Diseasementioning

confidence: 99%

24-h Activity Rhythms and Health in Older Adults

Feijter

Lysen

Luik

2020

Curr Sleep Medicine Rep

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Purpose of Review Circadian rhythms, including 24-h activity rhythms, change with age. Disturbances in these 24-h activity rhythms at older age have also been implied in various diseases. This review evaluates recent findings on 24-h activity rhythms and disease in older adults. Recent Findings Growing evidence supports that 24-h activity rhythm disturbances at older age are related to the presence and/or progression of disease. Longitudinal and genetic work even suggests a potential causal contribution of disturbed 24-h activity rhythms to disease development. Interventional studies targeting circadian and 24-h activity rhythms demonstrate that 24-h rhythmicity can be improved, but the effect of improving 24-h rhythmicity on disease risk or progression remains to be shown. Summary Increasing evidence suggests that 24-h activity rhythms are involved in age-related diseases. Further studies are needed to assess causality, underlying mechanisms, and the effects of treating disturbed 24-h activity rhythms on age-related disease.

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“…[24][25][26] Sleep problems are common among nursing home residents 27 and people suffering from dementia, 28 and have been linked to increased morbidity and mortality, cognitive decline 29 and additional symptoms such as agitation, hallucinations, depressed mood and disturbed appetite. 30,31 Studies have found that exposure to bright light can improve sleep and entrainment of circadian rhythms, 32 as well as ameliorate aggressive behavior and depression [33][34][35] in people with dementia, suggesting that dementia patients are exposed to inadequate levels of illuminance.…”

Section: Introductionmentioning

confidence: 99%

Insufficient melanopic equivalent daylight illuminance in nursing home dementia units across seasons and gaze directions

Kolberg

Pallesen

Hjetland

et al. 2021

Lighting Research & Technology

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Adequate illumination plays an important part in providing a healthy environment for nursing home patients with dementia. With increasing awareness of non-visual responses to light, new approaches to quantifying illuminance have emerged. In the present study, we assessed the illuminance in nursing home dementia units in terms of melanopic equivalent daylight illuminance, a metric which aims to quantify the non-visual physiological effects of light by weighing irradiance according to non-visual photoreception. It is among the most comprehensive studies of light conditions conducted in dementia units in terms of melanopic equivalent daylight illuminance to date, and the first to elucidate seasonal differences in melanopic illumination. Light conditions were assessed in all 15 nursing homes with dedicated long-term dementia units in Bergen municipality (60.39°N), Norway, during summer and winter. Results indicated that seasonal differences and gaze direction had some impact on melanopic equivalent daylight illuminance, but most measurements still fell below even conservative recommendations across seasons. The findings indicate a need for additional light sources that can compensate for limited natural daylight in dementia units. The ubiquity of insufficient melanopic equivalent daylight illuminance in dementia units suggests a role for lighting interventions in future research seeking to improve entrainment, sleep and mental health of dementia unit residents.

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The association between circadian rest-activity patterns and the behavioral and psychological symptoms depending on the cognitive status in Japanese nursing-home residents

Cited by 18 publications

References 26 publications

A Systematic Review of Evidence for a Role of Rest-Activity Rhythms in Dementia

A Systematic Review of Evidence for a Role of Rest-Activity Rhythms in Dementia

24-h Activity Rhythms and Health in Older Adults

Insufficient melanopic equivalent daylight illuminance in nursing home dementia units across seasons and gaze directions

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