UT-Austin Researchers Join Wisconsin Counterparts In Tackling Alzheimer's 'Nighttime Agitation'

AUSTIN, TX — Researchers at The University of Texas at Austin have teamed up with their counterparts at the University of Wisconsin–Milwaukee on research toward improving treatment of nighttime agitation among people affected with Alzheimer's disease.

The research is being funded with a $3.9 million, five-year award from the National Institute on Aging, the largest award ever given to the UT Austin School of Nursing.

Research focuses on alleviating the agitation side effect of Alzheimer's, a commonly occurring condition that often has devastating effects, researchers said. Also known as "sundowning," nighttime agitation is the appearance or exacerbation of behavioral disturbances, such as wandering and aggression, researchers explained. The condition increases the burden and costs of caring for persons with the disease and often results in more restrictive living environments for them, officials added.

Kathy Richards, a research professor at the UT Austin School of Nursing, is co-principal investigator of the Nighttime Agitation and Restless Legs Syndrome in the People with Alzheimer’s Disease research project. Christine Kovach, a research professor in aging at the Jewish Home and Care Center at the University of Wisconsin–Milwaukee, is also a co-investigator.

“Safe, effective treatments for nighttime agitation are lacking," Richards said. "One major cause for these past failures has been the ‘one size fits all’ approach. The precision medicine method we are using tailors treatment to a specific sleep disorder, restless legs syndrome or RLS, that causes discomfort and an inability to sit or lie still in the evening and night. We hypothesize that RLS may be a cause for nighttime agitation and sleep disturbance in people with Alzheimer’s disease.”

Nighttime agitation behaviors are often treated with powerful anti-psychotic drugs, but alarming statistics on the prevalence of these medications and their danger to the health of persons with Alzheimer’s disease has resulted in a federal mandate to reduce their use and frequency, researchers noted. This research may lead to a reduction in dangerous anti-psychotic medications, they added.

According to university officials, this is the first time that a new diagnostic tool, the Behavioral Indicators Test–Restless Legs, that Richards and her team developed and validated for diagnosing RLS in persons with Alzheimer’s will be used in research on nighttime agitation.

The eight-week, double-blind, randomized controlled trial will include 136 long-term care residents with nighttime agitation and RLS living in long-term care settings in Central Texas. Residents will receive either gabapentin enacarbil (HORIZANT®) the FDA-approved drug for RLS, or a placebo.

“Nighttime agitation is the No. 1 reason why people with Alzheimer’s cannot be cared for at home,” Richards said. “If we can find a better and more precise way to treat nighttime agitation, we can improve the quality of life for many persons who are living with Alzheimer’s disease.”

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