Abstract
Background and goalSleep problems and challenging behavioural symptoms are frequently reported among nursing home residents with dementia. Coffee with caffeine is consumed frequently by these residents and can have a negative effect on sleep and behaviour in older persons with dementia. In this interventional study, the effect of caffeine reduction on sleep and challenging behavioural symptoms in nursing home residents with dementia was investigated.MethodsIn 21 nursing home residents with dementia living in 1 dementia special care unit, caffeine was gradually eliminated in the afternoon and evening. During pre-intervention and post-intervention period the care workers daily scored sleep by a specially developed sleep questionnaire. Behavioural symptoms were scored in the afternoon and evening using four items of the NPI-NH: agitation/aggression, apathy, irritability and aberrant motor behaviour.ResultsA significant improvement in sleep scores (Wilcoxon signed-rank test, p = 0.015) and apathy (Wilcoxon signed-rank test, p = 0.020) was found after eliminating caffeine intake in the afternoon and evening. No significant changes occurred in agitation/aggression, irritability and aberrant motor behaviour.DiscussionThis pre-post pilot study found a significant positive effect of caffeine reduction on sleep and apathy and warrants further investigation in a larger controlled study.
Highlights
Sleep problems occur in 25–35% of patients with Alzheimer dementia [1]
Due to its stimulating effects, caffeine reduction might improve sleep and might change behavioural symptoms. In this pilot study with pre- and post-comparison, we investigate whether eliminating caffeine intake in the afternoon and evening has an effect on sleep and behavioural symptoms of nursing home residents with dementia
Physical illness occurred in three participants in the pre-intervention period, three in the intervention period and two in the post-intervention period. In this pilot intervention study in nursing home residents with dementia, a significant improvement of sleep scores and apathy was found after eliminating caffeine in the afternoon and evening
Summary
Sleep problems occur in 25–35% of patients with Alzheimer dementia [1]. Sleep disorders are associated with cognitive decline, behavioural symptoms, reduction of quality of life and they place an extra burden on informal caregivers and nursing staff [1, 2]. Sleep problems and challenging behavioural symptoms are frequently reported among nursing home residents with dementia. Coffee with caffeine is consumed frequently by these residents and can have a negative effect on sleep and behaviour in older persons with dementia. In this interventional study, the effect of caffeine reduction on sleep and challenging behavioural symptoms in nursing home residents with dementia was investigated. Results A significant improvement in sleep scores (Wilcoxon signed-rank test, p = 0.015) and apathy (Wilcoxon signed-rank test, p = 0.020) was found after eliminating caffeine intake in the afternoon and evening. Discussion This pre-post pilot study found a significant positive effect of caffeine reduction on sleep and apathy and warrants further investigation in a larger controlled study
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