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Buying time: a proof-of-concept randomized controlled trial to improve sleep quality and cognitive function among older adults with mild cognitive impairment.
Trials 2018; 19(1):445T

Abstract

BACKGROUND

Current evidence suggests that good quality sleep is associated with preserved cognitive function and reduced dementia risk in older adults. Sleep complaints are especially common among older adults with mild cognitive impairment (MCI), and this may contribute to their increased risk for progression to dementia. Thus, improving their sleep may be important for maintaining their cognitive health. Chronotherapy is a set of intervention strategies that can improve sleep quality through strengthening the entrainment of the biological clock to the solar light-dark cycle, and includes strategies such as (1) bright light therapy (BLT); (2) physical activity (PA); and (3) good sleep hygiene. Of these strategies, BLT is the most potent and is based on providing individualized timing to entrain circadian rhythms. Thus, a personalized chronotherapy intervention of individually timed BLT and individually tailored PA promotion, in conjunction with general sleep hygiene education may promote older adult sleep quality. We therefore aim to carry out a proof-of-concept randomized controlled trial (RCT) to examine the efficacy of such a personalized chronotherapy intervention to improve sleep quality among older adults with MCI.

METHODS/DESIGN

This was a 24-week RCT of a personalized chronotherapy intervention aimed to primarily improve sleep quality as measured by the MotionWatch8©. Participants in the personalized chronotherapy group (INT) will receive four once-weekly, general sleep hygiene education classes, followed by 20 weeks of (1) individually timed BLT and (2) bi-weekly, individually tailored PA counseling phone calls in conjunction with receiving a consumer-available PA tracker-the Fitbit® Flex™. Ninety-six adults (aged 65-85 years) classified as having MCI (i.e., Mini-Mental State Exam (MMSE) ≥ 24; Montreal Cognitive Assessment (MoCA) ≤ 26; without dementia or significant functional impairment) will be randomized to either INT or a waitlist control group (CON).

DISCUSSION

The results of this trial will help determine if a personalized chronotherapy intervention that includes individually timed BLT and individually tailored PA promotion, along with general sleep hygiene education can promote sleep quality among older adults at increased risk for dementia. Our results will help inform best practices for promoting sleep quality among older adults with MCI.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT02926157 . Registered on 6 October 2016.

Authors+Show Affiliations

Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Management, University of British Columbia - Okanagan Campus, Kelowna, BC, Canada.Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Physical Therapy, Arthritis Research Canada, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.Department of Physical Therapy, Aging, Mobility and Cognitive Neuroscience Laboratory, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. teresa.ambrose@ubc.ca.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30119694

Citation

Falck, Ryan S., et al. "Buying Time: a Proof-of-concept Randomized Controlled Trial to Improve Sleep Quality and Cognitive Function Among Older Adults With Mild Cognitive Impairment." Trials, vol. 19, no. 1, 2018, p. 445.
Falck RS, Davis JC, Best JR, et al. Buying time: a proof-of-concept randomized controlled trial to improve sleep quality and cognitive function among older adults with mild cognitive impairment. Trials. 2018;19(1):445.
Falck, R. S., Davis, J. C., Best, J. R., Li, L. C., Chan, P. C. Y., Wyrough, A. B., ... Liu-Ambrose, T. (2018). Buying time: a proof-of-concept randomized controlled trial to improve sleep quality and cognitive function among older adults with mild cognitive impairment. Trials, 19(1), p. 445. doi:10.1186/s13063-018-2837-7.
Falck RS, et al. Buying Time: a Proof-of-concept Randomized Controlled Trial to Improve Sleep Quality and Cognitive Function Among Older Adults With Mild Cognitive Impairment. Trials. 2018 Aug 17;19(1):445. PubMed PMID: 30119694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Buying time: a proof-of-concept randomized controlled trial to improve sleep quality and cognitive function among older adults with mild cognitive impairment. AU - Falck,Ryan S, AU - Davis,Jennifer C, AU - Best,John R, AU - Li,Linda C, AU - Chan,Patrick C Y, AU - Wyrough,Anne B, AU - Landry,Glenn J, AU - Liu-Ambrose,Teresa, Y1 - 2018/08/17/ PY - 2018/02/01/received PY - 2018/08/04/accepted PY - 2018/8/19/entrez PY - 2018/8/19/pubmed PY - 2018/12/12/medline KW - Bright light therapy KW - Cognitive function KW - Older adults KW - Physical activity KW - Sleep SP - 445 EP - 445 JF - Trials JO - Trials VL - 19 IS - 1 N2 - BACKGROUND: Current evidence suggests that good quality sleep is associated with preserved cognitive function and reduced dementia risk in older adults. Sleep complaints are especially common among older adults with mild cognitive impairment (MCI), and this may contribute to their increased risk for progression to dementia. Thus, improving their sleep may be important for maintaining their cognitive health. Chronotherapy is a set of intervention strategies that can improve sleep quality through strengthening the entrainment of the biological clock to the solar light-dark cycle, and includes strategies such as (1) bright light therapy (BLT); (2) physical activity (PA); and (3) good sleep hygiene. Of these strategies, BLT is the most potent and is based on providing individualized timing to entrain circadian rhythms. Thus, a personalized chronotherapy intervention of individually timed BLT and individually tailored PA promotion, in conjunction with general sleep hygiene education may promote older adult sleep quality. We therefore aim to carry out a proof-of-concept randomized controlled trial (RCT) to examine the efficacy of such a personalized chronotherapy intervention to improve sleep quality among older adults with MCI. METHODS/DESIGN: This was a 24-week RCT of a personalized chronotherapy intervention aimed to primarily improve sleep quality as measured by the MotionWatch8©. Participants in the personalized chronotherapy group (INT) will receive four once-weekly, general sleep hygiene education classes, followed by 20 weeks of (1) individually timed BLT and (2) bi-weekly, individually tailored PA counseling phone calls in conjunction with receiving a consumer-available PA tracker-the Fitbit® Flex™. Ninety-six adults (aged 65-85 years) classified as having MCI (i.e., Mini-Mental State Exam (MMSE) ≥ 24; Montreal Cognitive Assessment (MoCA) ≤ 26; without dementia or significant functional impairment) will be randomized to either INT or a waitlist control group (CON). DISCUSSION: The results of this trial will help determine if a personalized chronotherapy intervention that includes individually timed BLT and individually tailored PA promotion, along with general sleep hygiene education can promote sleep quality among older adults at increased risk for dementia. Our results will help inform best practices for promoting sleep quality among older adults with MCI. TRIAL REGISTRATION: ClinicalTrials.gov , NCT02926157 . Registered on 6 October 2016. SN - 1745-6215 UR - https://www.unboundmedicine.com/medline/citation/30119694/Buying_time:_a_proof_of_concept_randomized_controlled_trial_to_improve_sleep_quality_and_cognitive_function_among_older_adults_with_mild_cognitive_impairment_ L2 - https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2837-7 DB - PRIME DP - Unbound Medicine ER -