Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-22T18:10:04.833Z Has data issue: false hasContentIssue false
  • English
  • Français

Night-time activity forecast by season and weather in a longitudinal design – natural light effects on three years’ rest-activity cycles in nursing home residents with dementia

Published online by Cambridge University Press:  10 July 2017

Amely Wahnschaffe ,
Claudia Nowozin ,
Andreas Rath ,
Theresa Floessner ,
Stefan Appelhoff ,
Mirjam Münch  and
Dieter Kunz
Amely Wahnschaffe*
Affiliation:
Charité – Universitätsmedizin Berlin, Sleep Research & Clinical Chronobiology, Institute of Physiology, Berlin, Germany St. Hedwig-Hospital, Clinic for Sleep and Chronomedicine, Berlin, Germany
Claudia Nowozin
Affiliation:
Charité – Universitätsmedizin Berlin, Sleep Research & Clinical Chronobiology, Institute of Physiology, Berlin, Germany St. Hedwig-Hospital, Clinic for Sleep and Chronomedicine, Berlin, Germany
Andreas Rath
Affiliation:
SplittFennert Nursing Home, Berlin, Germany
Theresa Floessner
Affiliation:
University of Groningen, Groningen Institute for Evolutionary Life Sciences, Chronobiology Unit, Groningen, The Netherlands
Stefan Appelhoff
Affiliation:
Charité – Universitätsmedizin Berlin, Sleep Research & Clinical Chronobiology, Institute of Physiology, Berlin, Germany St. Hedwig-Hospital, Clinic for Sleep and Chronomedicine, Berlin, Germany
Mirjam Münch
Affiliation:
Charité – Universitätsmedizin Berlin, Sleep Research & Clinical Chronobiology, Institute of Physiology, Berlin, Germany St. Hedwig-Hospital, Clinic for Sleep and Chronomedicine, Berlin, Germany
Dieter Kunz
Affiliation:
Charité – Universitätsmedizin Berlin, Sleep Research & Clinical Chronobiology, Institute of Physiology, Berlin, Germany St. Hedwig-Hospital, Clinic for Sleep and Chronomedicine, Berlin, Germany
*
Correspondence should be addressed to: Dr rer. medic. Amely Wahnschaffe, Research Group: Sleep & Clinical Chronobiology, Institute of Physiology (CBF), Charité – Universitätsmedizin Berlin, Grosse Hamburger Strasse 5–11, 10115 Berlin, Germany. Phone: +49 30 23112901; Fax: +49 30 23112903. Email: [email protected].
Get access

Abstract

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.

Methods:

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.

Results:

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 (F1,1174 = 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).

Conclusions:

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.

