By Jamie Saunders
Worldwide, 50 million people are living with Alzheimer’s and other dementias. Alzheimer’s disease is one of the nation’s most significant public health crises. This makes finding a way to increase research to address this worldwide epidemic paramount. In recent years, with increases in funding from the National Health Institute, great strides have been made in studying the causes and effects of Alzheimer’s disease.
In 2019, The Alzheimer’s Association made its largest-ever research investment, granting more than $42 million to 162 scientific investigations. Researchers are currently studying everything from digital biomarkers for Alzheimer’s to the impact of daily behavior modifications. Many of these studies are ongoing in 2020, including Dr. Glenna Brewster’s study on sleep disturbances in patients[BG1] [AJ2] with Alzheimer’s and their caregivers.
Professional and Personal Experiences Intertwined
Dr. Brewster is an accomplished researcher with a Ph.D. in Nursing Science. She is an Assistant Professor at the Nell Hodgson Woodruff School of Nursing, and a board-certified Family Nurse Practitioner. She also currently serves as a volunteer Community Educator for the Georgia Chapter. A professional decision that quickly turned personal.
Says Dr. Brewster, “I started working with caregivers of persons living with dementia during my doctoral studies. When I moved to Atlanta to start my Emory position, I continued working with families living with dementia. I thought, what better way to get to know the community than to volunteer for the Alzheimer’s Association?”
Thanks to colleagues that were already volunteering, Dr. Brewster was introduced to Mia Chester, the Volunteer and Outreach Manager for the Alzheimer’s Association. Continues Dr. Brewster, “Mia was phenomenal in onboarding me as a community educator. Unfortunately, during this time, my grandmother had a stroke and was later diagnosed with vascular dementia.”
She now embodies the role of caregiver both professionally, and personally. Dr. Brewster lives with and assists her mother in caring for her grandmother while working with patients as a Nurse Practitioner at the Integrated Memory Care Clinic at Emory Healthcare.
Through it all, Dr. Brewster remains positive, saying, “I am putting what I present to the community into practice. I also let these experiences guide my research and nursing practice.” Persons living with Alzheimer’s disease and caregivers alike will benefit from Dr. Brewster’s education, experience, and interest in improving conditions for those struggling with the disease.
Past Meets Present
Long before current events, Dr. Brewster has been studying sleep and sleep disorders, specifically how sleep triggers or worsens depressive symptoms. This interest, plus her life experiences, recently presented Dr. Brewster with an opportunity to put all of her skills into play.
Through a grant from the Alzheimer’s Association, Dr. Brewster is currently recruiting qualified candidates to study the effects of sleep disturbance on persons living with Alzheimer’s disease and related dementias and their caregivers. Once again, her personal experience played a role in professional development.
“I had a close family member who was depressed. One of the symptoms was significant sleep disturbance, challenges with falling asleep, and staying asleep. Since then, the person has received treatment and is doing great. But I wanted to understand more about other ways sleep disturbance could impact psychological and other health outcomes,” says Dr. Brewster.
Dr. Brewster continues, “During my Ph.D., I worked with caregivers of persons living with dementia who were recruited to participate in a National Institute on Aging funded study. These caregivers had sleep problems. We found that compared to normed scores, these caregivers with poor sleep had worse fluid cognition composite scores. By fluid cognition, I mean, decision-making ability, speed of decision making, and memory.”
Those scores produced a significant finding. “During my postdoctoral fellowship, we published a manuscript that found that 60% of caregivers of persons living with dementia was aware of the care recipient having a sleep disturbance. This suggests that caregivers’ sleep is also influenced by the sleep of persons living with dementia. These factors reinforce my desire to continue focusing on this program of research,” Dr. Brewster concludes.
Studies like this one are desperately needed. Persons living with Alzheimer’s disease often experience sundowning, a state of confusion occurring in the late afternoon, and spanning into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression, or ignoring directions. Sundowning can also lead to pacing or wandering. It can also wreak havoc on caregivers’ sleep patterns and cause stress, anxiety, and depression with them.
In one study that influenced Dr. Brewster, it was concluded that spousal caregivers of persons living with dementia were six times more at risk of experiencing cognitive decline and dementia than spousal non-caregivers. That is an alarming number and reason enough for implementing a study on the effects of sleep and providing caregivers with possible preventative measures.
Study Aims to Prove Sleep is Key to Improving Alzheimer’s and Caregiver Lifestyles
Up to 71% of the persons living with dementia (PLwD) and 70% of their caregivers experience sleep disturbances, which are distressing for both the PLwD and their caregivers. Specifically, PLwD often experiences restlessness and fragmented sleep, affecting sleep patterns leading to multiple nightly awakenings, shorter sleep duration, and/or inconsistent sleep-wake times.
According to Dr. Brewster, “These disturbances increase the risk for a myriad of psychological, cognitive, behavioral, and physiological health issues and poor quality of life for the dyad. Given the interdependence of the dyadic sleep disturbances and the negative health consequences of sleep disturbances on the dyad, there is a critical need to develop and provide effective non-medication interventions to improve sleep.”
Dr. Brewster continues, “This project seeks to collect preliminary data on a non-medication, behavioral intervention. The behavioral intervention will be provided at the same time to the person living with dementia/memory loss and his/her caregiver. We want to determine if they can do the intervention, if the intervention is acceptable, and if it helps their sleep.”
How You Can Help Yourself and Others
The intervention is a 4 week intervention. Data is collected at 3 time points: 2 weeks before the intervention starts, when the intervention ends, and 3 months after the second data collection point. Participants will complete sleep diaries and wear a watch which records activity for 6 weeks: the 2 weeks before the intervention and the 4 weeks of the intervention. Participants will also complete questionnaires which ask about how their health. Each participant will receive $100 for their participation in the study and valuable information to help them with their sleep and hopefully, their current situations.
“We are recruiting people with memory loss, mild cognitive impairment, early dementia, and their caregivers or care partners. Both of them should be experiencing some disturbance with their sleep and must live in the same home. If you are interested, please call. We will screen you by asking some questions about sleep and about your memory and reasoning,” says Dr. Brewster.
Concludes Dr. Brewster, “My goal is to improve the lives of persons living with dementia and their caregivers by improving their sleep experience. I can only do this if families choose to participate in my research and provide feedback about their experience and how the intervention can be improved for other families.”
If you are interested in participating in this vital research study, email Dr. Brewster at email@example.com and firstname.lastname@example.org or call (404) 712-9164. Participants will be recruited through September 2021.
[BG1]I prefer to say persons living with Alzheimer’s disease instead of patients.