Abstract：
BACKGROUND: People with dementia often experience behavioral and psychological symptoms of dementia (BPSD), which are a major cause of caregiver burden and institutionalization. Therefore, we conducted a double-blind, parallel-group randomized controlled trial to examine the efficacy of blue-enriched light therapy for BPSD in institutionalized older adults with dementia.
METHODS: Participants were enrolled and randomly allocated into blue-enriched light therapy (N = 30) or the conventional light group (N = 30) for 60 min in 10 weeks with five sessions per week. The primary outcome was sleep quality measured by actigraphy and Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was overall BPSD severity (Cohen-Mansfield Agitation Inventory [CMAI] and Neuropsychiatric Inventory [NPI-NH]). The outcome indicators were assessed at baseline, mid-test, immediate posttest, 1-month, 3-month, and 6-month follow-up. The effects of the blue-enriched light therapy were examined by the generalized estimating equation model.
RESULTS: Blue-enriched light therapy revealed significant differences in the objective sleep parameters (sleep efficiency: β = 5.81, Waldχ2 = 32.60, CI: 3.82; 7.80; sleep latency: β = -19.82, Waldχ2 = 38.38, CI:-26.09; -13.55), subjective sleep quality (PSQI: β = -2.07, Waldχ2 = 45.94, CI: -2.66; -1.47), and overall BPSD severity (CMAI: β = -0.90, Waldχ2 = 14.38, CI: -1.37; -0.44) (NPI-NH: β = -1.67, Waldχ2 = 30.61, CI: -2.26; -1.08) compared to conventional phototherapy immediate posttest, 1-month, 3-month, and 6-month follow-up. Furthermore, the effects for sleep efficiency and sleep latency lasted for up to 6 months. In the subscale analysis, the differences of the behavioral symptoms changed significantly between the groups in physical/nonaggressive (CI: -1.01; -0.26) and verbal/nonaggressive (CI: -0.97; -0.29).
CONCLUSIONS: Blue-enriched light therapy is a feasible low-cost intervention that could be integrated as a comprehensive therapy program for BPSD among older adults with dementia.
METHODS: Participants were enrolled and randomly allocated into blue-enriched light therapy (N = 30) or the conventional light group (N = 30) for 60 min in 10 weeks with five sessions per week. The primary outcome was sleep quality measured by actigraphy and Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was overall BPSD severity (Cohen-Mansfield Agitation Inventory [CMAI] and Neuropsychiatric Inventory [NPI-NH]). The outcome indicators were assessed at baseline, mid-test, immediate posttest, 1-month, 3-month, and 6-month follow-up. The effects of the blue-enriched light therapy were examined by the generalized estimating equation model.
RESULTS: Blue-enriched light therapy revealed significant differences in the objective sleep parameters (sleep efficiency: β = 5.81, Waldχ2 = 32.60, CI: 3.82; 7.80; sleep latency: β = -19.82, Waldχ2 = 38.38, CI:-26.09; -13.55), subjective sleep quality (PSQI: β = -2.07, Waldχ2 = 45.94, CI: -2.66; -1.47), and overall BPSD severity (CMAI: β = -0.90, Waldχ2 = 14.38, CI: -1.37; -0.44) (NPI-NH: β = -1.67, Waldχ2 = 30.61, CI: -2.26; -1.08) compared to conventional phototherapy immediate posttest, 1-month, 3-month, and 6-month follow-up. Furthermore, the effects for sleep efficiency and sleep latency lasted for up to 6 months. In the subscale analysis, the differences of the behavioral symptoms changed significantly between the groups in physical/nonaggressive (CI: -1.01; -0.26) and verbal/nonaggressive (CI: -0.97; -0.29).
CONCLUSIONS: Blue-enriched light therapy is a feasible low-cost intervention that could be integrated as a comprehensive therapy program for BPSD among older adults with dementia.
摘要：
背景：痴呆症患者经常会出现痴呆症（BPSD）的行为和心理症状，这是照顾者负担和制度化的主要原因。因此,我们进行了双盲，平行组随机对照试验（RCT），以检查在住院的老年痴呆症患者中，富含蓝光的光疗法对BPSD的疗效。
方法：参与者被纳入并随机分配到富含蓝光的光疗组（N=30）或常规光疗组（N=30），在10周内持续60分钟，每周5次。主要结果是通过活动记录和匹兹堡睡眠质量指数（PSQI）测量的睡眠质量。次要结果是总体BPSD严重程度（Cohen-Mansfield躁动量表（CMAI）和神经精神量表（NPI-NH）。结果指标在基线时进行评估，中期测试，即时后测,1个月,3个月,6个月随访。通过广义估计方程（GEE）模型检查了富含蓝光的光疗法的效果。
结果：富含蓝色的光疗显示客观睡眠参数存在显着差异（睡眠效率：β=5.81，Waldχ2=32.60，CI：3.82；7.80；睡眠潜伏期：β=-19.82，Waldχ2=38.38，CI：-26.09；-13.55），主观睡眠质量（PSQI：β=-2.07，Waldχ2=45.94，CI：-2.66；-1.47），和总体BPSD严重程度（CMAI：β=-0.90，Waldχ2=14.38，CI：-1.37;-0.44）（NPI-NH：β=-1.67，Waldχ2=30.61，CI：-2.26;-1.08）与常规光疗即时测试相比，1个月,3个月,6个月随访。此外，对睡眠效率和睡眠潜伏期的影响持续长达六个月。在子量表分析中，行为症状在身体/非攻击性(CI:-1.01;-0.26)和言语/非攻击性(CI:-0.97;-0.29)方面的差异显著。
结论：富含蓝色的光疗是一种可行的低成本干预措施，可作为BPSD综合治疗方案纳入老年痴呆症患者。
方法：参与者被纳入并随机分配到富含蓝光的光疗组（N=30）或常规光疗组（N=30），在10周内持续60分钟，每周5次。主要结果是通过活动记录和匹兹堡睡眠质量指数（PSQI）测量的睡眠质量。次要结果是总体BPSD严重程度（Cohen-Mansfield躁动量表（CMAI）和神经精神量表（NPI-NH）。结果指标在基线时进行评估，中期测试，即时后测,1个月,3个月,6个月随访。通过广义估计方程（GEE）模型检查了富含蓝光的光疗法的效果。
结果：富含蓝色的光疗显示客观睡眠参数存在显着差异（睡眠效率：β=5.81，Waldχ2=32.60，CI：3.82；7.80；睡眠潜伏期：β=-19.82，Waldχ2=38.38，CI：-26.09；-13.55），主观睡眠质量（PSQI：β=-2.07，Waldχ2=45.94，CI：-2.66；-1.47），和总体BPSD严重程度（CMAI：β=-0.90，Waldχ2=14.38，CI：-1.37;-0.44）（NPI-NH：β=-1.67，Waldχ2=30.61，CI：-2.26;-1.08）与常规光疗即时测试相比，1个月,3个月,6个月随访。此外，对睡眠效率和睡眠潜伏期的影响持续长达六个月。在子量表分析中，行为症状在身体/非攻击性(CI:-1.01;-0.26)和言语/非攻击性(CI:-0.97;-0.29)方面的差异显著。
结论：富含蓝色的光疗是一种可行的低成本干预措施，可作为BPSD综合治疗方案纳入老年痴呆症患者。