Keywords

rest-activity cycleagitationdementialightseasonweathercircadian
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 2071 - 2080
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altimus, C. M. et al. (2010). Rod photoreceptors drive circadian photoentrainment across a wide range of light intensities. Nature Neuroscience, 13, 1107–1112. doi: 10.1038/nn.2617 CrossRefGoogle ScholarPubMed
Ancoli-Israel, S. et al. (1997). Variations in circadian rhythms of activity, sleep, and light exposure related to dementia in nursing-home patients. Sleep, 20, 18–23.Google ScholarPubMed
Ancoli-Israel, S. et al. (2003). Effect of light on agitation in institutionalized patients with severe Alzheimer disease. The American Journal of Geriatric Psychiatry, 11, 194–203.CrossRefGoogle ScholarPubMed
Ancoli-Israel, S., Martin, J. L., Kripke, D. F., Marler, M. and Klauber, M. R. (2002). Effect of light treatment on sleep and circadian rhythms in demented nursing home patients. Journal of the American Geriatric Society, 50, 282–289. doi: j gs50060 CrossRefGoogle ScholarPubMed
Bedrosian, T. A. and Nelson, R. J. (2012). Sundowning syndrome in aging and dementia: research in mouse models. Experimental Neurology, 243, 67–73.CrossRefGoogle ScholarPubMed
Beersma, D. G. et al. (2009). The progression of circadian phase during light exposure in animals and humans. Journal of Biological Rhythms, 24, 153–160. doi: 10.1177/0748730408330196.CrossRefGoogle Scholar
Berlin Online. (2015). BerlinOnline Stadtportal GmbH & Co. KG. Available at: http://www.berlin.de/wetter/; last accessed 18 March 2015.Google Scholar
Bromundt, V. et al. (2012). Circadian sleep-wake cycles, well-being, and light therapy in borderline personality disorder. Journal of Personality Disorders, 27, 680–696. doi: 10.1521/pedi_2012_26_057 CrossRefGoogle ScholarPubMed
Burns, A., Allen, H., Tomenson, B., Duignan, D. and Byrne, J. (2009). Bright light therapy for agitation in dementia: a randomized controlled trial. International Psychogeriatrics, 21, 711–721. doi: S1041610209008886 CrossRefGoogle ScholarPubMed
Burns, A., Jacoby, R. and Levy, R. (1990). Psychiatric phenomena in Alzheimer's disease. IV: disorders of behaviour. British Journal of Psychiatry, 157, 86–94.CrossRefGoogle ScholarPubMed
Campbell, S. S., Kripke, D. F. Gillin, J. C. and Hrubovcak, J. C. (1988). Exposure to light in healthy elderly subjects and Alzheimer's patients. Physioly and Behavior, 42, 141–144.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Werner, P. and Freedman, L. (1995). Sleep and agitation in agitated nursing home residents: an observational study. Sleep, 18, 674–680.Google ScholarPubMed
Comas, M., Beersma, D. G., Spoelstra, K. and Daan, S. (2007). Circadian response reduction in light and response restoration in darkness: a “skeleton” light pulse PRC study in mice (Mus musculus). Journal of Biological Rhythms, 22, 432–444. doi: 22/5/432 CrossRefGoogle ScholarPubMed
Declercq, T. et al. (2013). Withdrawal versus continuation of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia. Cochrane Database Systematic Revues, (3), CD007726. doi: 10.1002/14651858.CD007726.pub2 Google Scholar
Dowling, G. A. et al. (2005). Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. International Psychogeriatrics, 17, 221–236.CrossRefGoogle ScholarPubMed
DWD. (2015). Deutscher wetterdienst. Available at: www.dwd.de.; last accessed 18 March 2015.Google Scholar
Feinglass, J. et al. (2011). The effects of daily weather on accelerometer-measured physical activity. Journal of Physical Activity and Health, 8, 934–943.CrossRefGoogle ScholarPubMed
Fetveit, A. and Bjorvatn, B. (2005). Bright-light treatment reduces actigraphic-measured daytime sleep in nursing home patients with dementia: a pilot study. The American Journal of Geriatric Psychiatry, 13, 420–423. doi: 10.1176/appi.ajgp.13.5.420 CrossRefGoogle ScholarPubMed
Figueiro, M. G. (2008). A proposed 24 h lighting scheme for older adults. Lighting Research and Technology, 40, 153–160.CrossRefGoogle Scholar
Figueiro, M. G., Hamner, R., Higgins, P., Hornick, T. and Rea, , M. S. (2012). Field measurements of light exposures and circadian disruption in two populations of older adults. Journal of Alzheimers Disease, 31, 711–715. doi: 10.3233/JAD-2012-120484 CrossRefGoogle ScholarPubMed
Finkel, S. (2000). Introduction to behavioural and psychological symptoms of dementia (BPSD). International Journal of Geriatric Psychiatry, 15. S2–S4. doi: 10.1002/(SICI)1099-1166(200004)15:1+<S2::AID-GPS159>3.0.CO;2-3 [pii] 3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Foster, R. G. (2005). Neurobiology: bright blue times. Nature, 433, 698–699. doi: 10.1038/433698a CrossRefGoogle ScholarPubMed
