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O3‐05‐02: TAILORED LIGHTING INTERVENTION TO IMPROVE SLEEP, MOOD AND BEHAVIOR IN ALZHEIMER'S DISEASE PATIENTS
Author(s) -
Figueiro Mariana G.,
Rea Mark S.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.2795
Subject(s) - dementia , mood , pittsburgh sleep quality index , circadian rhythm , context (archaeology) , medicine , intervention (counseling) , sleep (system call) , crossover study , psychology , gerontology , physical therapy , sleep quality , psychiatry , disease , cognition , paleontology , alternative medicine , pathology , biology , computer science , placebo , operating system
Background: Apathy is a common and disabling behavioral concomitant of many neurodegenerative conditions including Alzheimer’s disease (AD), and improving apathy may slow the neurodegenerative process. Frontal lobe dysfunction and hypodopaminergic state in the brain are implicated in the etiology of apathy. Since repetitive transcranial magnetic stimulation (rTMS) to frontal lobe of the brain increases dopamine, we hypothesized that rTMS would improve apathy in AD. The objective was to investigate the efficacy and safety of rTMS in improving apathy in older adults with AD. Methods:A 4-week, prospective, doubleblind, randomized, sham-controlled study was conducted in older adults (N1⁄420) with apathy and AD. Subjects were randomized to active rTMS or sham treatment (5 days/week) for 4 weeks for a total of 20 treatments. Treatment parameters were set at 10hz stimulation, 120% motor threshold (MT), and 3000 pulses per treatment although there were protocols in place to lower theMT if necessary. The primary (apathy (Apathy Evaluation Scale-Clinician version)) and secondary (cognition (Modified Mini Mental State Examination (3MS) & MMSE), executive function (TMT-A, TMT-B, Exit-25), functional status (ADL, IADL), clinical global impression (CGI-I, CGI-S), and caregiver burden (ZBS)) outcomes were assessed at baseline and 4 weeks. Results: Nineteen subjects completed the study. Mean age was 77.3 (67.2) years, 80% were Caucasians and 10% were females. After adjusting for baseline, there was a significantly greater improvement in the AES-C with active rTMS compared to sham treatment [-10.1 (-15.9 to -4.3); p1⁄40.002] at 4 weeks. There was significantly greater improvement in 3MS (p1⁄40.030), IADL (p1⁄40.006), CGI-S (p1⁄40.007), and CGI-I (p<0.001) with rTMS compared to the sham treatment. Treatment site discomfort was the most common adverse event. None of the subjects had a seizure. Conclusions: rTMS may be used safely in subjects with AD and may improve apathy and cognition.