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Music-based Intervention for Insomnia in Persons Living with Dementia and their Caregivers

Project Number: 1K23AG073618-01

Rutgers Biomedical and Health Sciences, School of Nursing

Sponsor: National Institutes of Health / National Institute on Aging

Project Start Date: 01-September-2021. Project End Date: 31-August-2026.

Status: Recruiting

Project Summary

  • Insomnia symptoms (i.e., difficulty initiating sleep, maintaining sleep) in persons living with Alzheimer’s Disease and related Dementias are debilitating and contribute to increased institutionalization, reduced cognitive function and accelerated disease progression. Furthermore, insomnia disruption is linked to poor health outcomes in caregivers, such as poor quality of life and increased burden. Given the potential harmful side effects of pharmacologic treatment, non-pharmacologic approaches, such as music, may provide a safer alternative to improving insomnia symptoms. Music interventions are particularly promising because long-term memory for music remains relatively preserved in Alzheimer’s Disease and related Dementias -even in the moderate stage of the disease. Prior studies of music interventions to improve sleep in older adults were conducted with persons without Alzheimer’s Disease and related Dementias in primarily Caucasian older adults. Thus, the evidence for tailored music interventions to improve sleep in underrepresented community-dwelling persons living with dementia (PLWD) and their caregivers is lacking. In a pilot study (funded by the NIA, F32AG060630) the applicant has examined the feasibility of one component of the proposed music-based intervention in PLWD and their caregivers and identified opportunities to improve the delivery of the intervention. The purpose of this K23 Mentored Patient-Oriented Research Career Development Award is to provide her with the expertise necessary to initiate a successful and independent program of research –with the ultimate goal to improve sleep and behavioral symptoms in PLWD and their caregivers using music-based approaches. The specific aims of this proposal are to: i) build and iteratively refine the prototype of the mobile application, entitled, “Calming Music Personalized for Sleep Enhancement in PeRsons living with Dementia” (CoMPoSER) for use among PLWD and their caregivers; ii) in a pilot RCT examine its acceptability; and iii) efficacy. The development of the intervention will be guided by the input from stakeholders, including PLWD and their caregivers. Seventy-two dyads will be randomized to either the 4-week CoMPoSER intervention or sleep education group. Music selections will be tailored to PLWD and account for known sleep-inducing properties. Acceptability will be examined using survey and qualitative data. The effects of the intervention on PLWD and caregiver outcomes will be determined using objective (actigraphy) and subjective (proxy reported) measures. Under the guidance of the mentoring team, the applicant has carefully constructed research training activities to gain knowledge and expertise in four core areas: i) user-centered design of mobile application technology,ii) behavioral intervention development, iii) Community-based Participatory Research, and iv) behavioral research methods, including measurement, analysis and dissemination of clinical trial research. Results from the proposed research project will not only inform a larger efficacy trial, but also provide an opportunity for the applicant to gain the necessary skills to launch her career as an independent investigator.

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

Project Number: 5F32AG060630-03

University of Pennsylvania

Sponsor: National Institutes of Health / National Institute on Aging

Project Start Date: 11-June-2018. Project End Date: 31-May-2021.

Status: Recruiting Completed.

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.