Friborg, O., Bjorvatn, B., Amponsah, B. and Pallesen, S. (2012). Associations between seasonal variations in day length (photoperiod), sleep timing, sleep quality and mood: a comparison between Ghana (5 degrees) and Norway (69 degrees). Journal of Sleep Research, 21, 176–184. doi: 10.1111/j.1365-2869.2011.00982.x CrossRefGoogle Scholar
Gerding, G. (2015). Sonnenaufgang-Sonnenuntergang. Available at: www.sonnenaufgang-sonnenuntergang.de; last accessed18 March 2015.Google Scholar
Goodman, A., Paskins, J. and Mackett, R. (2012). Day length and weather effects on children's physical activity and participation in play, sports, and active travel. Journal of Physical Activity and Health, 9, 1105–1116.CrossRefGoogle ScholarPubMed
Harper, D. G. et al. (2005). Disturbance of endogenous circadian rhythm in aging and Alzheimer disease. The American Journal of Geriatric Psychiatry, 13, 359–368. doi: 10.1176/appi.ajgp.13.5.359 CrossRefGoogle ScholarPubMed
Klenk, J., Buchele, G., Rapp, K., Franke, S. and Peter, R. (2011). Walking on sunshine: effect of weather conditions on physical activity in older people. Journal of Epidemiology and Community Health, 66, 474–476. doi: 10.1136/jech.2010.128090 CrossRefGoogle ScholarPubMed
Laakso, M. L., Porkka-Heiskanen, T., Alila, A., Stenberg, D. and Johansson, G. (1994). Twenty-four-hour rhythms in relation to the natural photoperiod: a field study in humans. Journal of Biological Rhythms, 9, 283–293.CrossRefGoogle Scholar
Liu, R. Y. et al. (2000). Decreased vasopressin gene expression in the biological clock of Alzheimer disease patients with and without depression. Journal of Neuropathology and Experimental Neurology, 59, 314–322.CrossRefGoogle ScholarPubMed
Lockley, S. W. (2009). Circadian rhythms: influence of light in humans. In Larry, R. S. (ed.), Encoclepedy of Neuroscience (pp 971–988). Oxford, UK: Academic Press.CrossRefGoogle Scholar
Lovell, B. B., Ancoli-Israel, , , S. and Gevirtz, R. (1995). Effect of bright light treatment on agitated behavior in institutionalized elderly subjects. Psychiatry Research, 57, 7–12. doi: 016517819502550G CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Lindell Veiel, L., Baker, A. and Steele, C. (1999). A randomized, controlled trial of bright light therapy for agitated behaviors in dementia patients residing in long-term care. International Journal of Geriatric Psychiatry, 14, 520–525. doi: 10.1002/(SICI)1099-1166(199907)14:7<520::AID-GPS983>3.0.CO;2-M 3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Mahlberg, R. et al. (2008). Pineal calcification in Alzheimer's disease: an in vivo study using computed tomography. Neurobiology of Aging, 29, 203–209.CrossRefGoogle Scholar
Mahlberg, R., Kunz, D., Sutej, I., Kuhl, K. P. and Hellweg, R. (2004). Melatonin treatment of day-night rhythm disturbances and sundowning in Alzheimer disease: an open-label pilot study using actigraphy. Journal of Clinical Psychopharmacology, 24, 456–459.CrossRefGoogle ScholarPubMed
Mishima, K. et al. (1994). Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia. Acta Psychiatrica Scandinavica, 89, 1–7.CrossRefGoogle ScholarPubMed
Mishima, K., Hishikawa, Y. and Okawa, M. (1998). Randomized, dim light controlled, crossover test of morning bright light therapy for rest-activity rhythm disorders in patients with vascular dementia and dementia of Alzheimer's type. Chronobiology International, 15, 647–654.CrossRefGoogle ScholarPubMed
Mishima, K., Okawa, M., Shimizu, T. and Hishikawa, Y. (2001). Diminished melatonin secretion in the elderly caused by insufficient environmental illumination. Journal of Clinical Endocrinology and Metabolism, 86, 129–134. doi: 10.1210/jcem.86.1.7097 Google ScholarPubMed
Münch, M. et al. (2017) Bright light delights: effects of daily light exposure on emotions, rest-activity cycles, sleep and melatonin secretion in severely demented patients. Current Alzheimer Research. doi: 10.2174/1567205014666170523092858 Google ScholarPubMed
Obayashi, K. et al. (2012). Positive effect of daylight exposure on nocturnal urinary melatonin excretion in the elderly: a cross-sectional analysis of the HEIJO-KYO study. Journal of Clinical Endocrinology and Metabolism, 97, 4166–4173. doi: 10.1210/jc.2012-1873 CrossRefGoogle ScholarPubMed
Oxford Dictionaries (2016). Available at: http://www.oxforddictionaries.com; last accessed 15 March 2016.Google Scholar
Park, D. H., Kripke, D. F. and Cole, R. J. (2007). More prominent reactivity in mood than activity and sleep induced by differential light exposure due to seasonal and local differences. Chronobiology International, 24, 905–920. doi: 10.1080/07420520701669677 CrossRefGoogle ScholarPubMed
