The feasibility of a tailored music intervention to reduce symptoms of sleep disruption in older adults with dementia

量身定制的音乐干预措施减少痴呆症老年人睡眠中断症状的可行性

• 批准号: 9539465
• 负责人: Darina V. Petrovsky
• 金额: $ 6.28万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-11 至 2021-06-10
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9539465
• 关键词: Address; Adverse effects; Agitation; Alzheimer' s Disease; Anxiety; Area; Arousal; Award; Behavior; Behavior Therapy; Biometry; Caregiver Burden; Caregivers; Caring; Clinical Trials; Clinical Trials Design; Communities; Control Groups; Data; Dementia; Disease Progression; Distress; Elderly; Environment; Family Caregiver; Funding; Future; Goals; Health; Hippocampus (Brain); Home environment; Impaired cognition; Individual National Research Service Award; Institutionalization; Intervention; Intervention Studies; Intervention Trial; Knowledge; Link; Literature; Mean Survival Times; Measures; Memory Loss; Mental Depression; Mentors; Methodology; Monitor; Music; Napping; Nurses; Nursing Homes; Outcome; Participant; Patient Self-Report; Pennsylvania; Pharmacological Treatment; Pharmacotherapy; Population; Postdoctoral Fellow; Prevalence; Preventive Intervention; Process; Property; Protocols documentation; Proxy; Publishing; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Research; Research Design; Research Personnel; Research Project Grants; Research Training; Sampling; Sleep; Sleep Fragmentations; Statistical Methods; Stress; Surveys; Symptoms; Testing; Therapeutic; Time; Training; Training Activity; Treatment Efficacy; Underserved Population; Universities; Vulnerable Populations; Waiting Lists; Work; actigraphy; base; career; cognitive ability; cognitive function; efficacy testing; efficacy trial; evidence base; executive function; experience; group intervention; improved; mild cognitive impairment; mobile computing; novel; palliative; programs; recruit; reduce symptoms; satisfaction; skills; sleep onset; sleep quality; success

Project Summary Sleep disruption in older adults living with Alzheimer’s disease and related dementias (ADRD) is very debilitating and contributes to increased institutionalization, reduced cognitive function, and accelerated disease progression. Furthermore, sleep disruption is linked to poor health outcomes in caregivers (CGs), such as poor quality of life and increased CG burden. Given the potential harmful side effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to reducing sleep disruption in this vulnerable population. Listening to music has been shown to decrease agitation, anxiety and depression in nursing home residents with ADRD. A growing body of literature suggests that individualized music may improve sleep quality in older adults with early memory loss, but its efficacy has not been demonstrated in older adults with ADRD in the community, where most older adults with ADRD live. If proven feasible and acceptable, tailored music interventions can then be tested for efficacy in reducing sleep disruption. The purpose of this individual National Research Service Award (NRSA) application is to provide post-doctoral research training for a candidate to gain the knowledge and skills essential for an independent research career. In a cross-sectional dissertation study (funded by NIA F31AG055148) the applicant has previously examined cognitive abilities associated with engagement in music activities and music-related behaviors in older adults with mild cognitive impairment. The applicant’s long-term career objective is to address sleep disruption in older adults with ADRD using palliative non-pharmacologic approaches. The specific aims of this proposal are to examine the 1) feasibility; 2) acceptability; and 3) preliminary efficacy of a tailored music intervention in home-dwelling older adults with ADRD suffering from sleep disruption. Sixty dyads (older adults with ADRD and their CGs) will be randomized to receive the tailored music intervention immediately or following a four week delay. Music selections will be individualized to older adults with ADRD and account for known sleep-inducing properties. Feasibility of processes that are key to the success of the subsequent study will be examined. Preliminary efficacy of the intervention will be assessed using objective (actigraphy) and subjective (proxy reported) sleep quality measures. In addition, qualitative data will be solicited from the dyads examining the acceptability and satisfaction with the intervention. Under the guidance of the mentoring team, the applicant has carefully selected research training activities to gain knowledge and expertise in five core areas: 1) behavioral intervention research, 2) clinical trial methodology; 3) sleep assessment measures in older adults; 4) advanced statistical methods pertaining to the analysis of clinical trials; and 5) novel remote monitoring applications. Results from the proposed research project will not only inform a future 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 患有阿尔茨海默氏病和相关痴呆症（ADRD）的老年人的睡眠中断非常 使人衰弱并有助于增加制度化，认知功能降低并加速 疾病进展。此外，睡眠中断与护理人员的健康状况不佳有关，例如 随着生活质量差和CG伯恩的增加。考虑到药理的潜在有害副作用 治疗，非药理学方法（例如音乐）可能为减少睡眠提供更安全的替代品 这个脆弱人群的破坏。聆听音乐已显示可减少躁动，焦虑和 护士居民居民的抑郁症患有ADRD。越来越多的文献表明个性化 音乐可能会改善早期记忆力丧失的老年人的睡眠质量，但其有效性并非 大多数Adrd Live的老年人在社区中有ADRD的老年人展示。如果经过证明 然后可以测试可行且可接受的，量身定制的音乐干预措施，以降低睡眠的效率 破坏。该个人国家研究服务奖（NRSA）申请的目的是提供 博士后研究培训，供候选人获得独立的知识和技能的知识和技能 研究职业。在一项横断面论文研究（由NIA F31AG055148资助）中 以前检查了与参与音乐活动和与音乐有关的认知能力 老年人轻度认知障碍的行为。申请人的长期职业目标是 使用姑息性非药物方法来解决ADRD老年人的睡眠中断。这 该提案的具体目的是检查1）可行性； 2）可接受性； 3） 量身定制的音乐干预在居住的老年人中，患有睡眠中断的人。六十 二元组（ADRD及其CGS的老年人）将随机分配以接受量身定制的音乐干预措施 立即或之后四个星期的延迟。音乐选择将为ADRD的老年人个性化 并说明已知的诱导睡眠特性。流程的可行性，这是成功的关键 随后的研究将进行检查。干预的初步效率将使用目标评估 （行动摄影）和主观（报道的代理）睡眠质量度量。此外，定性数据将是 从二元组中征求了对干预的可接受性和满意度。在指导下 在心理团队中，申请人已经精心选择了研究培训活动，以获得知识和 五个核心领域的专业知识：1）行为干预研究，2）临床试验方法； 3）睡觉 老年人的评估措施； 4）与临床分析有关的高级统计方法 试验； 5）新型的远程监控应用程序。拟议的研究项目的结果不仅将 告知未来效率试验，但也为申请人提供了获得必要技能的机会 启动她作为独立调查员的职业。