Music-based Intervention for Insomnia in Persons Living with Dementia and their Caregivers

基于音乐的痴呆症患者及其护理人员的失眠干预

• 批准号: 10283569
• 负责人: Darina V. Petrovsky
• 金额: $ 17.69万
• 依托单位: RBHS-SCHOOL OF NURSING
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10283569
• 关键词: Address; Alzheimer' s disease related dementia; Area; Behavior Therapy; Behavioral Model; Behavioral Research; Behavioral Symptoms; Caregiver Burden; Caregivers; Caucasians; Clinical Trials; Cognitive Therapy; Communities; Control Groups; Data; Data Collection; Dementia; Dementia caregivers; Disease; Disease Progression; Education; Educational workshop; Elderly; Focus Groups; Funding; Future; Goals; Health; Home; Institutionalization; Intervention; Intervention Studies; Interview; Knowledge; Link; Measurement; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Music; Outcome; Participant; Patient Self-Report; Personal Satisfaction; Persons; Pharmacological Treatment; Pharmacotherapy; Pilot Projects; Population; Property; Proxy; Quality of life; Randomized; Relaxation; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Research Training; Risk; Sleep; Sleeplessness; Surveys; Symptoms; Technology; Testing; Time; Training; Training Activity; Treatment Efficacy; Underrepresented Populations; United States National Institutes of Health; actigraphy; base; career; cognitive function; community based participatory research; cost; design; diaries; efficacy trial; evidence base; experience; fall risk; high risk; implementation facilitation; improved; intervention effect; intervention refinement; long term memory; mobile application; novel; perceived stress; post intervention; preservation; programs; prototype; satisfaction; side effect; skills; sleep onset; sleep quality; therapy development; user centered design; user-friendly

Project Summary Insomnia symptoms (i.e., difficulty initiating sleep, maintaining sleep) in persons living with Alzheimer’s Disease and related Dementias are debilitating and contribute to increased institutionalization, reduced cognitive function and accelerated disease progression. Furthermore, insomnia disruption is linked to poor health outcomes in caregivers, such as poor quality of life and increased burden. Given the potential harmful side effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to improving insomnia symptoms. Music interventions are particularly promising because long-term memory for music remains relatively preserved in Alzheimer’s Disease and related Dementias - even in the moderate stage of the disease. Prior studies of music interventions to improve sleep in older adults were conducted with persons without Alzheimer’s Disease and related Dementias in primarily Caucasian older adults. Thus, the evidence for tailored music interventions to improve sleep in underrepresented community- dwelling persons living with dementia (PLWD) and their caregivers is lacking. In a pilot study (funded by the NIA, F32AG060630) the applicant has examined the feasibility of one component of the proposed music-based intervention in PLWD and their caregivers and identified opportunities to improve the delivery of the intervention. The purpose of this K23 Mentored Patient-Oriented Research Career Development Award is to provide her with the expertise necessary to initiate a successful and independent program of research – with the ultimate goal to improve sleep and behavioral symptoms in PLWD and their caregivers using music-based approaches. The specific aims of this proposal are to: i) build and iteratively refine the prototype of the mobile application, entitled, “Calming Music Personalized for Sleep Enhancement in PeRsons living with Dementia” (CoMPoSER) for use among PLWD and their caregivers; ii) in a pilot RCT examine its acceptability; and iii) efficacy. The development of the intervention will be guided by the input from stakeholders, including PLWD and their caregivers. Seventy-two dyads will be randomized to either the 4-week CoMPoSER intervention or sleep education group. Music selections will be tailored to PLWD and account for known sleep-inducing properties. Acceptability will be examined using survey and qualitative data. The effects of the intervention on PLWD and caregiver outcomes will be determined using objective (actigraphy) and subjective (proxy reported) measures. Under the guidance of the mentoring team, the applicant has carefully constructed research training activities to gain knowledge and expertise in four core areas: i) user-centered design of mobile application technology, ii) behavioral intervention development, iii) Community-based Participatory Research, and iv) behavioral research methods, including measurement, analysis and dissemination of clinical trial research. Results from the proposed research project will not only inform a larger efficacy trial, but also provide an opportunity for the applicant to gain the necessary skills to launch her career as an independent investigator.

项目摘要 患有阿尔茨海默氏症的人的失眠症状（即困难发起睡眠，保持睡眠） 疾病和相关痴呆症正在使人衰弱，并导致制度化增加，减少 认知功能和加速疾病进展。此外，失眠的干扰与差有关 护理人员的健康成果，例如生活质量差和伯恩的增加。鉴于潜在有害 药理学治疗，非药理学方法（例如音乐）的副作用可能会提供更安全的 改善失眠症状的替代方案。音乐干预特别有希望，因为长期 音乐记忆在阿尔茨海默氏病和相关痴呆症中仍然相对保存 - 即使在 疾病中等阶段。对改善老年人睡眠的音乐干预措施的先前研究是 与没有阿尔茨海默氏病和相关痴呆症的人在原发性高加索老年人中进行 成年人。这是量身定制的音乐干预措施以改善代表性不足的社区睡眠的证据 - 缺乏患有痴呆症（PLWD）及其护理人员的住宅。在一项试点研究中（由 NIA，F32AG060630）适用的研究已检查了拟议的基于音乐的一个组成部分的可行性 干预PLWD及其护理人员，并确定了改善交付的机会 干涉。这项K23指导的以患者为导向的研究职业发展奖的目的是 为她提供必要的专业知识，以启动成功的独立研究计划 - 使用基于音乐的PLWD及其护理人员改善睡眠和行为症状的最终目标 方法。该建议的具体目的是：i）构建和迭代完善移动的原型 应用程序，题为“在患有痴呆症患者中为睡眠增强睡眠的音乐镇定音乐” （作曲家）在PLWD及其护理人员中使用； ii）在试点RCT检查中其可接受性；和iii） 效率。干预措施的发展将由利益相关者（包括PLWD）的意见指导 和他们的照顾者。 72个二元组将被随机分为4周的作曲家干预或 睡眠教育小组。音乐选择将针对PLWD量身定制，并说明已知的睡眠诱导 特性。可接受性将使用调查和定性数据检查。干预对 PLWD和护理人员的结果将使用客观（Actiography）和主观（报告）确定 措施。在心理团队的指导下，申请人精心构建了研究培训 在四个核心领域获得知识和专业知识的活动：i）以用户为中心的移动应用程序 技术，ii）行为干预发展，iii）基于社区的参与性研究，IV） 行为研究方法，包括临床试验研究的测量，分析和传播。 拟议的研究项目的结果不仅会为更大的效率试验提供信息，而且还提供了一个 申请人有机会获得必要的技能来启动她作为独立调查员的职业。