Riemersma-van der Lek, R. F., Swaab, D. F., Twisk, J., Hol, E. M., Hoogendijk, W. J. and Van Someren, E. J. (2008). Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial. JAMA, 299, 2642–2655.CrossRefGoogle ScholarPubMed
Rimmer, D. W. et al. (2000). Dynamic resetting of the human circadian pacemaker by intermittent bright light. American Journal of Physiology: Regular, Integrative and Comperative Physioly, 279, R1574–R1579.Google ScholarPubMed
Sanford, J. R. (1975). Tolerance of debility in elderly dependants by supporters at home: its significance for hospital practice. British Medical Journal, 3, 471–473.CrossRefGoogle ScholarPubMed
Satlin, A. et al. (1991). Circadian locomotor activity rhythms in Alzheimer's disease. Neuropsychopharmacology, 5, 115–126.Google ScholarPubMed
Satlin, A., Volicer, L., Ross, V., Herz, L. and Campbell, S. (1992). Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer's disease. American Journal of Psychiatry, 149, 1028–1032.Google ScholarPubMed
Seitz, D. P. et al. (2011). Antidepressants for agitation and psychosis in dementia. Cochrane Database Systematic Revues, doi: 10.1002/14651858.CD008191.pub2 CrossRefGoogle ScholarPubMed
Sellix, M. T. et al. Aging differentially affects the re-entrainment response of central and peripheral circadian oscillators. Journal of Neuroscience, 32, 16193–16202. doi: 10.1523/JNEUROSCI.3559-12.2012 CrossRefGoogle Scholar
Shochat, T., Martin, J., Marler, M. and Ancoli-Israel, S. (2000). Illumination levels in nursing home patients: effects on sleep and activity rhythms. Journal of Sleep Research, 9, 373–379.CrossRefGoogle ScholarPubMed
Skjerve, A. et al. (2004). Improvement in behavioral symptoms and advance of activity acrophase after short-term bright light treatment in severe dementia. Psychiatry and Clinical Neuroscience, 58, 343–347. doi: 10.1111/j.1440-1819.2004.01265.x CrossRefGoogle ScholarPubMed
Sokolove, P. G. and Bushell, W. N. (1978). The chi square periodogram: its utility for analysis of circadian rhythms. Journal of Theoretical Biology, 72, 131–160.CrossRefGoogle ScholarPubMed
Spira, A. P. et al. (2012). Objectively measured sleep quality and nursing home placement in older women. Journal of the American Geriatric Society, 60 (7) 1237–1243.CrossRefGoogle ScholarPubMed
Turner, P. L., Van Someren, E. J. and Mainster, M. A. (2010). The role of environmental light in sleep and health: effects of ocular aging and cataract surgery. Sleep Medicine Reviews, 14, 269–280.CrossRefGoogle ScholarPubMed
Van Gool, W. A. and Mirmiran, M. (1986). Aging and circadian rhythms. Progressive Brain Research, 70, 255–277.CrossRefGoogle ScholarPubMed
Van Someren, E. J. et al. (1996). Circadian rest-activity rhythm disturbances in Alzheimer's disease. Biological Psychiatry, 40, 259–270. doi: 0006–3223(95)00370-3 CrossRefGoogle ScholarPubMed
Van Someren, E. J. et al. (1999). Bright light therapy: improved sensitivity to its effects on rest-activity rhythms in Alzheimer patients by application of nonparametric methods. Chronobiology International, 16, 505–518.CrossRefGoogle ScholarPubMed
Van Someren, E. J., Kessler, A., Mirmiran, M. and Swaab, D. F. (1997a). Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients. Biological Psychiatry, 41, 955–963. doi: S0006-3223(97)89928-3 CrossRefGoogle ScholarPubMed
Van Someren, E. J., Lijzenga, C., Mirmiran, M. and Swaab, D. F. (1997b). Long-term fitness training improves the circadian rest-activity rhythm in healthy elderly males. Journal of Biological Rhythms, 12, 146– 156.CrossRefGoogle ScholarPubMed
Van Someren, E. J., Mirmiran, M. and Swaab, D. F. (1993). Non-pharmacological treatment of sleep and wake disturbances in aging and Alzheimer's disease: chronobiological perspectives. Behavioural Brain Research, 57, 235–253.CrossRefGoogle ScholarPubMed
Wahnschaffe, A. et al. (2017). Implementation of dynamic lighting in a nursing home: impact on agitation but not on rest-activity patterns. Current Alzheimer Research. doi: 10.2174/1567205014666170608092411.CrossRefGoogle Scholar
Witting, W., Kwa, I. H., Eikelenboom, P., Mirmiran, M. and Swaab, D. F. (1990). Alterations in the circadian rest-activity rhythm in aging and Alzheimer's disease. Biological Psychiatry, 27, 563–572. doi: 0006-3223(90)90523-5 CrossRefGoogle ScholarPubMed
Wu, Y. H., Zhou, J. N., Van Heerikhuize, J., Jockers, R. and Swaab, D. F. (2007). Decreased MT1 melatonin receptor expression in the suprachiasmatic nucleus in aging and Alzheimer's disease. Neurobioliology of Aging, 28, 1239–1247. doi: 10.1016/j.neurobiolaging.2006.06.002 CrossRefGoogle ScholarPubMed