BackgroundThe visual system plays an important role in maintaining balance. As a person ages, gait becomes slower and stride becomes shorter, especially in dimly lighted environments. Falls risk has been associated with reduced speed and increased gait variability.MethodsTwenty-four older adults (half identified at risk for falls) experienced three lighting conditions: pathway illuminated by 1) general ceiling-mounted fixtures, 2) conventional plug-in night lights and 3) plug-in night lights supplemented by laser lines outlining the pathway. Gait measures were collected using the GAITRite© walkway system.ResultsParticipants performed best under the general ceiling-mounted light system and worst under the night light alone. The pathway plus night lights increased gait velocity and reduced step length variability compared to the night lights alone in those at greater risk of falling.ConclusionsPractically, when navigating in more challenging environments, such as in low-level ambient illumination, the addition of perceptual cues that define the horizontal walking plane can potentially reduce falls risks in older adults.

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This paper discusses a proposed 24-hr lighting scheme for older adults that can positively impact the aging visual, circadian and perceptual systems. New lighting was installed in eight private rooms in an assisted living facility. Measurements of residents' sleep quality and circadian rest-activity patterns were obtained, before and after the new lighting was installed. Consistent with predictions based upon previous research, the subjects who completed the study showed an improvement in sleep quality and rest/activity rhythms under the new 24-hr lighting scheme. In addition, all study participants reported a strong preference for the 24-hr lighting. The new lighting not only provides older adults with good lighting for performing their routine visual tasks, but also promotes high circadian light stimulation during the day and low circadian light stimulation at night. Although not studied here, but also discussed as part of the 24-hr lighting scheme, is the impact of a previously studied, novel night-light system that provides older adults with enhanced perceptual cues for nighttime navigation within the room. The new 24-hr lighting scheme appears to have important practical implications for improving the quality of life for seniors and will hopefully be adopted by architects, lighting specifiers and engineers.

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