Nighttime Agitation and Restless Legs Syndrome in People with Alzheimer's Disease

Summary/Abstract. Factors associated with Covid-19 social distancing - such as isolation from family, restrictedmovement, insufficient sunlight and social and physical activity, lack of caregiver supportservices, and caregiver exhaustion - may adversely impact the well-being of older adults withAlzheimer's disease related dementia. Because older adults with dementia are cognitively andverbally unable to express their distress, and both sunlight and activity are necessary for healthysleep patterns, social distancing may increase agitation behaviors, worsen sleep patterns, andincrease prescriptions for antipsychotics and sedating medications to manage these problems. We propose an Administrative Supplement to the NightRest study, R01AG051588, todetermine the impact of social distancing on the well-being of older adults with Alzheimer'sdisease related dementia. The primary specific aim is to determine the impact of socialdistancing on nighttime agitation and sleep. The hypothesis is: social distancing will result inmore nighttime agitation and less sleep. Aim 2 will explore the impact of social distancing onphysical function and use of antipsychotics and other sedating medications. Aim 3 will explorethe impact of social distancing from the perspectives of family caregivers using qualitativeinterviews and a Facebook survey. The research will employ an observational study design.Participants from the NightRest trial, 50 pre- and 50 post-Covid-19, living independently or innursing homes, matched on relevant variables, will be used for Aims 1 and 2. Content analysisof 30 family caregiver qualitative interviews (Aim 3) will result in a list of priorities to minimize theimpact of social distancing. Family caregivers accessed via a Facebook survey will rank andadd to the priorities. Because the NightRest study team possesses pre-Covid-19 data, has access to familycaregivers who have expressed interest in future studies, and has developed and piloted virtualdata collection methods, we are uniquely positioned to determine the impact of Covid-19 socialdistancing policies on well-being. We also have the ability and the networks to translate thefindings. The results will be widely disseminated in November/December, 2020 to stakeholdersand other policy influencers through social media, press releases, and presentations. Theproposed project may result in more tailored social distancing policies in the future. Further,dissemination of nursing home realities to a world closely following Covid-19 developments mayultimately result in better nursing home care, not just for now, but also in the future.