Could teaching individuals with mild cognitive decline how to sleep better actually stave off their descent into Alzheimer's disease and dementia?
1 in 5proportion of American adults over age 65 diagnosed with Mild Cognitive Impairment, a precursor to Alzheimer's disease
That's Meghan Mattos’ (COLL ’06, CNL ’09) focus. And with support from a $300,000 Translational Health Research Institute (THRIV) grant, Mattos—an assistant professor who's studied rural-dwelling adults with Mild Cognitive Impairment (MCI)—will assess the effect of an online sleep education program developed by UVA psychology professor Lee Ritterband in older adults with this early form of dementia.
The hypothesis, Mattos explains, is not only that the six-week program may offer MCI patients non-pharmacological insomnia relief, but that purposefully improving their sleep patterns through an accessible online program may slow their otherwise likely decline towards Alzheimer’s.
"There's no drug, there's no way to ward off time to possible progression to Alzheimer's and other dementias, so if this intervention improves patients' quality of life, gives more functional ability, and joy in life? Well, that's why we want to do this."nurse researcher Meghan Mattos, assistant professor
"We don't know if bad sleep is causing dementia, or dementia is causing bad sleep," explains Mattos, "but we do know that there's a relationship between them, and hope to find out what is causing what”—and what difference a program like Ritterband’s SHUTi OASIS (Sleep Healthy Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness) might make.
Recruiting subjects age 55 and older from UVA's Memory and Aging Care Clinic, Mattos will enroll 30 individuals diagnosed with MCI and insomnia who, over six weeks, are taking a series of online hour-long "core” classes: everything from sleep hygiene to guided relaxation techniques. Wristwatch-sized actigraphs capture minute details about subjects’ sleep and wake patterns, data that, with subjects’ pre- and post-intervention sleep diaries and interviews, will enable Mattos to assess sleep and cognitive change over time.
While earlier versions of SHUTi have been tested and validated, this newer version—which is being evaluated as part of a National Institutes of Health grant—has been optimized for adults 55 and older through the use of more senior actors and with the inclusion of topics like incontinence.
Older adults with MCI, who are significantly more likely to develop Alzheimer’s and associated dementias, are familiar terrain for Mattos. With the sizable proportion of older adults who suffer from insomnia—roughly one-third of older Americans—“we’re looking at something that’s an issue for a large part” of the population, Mattos says.
Currently, there’s no known cure for MCI. Current treatments focus on maintenance of cognitive function and management of behavioral symptoms to slow or delay disease symptoms.
“Targeting this at-risk group is important because there’s no drug, and no way to ward off time to possible progression to Alzheimer’s and other dementias,” says Mattos, “so if this intervention improves these patients’ quality of life, and gives more functional ability, joy in life—well, that’s why we want to do this.”