Charité - Universitätsmedizin Berlin,Sleep Research & Clinical Chronobiology,Institute of Physiology,Berlin,Germany.
SplittFennert Nursing Home,Berlin,Germany.
Int Psychogeriatr. 2017 Dec;29(12):2071-2080. doi: 10.1017/S1041610217001235. Epub 2017 Jul 10.
Backround: Night-time agitation is a frequent symptom of dementia. It often causes nursing home admission and has been linked to circadian rhythm disturbances. A positive influence of light interventions on night-time agitation was shown in several studies. The aim of our study was to investigate whether there is a long-term association between regional weather data (as indicator for daylight availability) and 24-hour variations of motor activity.
Motor activity of 20 elderly nursing home residents living with dementia was analyzed using recordings of continuously worn wrist activity monitors over a three-year period. The average recording duration was 479 ± 206 days per participant (mean ± SD). Regional cloud amount and day length data from the local weather station (latitude: 52°56'N) were included in the analysis to investigate their effects on several activity variables.
Nocturnal rest, here defined as the five consecutive hours with the least motor activity during 24 hours (L5), was the most predictable activity variable per participant. There was a significant interaction of night-time activity with day length and cloud amount (F 1,1174 = 4.39; p = 0.036). Night-time activity was higher on cloudy short days than on clear short days (p = 0.007), and it was also higher on cloudy short days than on cloudy long days (p = 0.032).
The need for sufficient zeitgeber (time cue) strength during winter time, especially when days are short and skies are cloudy, is crucial for elderly people living with dementia. Activity forecast by season and weather might be a valuable approach to anticipate adequately complementary use of electrical light and thereby foster lower night-time activity.
背景:夜间躁动是痴呆症的常见症状。它常导致入住养老院,并与昼夜节律紊乱有关。几项研究表明,光照干预对夜间躁动有积极影响。我们的研究旨在调查区域天气数据(作为日光可用性的指标)与 24 小时运动活动变化之间是否存在长期关联。
方法:通过连续佩戴腕部活动监测器对 20 名居住在养老院的痴呆症老年居民的运动活动进行了 3 年的记录分析。每位参与者的平均记录时长为 479 ± 206 天(平均值 ± 标准差)。分析中纳入了当地气象站(纬度:52°56'N)的区域云量和昼长数据,以研究它们对几个活动变量的影响。
结果:夜间休息(定义为 24 小时内连续 5 小时活动最少的时间)是每位参与者最可预测的活动变量。夜间活动与昼长和云量存在显著的交互作用(F 1,1174 = 4.39;p = 0.036)。与晴天相比,阴天短日照时夜间活动较高(p = 0.007),阴天短日照时夜间活动也高于阴天长日照时(p = 0.032)。
结论:对于患有痴呆症的老年人来说,冬季需要足够的 zeitgeber(时间提示)强度,尤其是在白天短、天空多云时。根据季节和天气进行活动预测可能是一种有价值的方法,可以充分补充使用电灯,并促进夜间活动减少。