The Effects of Light on Sundowning in Alzheimer's Disease

Category Health

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A recent study from UVA Health suggests that increased sensitivity to light might be a contributor to "sundowning" and sleep disruptions in Alzheimer's Disease, which could lead to treatments and management of symptoms. There could also be implications for preventing the disease. The researchers studied mouse models and found that the mice reacted differently to light, with the Alzheimer’s mice adapting to a six-hour time change significantly more quickly than the control mice.

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A recent study from UVA Health on Alzheimer’s disease suggests that increased sensitivity to light might contribute to "sundowning" – the deterioration of the disease’s symptoms towards the end of the day – and spur sleep disruptions, which are believed to accelerate the progression of the disease. The recent understanding of the biological clock disturbances associated with Alzheimer’s could be significant for devising treatments and managing symptoms, according to the researchers. Caregivers often find it challenging to deal with the unpredictable sleep schedules caused by the altered "circadian rhythms" or the body’s innate daily cycle in Alzheimer’s patients. The new study proposes that light therapy could potentially be a useful strategy to control these disruptions.

Alzheimer's is thought to be caused by protein tangles in the brain's neurons.

A better understanding of Alzheimer’s disease’s effects on the biological clock could also have implications for preventing the disease. Poor sleep quality in adulthood is a risk factor for Alzheimer’s, as our brains, when at rest, naturally cleanse themselves of amyloid beta proteins that are thought to form harmful tangles in Alzheimer’s.

"Circadian disruptions have been recognized in Alzheimer’s disease for a long time, but we’ve never had a very good understanding of what causes them," said researcher Thaddeus Weigel, a graduate student working with Dr. Heather Ferris of the University of Virginia School of Medicine’s Division of Endocrinology and Metabolism. "This research points to changes in light sensitivity as a new, interesting possible explanation for some of those circadian symptoms." .

The progression of Alzheimer's can be tied to a number of lifestyle changes.

Alzheimer’s is the most common form of dementia, affecting 50 million people around the world. Its hallmark is progressive memory loss, to the point that patients can forget their own loved ones, but there can be many other symptoms such as restlessness, aggression, poor judgment, and endless searching. These symptoms often worsen in the evening and at night.

Ferris and her collaborators used a mouse model of Alzheimer’s to better understand what happens to the biological clock in Alzheimer’s disease. They essentially gave the mice "jet lag" by altering their exposure to light, then examined how it affected their behavior. The Alzheimer’s mice reacted very differently than did regular mice.

The researchers tested the hypothesis of neuroinflammation in their studies, but ultimately ruled it out.

The Alzheimer’s mice, the scientists found, adapted to a six-hour time change significantly more quickly than the control mice. This, the scientists suspect, is the result of a heightened sensitivity to changes in light. While our biological clocks normally take cues from light, this adjustment happens gradually, as the body needs time to adapt. But for the Alzheimer’s mice, this change happened abnormally fast.

Light therapy is often used to aide with sleep disruption.

The researchers initially thought this might be because of inflammation in the brain, or "neuroinflammation." So they looked at immune cells called microglia that have become promising targets in efforts to develop better Alzheimer’s treatments.

While targeting microglia could be beneficial for other reasons in treating Alzheimer’s, the scientists ultimately ruled out the hypothesis, determining that microglia did not make a difference in how quicly the mice adapted to time changes.

Poor sleep quality in adulthood is linked to an increased risk for Alzheimer's.

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