Circadian Adjusted LED Light's Effect on Sleep, Circadian Rhythm, and Well-being in People Living in Elderly Housing: a Cross-over Non-blinded Randomized Trial.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 34
- 试验地点
- 2
- 主要终点
- The average difference in plasma soluble urokinase plasminogen receptor (suPAR) between the end of the intervention period and the end of the control period.
研究概览
简要总结
Europe is undergoing a demographic change with a rapidly growing population of 65 years+. This challenges municipalities and hospitals as the ageing citizens need care and treatment due to an age-related decline in physical and mental capacity. Therefore municipalities are experiencing a growing need for sufficient and customized housing, which can support the elderly citizens in sustaining well-being and health along with preventing functional decline. Well-fare technologies, such as Circadian adjusted LED-based lighting (CALED), are suggested as a remedy for this.
To obtain proper visual sharpness and better contrast, people of older age require heightened light levels due to age-related failing vision. Furthermore, inappropriate light at night disrupts not only sleep but also the timing of the circadian rhythm, with negative consequences on cognition and emotions. Therefore CALED is being increasingly considered for use in hospitals and elderly housing because of its wide spectrum of wavelengths, good contrast and fast switching, and possibility to support a normalised circadian rhythm.
Lighting based on LED has been shown to improve the quality of sleep and to improve well-being in the elderly. However, it is not known whether CALED mimicking a normal circadian rhythm has the same benefits for elderly persons with frailty or dementia. The investigators therefore want to test the effects of CALED in elderly people with frailty and mobility disabilities and/or dementia living in elderly housing. The investigators hypothesise that CALED can improve sleep and well-being in both elderly with frailty and dementia.
详细描述
Due to the technical requirements, CALED will not be installed in all elderly housing facilities at Sundhedshuset, Albertslund, Denmark, limiting the number of participants receiving the intervention to 24. CALED will be installed in the residents rooms/flats and in the common areas. Residents accepting participation will comprise the following (numbers are the maximal possible): 15 elderly with frailty receiving CALED as an intervention, 9 people with dementia receiving CALED as an intervention, and 15 elderly with frailty not receiving CALED during the trial as a control group (Group 3).
The elderly receiving CALED as an intervention (15 people with frailty, 9 people with dementia) will be randomized to two groups (Group 1 and Group 2) based on equal distributions of elderly with dementia and frailty in each group and similar numbers of men and women in each group. Since the residents spend a lot of time in the same common areas where CALED is installed, the two groups are subjected to the intervention at the same time, and Group 2 therefore has a delayed start. Group 1 starts with an 8 week control period followed immediately by an 8 week intervention period. Group 2 starts with an 8 week intervention period, at the same time as Group 1, followed by and 8 week control period. Group 3 has a 16 week control period starting 4 weeks after the beginning of the control period for Group 1, and ending 4 weeks before the end of the control period for Group 2.
Timeline: Participants are included when informed consent has been obtained. CALED is installed afterwards. Randomization takes place immediately before baseline testing of Group 1, and participants are randomized by block randomization. The trial participants will be assessed at baseline, in the 4th, 8th, 12th, and 16th week, respectively. For Group 1, baseline testing takes place within two weeks prior to the beginning of the Control period. For Group 2 baseline testing takes place within two weeks prior to the beginning of the Intervention period. For Group 3 baseline testing takes place within the two weeks prior to the beginning of the Control period. See outcome measures for further details of tests.
Data collection: All data collection and assessments will be performed at "Sundhedshuset" by trained staff under the instruction and supervision of the primary investigator. Date of all assessments will be noted. Blood samples (approximately 20 ml) will be taken in "Sundhedshuset" by trained staff under the supervision of the primary investigator. Date and time of blood sampling will be documented. Blood samples will be transported to Hvidovre Hospital after collection, and plasma and serum will be stored in a biobank at -80°C until analysis.
Data management: All case report forms will be checked for errors and missing data by the assessor before being archived in a trial database and all paper-based versions will be locked in a filing cabinet in a locked room to ensure confidentiality. Data management will follow the rules of the Danish Data Protection Agency.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Group 1 and 2: Frail elderly (+65 years) and elderly (+50 years) with dementia, who live in the flats/rooms in Sundhedshuset, Albertslund, Denmark that have been chosen for a test installation of CALED will be invited to participate.
- •Group 3: Frail elderly (+65 years) who live in the flats/rooms in Sundhedshuset, Albertslund, Denmark that have not been chosen for a test installation of CALED will be invited to participate.
- •Exclusion Criteria for Group 1, 2, 3:
- •Terminal illness
排除标准
- 未提供
结局指标
主要结局
The average difference in plasma soluble urokinase plasminogen receptor (suPAR) between the end of the intervention period and the end of the control period.
时间窗: End of intervention period (8th week assessment), end of control period (8th week assessment)
suPAR is a stable unspecific plasma biomarker. Elevated suPAR levels are associated with morbidity and mortality, and with unhealthy lifestyle, low muscle mass, lower physical performance, and depression. suPAR is measured in plasma using the commercially available suPARnostic ELISA from Virogates. Plasma samples are stored in a biobank at -80°C, and measured after study completion. suPAR is assessed at baseline, in the 4th and 8th week of the intervention period, and in the 4th and 8th week of the control period. The primary analysis will follow the intention-to-treat principle (using multiple imputations). The investigators report estimates for the 8th week. Data from both the 4th and 8th week assessment will be included in the statistical model.
The average difference in Pittsburgh Sleep Quality Index (PSQI) between the end of the intervention period and the end of the control period assessed by the both participants and by staff at the nursing home.
时间窗: End of intervention period (8th week assessment), end of control period (8th week assessment)
PSQI is a measure of sleep quality consisting of 19 self-report items. Both participants and staff at the nursing home that knows the participant well evaluate the PSQI, since the participants exhibit various degrees of dementia that may affect their ability to answer the PSQI. Participants and staff indicate the amount of sleep obtained as well as factors interfering with the sleep of the participant. The subscale scores of the PSQI are summed to a total score of 0 to 21 with higher scores indicating poorer sleep quality. PSQI is assessed at baseline, in the 4th and 8th week of the intervention period, and in the 4th and 8th week of the control period. The investigators report estimates for the 8th week assessement by participants and staff, independently. Data from both the 4th and 8th week assessment will be included in the statistical model.
次要结局
- The average difference in endocrinologic biomarkers such as insulin, glucose, cortisol, leptin and melatonin between the end of the intervention period and the end of the control period(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in the Major Depression Inventory (MDI) between the end of the intervention period and the end of the control period assessed by the both participants and by staff at the nursing home.(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in the Health related quality of life by the EuroQol (EQ-5D-3L) between the end of the intervention period and the end of the control period assessed by the both participants and by staff at the nursing home.(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in Epwoth Sleepiness Scale between the end of the intervention period and the end of the control period assessed by the both participants and by staff at the nursing home.(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in the Mini Mental State Examination between the end of the intervention period and the end of the control period(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in 24-hour mobility between the end of the intervention period and the end of the control period.(: End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in inflammatory biomarkers such as interleukin (IL)-6, IL-10, soluble CD14, and C reactive protein between the end of the intervention period and the end of the control period.(End of intervention period (8th week assessment), end of control period (8th week assessment))
- The average difference in Activities of Daily living by the Barthel 20 index between the end of the intervention period and the end of the control period(End of intervention period (8th week assessment), end of control period (8th week assessment))
研究者
Ove Andersen
Research Director, MD, PhD, DMSc
Hvidovre University Hospital