263918 Adapting an Evidenced Based Insomnia Intervention for Older Adults in Residential Care

Monday, October 29, 2012

Erin Cassidy-Eagle, PhD , Research Department, ETR Associates, Scotts Valley, CA
Ruth O'Hara, PhD , Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
Sherry Beaudreau, PhD , Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
Sean Lauderdale, PhD , Department of Psychology and Counseling, Pittsburg State University, Pittsburg, KS
Jill R. Glassman, PhD, MSW , Research, ETR Associates, Scotts Valley, CA
Morin and Espie's cognitive behavioral therapy (CBT), 8-session, evidence based manual for sleep disturbance, entitled, “Insomnia: A Clinical Guide to Assessment and Treatment” was piloted with a small group of older adults (N=5) living in a residential care facility for the elderly (RCFE) who suffered from mild cognitive impairment. Sleep disturbance is one of the most frequent symptoms observed in older patients with mild cognitive impairment (MCI), occurring 14-59% of the time. Sleep is an ideal target due to evidence that treatments are very successful for a broad range of individuals; improvements have the potential to broadly impact public health; and further, sleep represents a modifiable risk factor for a range of other disorders, such as declining cognition, depression and functional impairment. Pre-post, paired sample t-tests showed significant improvements in the participants ratings of their sleep quality via the Insomnia Severity Index [t(4)=10.61, p<.00], as well as a decrease in the number of awakenings after sleep onset via actigraphy [t(4)=5.74, p<.00]. It is not yet understood how MCI may moderate the effects of treatment and what therapeutic adaptations are needed to maximize treatment effects. Adaptations found to aid implementation and outcome will be detailed. Specifically the content (e.g., amount covered, need for simplified language), delivery (e.g., pace, use of repetition) and measurement (e.g., reliability, validity, burden) adaptations used with RCFE residents with both sleep disturbances and MCI will be presented. If effective on a larger scale, future studies would focus on transferability and scalability across residential care settings.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
1. Describe ways to adapt interventions for older adults suffering from cognitive impairments.

Keywords: Interventions, Elderly

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a licensed, clinical geropsychologist with extensive experience working with older adults. I have over 20 years of experience in conducting clinical and research work in long term care settings. I have conducted investigations and trainings in the areas of geriatric depression, anxiety, Alzheimer’s disease and associated behavioral manifestations, along with other topics in the area of aging and mental health, including being the principal investigator on the project detailed in this submission.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.