Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
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There are few studies addressing caregivers of bipolar disorder (BD) patients, especially patients who are older adults with an increased need for care, often given by a relative. The aim of this study was to describe which factors increase caregiver burden among caregivers of elderly BD outpatients. ⋯ In this group of elderly BD patients, caregiver burden was more associated with symptoms frequently seen in others diseases as in dementia than with depressive, manic, or anxiety symptoms, which are often used as treatment outcomes measures goals in BD. Potential treatable and modifiable factors associated with caregiver burden could be caregivers' depression, anxiety, and medical comorbidities, as well as support for caregivers in terms of services and social relationships.
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Sleep problems in people with dementia are common and place a high burden on caregivers. Although hypnotic agents are often used to treat sleep disturbances, their use is associated with a considerable number of high-risk side-effects such as daytime sleepiness, amnesia, and an increased frequency of falling. The administration of bright light therapy (BLT) in the morning was a non-pharmacological remedy that was expected to treat sleep disorders in patients with dementia by entraining the circadian rhythm to ameliorate disturbances to the normal sleep-wake cycle. However, there are some unsolved issues related to the application of BLT, including the types of dementia for which it is effective and its efficacy in the different stages of cognitive decline and dementia. Furthermore, a protocol for effective BLT has not yet been proposed. ⋯ BLT could be an effective strategy for treating dementia patients, depending on their type and grade of their dementia. To confirm this hypothesis, it would be necessary to study a larger number of cases. Non-pharmacological therapies for sleep disorders should be emphasized as a safe form of treatment for patients with dementia.