Lyketsos C G, Lindell Veiel L, Baker A, Steele C
Department of Psychiatry and Behavioral Sciences, School of Medicine, The Johns Hopkins University, Baltimore, Maryland 21287, USA.
Int J Geriatr Psychiatry. 1999 Jul;14(7):520-5.
Agitated behaviors are common in dementia patients residing in chronic care settings. Their occurrence may be associated with lack of adequate exposure to sunlight and with circadian rhythm disturbances.
Prior research has suggested that bright light therapy (BLT) may reduce agitated behaviors in dementia patients. The aim of this study was to test the efficacy of BLT in a randomized, controlled, crossover clinical trial.
Fifteen patients with dementia and agitated behaviors residing in a chronic care facility were randomized in a crossover design to morning BLT for 1 hour per day or to a control condition with dim light exposure. Patients were treated in either condition for 4 weeks, followed by 1 week on no treatment, prior to being crossed over to the other condition.
Eight out of 15 patients completed the entire study. The rest completed at least 2 weeks of study. Patients randomized to the BLT condition exhibited a statistically significant improvement in nocturnal sleep from a mean of 6.4 hours/night to 8.1 hours/night 4 weeks later (p<0.05). The sleep of patients in the control condition did not improve significantly. There were no other significant differences between baseline and follow-up, nor between BLT and control treated patients on the other outcome measures, which included the Behavioral Pathology in Alzheimer Disease scale (Behave-AD) and the Cornell Scale for Depression in Dementia.
Patients with dementia in chronic care who exhibit agitated behaviors sleep more hours at night when administered morning BLT. However, BLT does not lead to improvements in agitated behaviors in institutionalized patients with dementia with non-disturbed sleep-wake cycles.
在长期护理机构中的痴呆患者中，激越行为很常见。其发生可能与缺乏充足的阳光照射以及昼夜节律紊乱有关。
先前的研究表明，强光疗法（BLT）可能会减少痴呆患者的激越行为。本研究的目的是在一项随机、对照、交叉临床试验中测试BLT的疗效。
15名居住在长期护理机构且有激越行为的痴呆患者采用交叉设计随机分为两组，一组每天早晨接受1小时的BLT，另一组接受昏暗光线照射的对照条件。患者在每种条件下接受治疗4周，然后有1周不接受治疗，之后再转换到另一种条件。
15名患者中有8名完成了整个研究。其余患者至少完成了2周的研究。随机分配到BLT组的患者夜间睡眠在4周后从平均每晚6.4小时显著改善到8.1小时（p<0.05）。对照条件下患者的睡眠没有显著改善。在其他结局指标上，包括阿尔茨海默病行为病理学量表（Behave-AD）和康奈尔痴呆抑郁量表，基线与随访之间以及BLT组与对照组患者之间均无其他显著差异。
在长期护理机构中表现出激越行为的痴呆患者，早晨接受BLT时夜间睡眠时间会增加。然而，对于睡眠-觉醒周期未受干扰的机构化痴呆患者，BLT并不会改善激越行为。
