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To test the long term effect of a light treatment on cognition, sleep and metabolism in patients with Mild cognitive impairment (MCI) or mild Alzheimer's disease or related dementia (ADRD).
Test if a tailored light intervention (TLI) that promotes entrainment can improve sleep disturbances, inflammation, insulin sensitivity (Si) and glucose disposal (Sg) and cognition in patients with MCI and mild ADRD and sleep disturbances. Using a single-arm, between-subjects, placebo-controlled study the investigators will investigate if long-term (6-month) exposure to TLI improves glucose homeostasis and insulin sensitivity in patients with MCI and mild AD who suffer from sleep disturbance and are living at home. Participants will be recruited from the Mount Sinai AD research center (ADRC) and randomized to receive the TLI (or comparison control treatment) at home. The investigators hypothesize that, compared to the comparison light, a TLI will increase entrainment, improve sleep, reduce depression, reduce inflammation, improve metabolic control, increase insulin sensitivity, and reduce susceptibility to T2DM and metabolic disease during and after the completion of the 6-month intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active Lighting Intervention | Active Comparator | The TLI will provide high circadian stimulation during the day produced by light sources that provide moderate light levels of spectra that are tuned to the sensitivity of the circadian system. Combining spectrum and light level, TLI will allow us to: (a) use a light source that will stimulate the circadian system, and (b) provide the participants with options as to how the light treatment will be delivered. The investigators will deliver at least 300-400 lux at the eye of the bluish-white light during the day (CS of 0.4 or greater). The lighting intervention will be in place for 24 weeks |
|
| Placebo Lighting Intervention | Placebo Comparator | The placebo condition light source will be a warm yellow - white (2700 - 3000 K) source providing 50 -100 lux at the eye. The lighting intervention will be in place for 24 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tailored Lighting Intervention | Device | Lighting Intervention either Active or Placebo |
|
| Measure | Description | Time Frame |
|---|---|---|
| Metabolic control | Changes in glucose homeostasis and insulin sensitivity will be measured using the Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT). | Done at Baseline, week 13 and 25 |
| Measure | Description | Time Frame |
|---|---|---|
| Sleep disturbance using actigraphy | Actigraphs will be worn for 7 days during assessment weeks to measure sleep | Done at Baseline, week 13, 25 and 48 |
| Light measurements | Light measurements will be collected using the Daysimeter for 7 days. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mariana G Figueiro, PhD | Icahn School of Medicine at Mount Sinai | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rutgers University | New Brunswick | New Jersey | 08854 | United States | ||
| Icahn School of Medicine at Mount Sinai |
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| D000544 | Alzheimer Disease |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D003704 | Dementia |
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Participants will be randomly assigned to receive the active or placebo lighting condition
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| Done at Baseline, week 13, 25 and 48 |
| Melatonin Levels | First morning urine will be collected and assayed for melatonin levels | One morning during Baseline, week 13, 25 and 48 |
| Sleep disturbance | Change in sleep disturbance will be assessed using the Pittsburgh Sleep Quality Index. The sum of the 7 component scores yields a single global score. A person with a global score above 5 is considered to have sleep disturbances. A higher score indicates worsening sleep disturbance. | Done at Baseline, week 13, 25 and 48 |
| Depression | A change in depression will be assessed using the Cornell Scale for Depression in Dementia. A score of nine or more points indicates depression. | Done at Baseline, week 13, 25 and 48 |
| Cognition | Changes in cognition will be assessed by use of the Alzheimer's Disease Assessment Scale- Cognitive Sub scale (ADAS-Cog). Scores range from 0 to 70 and a higher score signifies a greater degree of cognitive impairment. | Done at Baseline, week 13, 25 and 48 |
| New York |
| New York |
| 10029 |
| United States |
| D001927 |
| Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
| D019636 | Neurodegenerative Diseases |