UT receives grant to study nighttime agitation in people with Alzheimer’s disease

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Researchers at the UT School of Nursing want to make it easier for people with Alzheimer’s to get a good night’s sleep.

The UT School of Nursing, along with the University of Wisconsin-Milwaukee, recently received a $3.9 million grant from the National Institute on Aging to study and try to reduce nighttime agitation in people with Alzheimer’s. Nighttime agitation, also known as sundowning, refers to the increase in certain behaviors, such as wandering around, trying to leave the house, yelling, screaming and hitting other people, in the evening and nighttime.

Kathy Richards is a research professor in the School of Nursing and the co-principal investigator of the Nighttime Agitation and Restless Legs Syndrome in the People with Alzheimer’s Disease research project, which is the recipient of the grant. She said the grant will help fund a clinical study to determine a more effective treatment for nighttime agitation.

Richards said the condition can be quite harmful and current treatments are dangerous.

“(The people affected) have the potential to harm themselves because their caregivers are often worn out trying to take care of the person,” Richards said. “For example, [the affected person] might try to turn on the stove and try to cook when their caregivers are asleep, but having their memory impaired, they may not be able to do it and put themselves in danger.”

According to Richards, around 60 percent of people with Alzheimer’s disease experience sundowning.

“One of the most common things that happens when someone has (sundowning is) the people who are trying to care for them at home can’t rest and are exhausted,” Richards said. “(Sundowning) is the most common reason for institutionalization, which is very costly and reduces the quality of life for people.” 

Currently, patients with nighttime agitation often are treated with antipsychotic drugs, but Richards said there have been several federal mandates to try to decrease these types of medications. 

“(Antipsychotics) have been shown to lead to strokes, falls and death,” Richards said. “Now, there’s a big emphasis to determine a more effective treatment.”

Richard and her colleagues’ are introducing a new approach called precision medicine. 

“Precision medicine focuses on very carefully identifying the specific cause of the problem,” Richards said. “We believe one of the major reasons why people have sundowning is because of a sleep disorder that is unidentified and untreated in this population.”

Richards said this sleep disorder, called restless legs syndrome, leads to an inability to sit or lie still in the evening. 

“The purpose of this study is to use precision medicine to identify this problem, restless legs syndrome, and to treat it with a FDA-approved medication,” Richards said. 

The study will randomly assign people to receive either the drug or a placebo for eight weeks, and will test if treating restless legs syndrome reduces sundowning behaviors, improves sleep and reduces the need for
antipsychotic medications. 

“We think (precision medicine) has the potential to really improve the quality of life for people with Alzheimer’s disease and reduce the cost of caring for them in long-term care settings,” Richards said. “Eventually, we hope to apply it to people living at home to hopefully reduce institutionalization and reduce caregiver burden in the home.”