A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation

Abstract

Background: Even though poor lighting at nighttime is an important risk factor for falls (and most falls occur during the night), lighting interventions to improve nightly lighting from bed to bathroom are rarely evaluated for fall prevention. Objective: We tested the hypothesis that an automated guiding light would reduce nightly fear of falling (FOF) and increase sleep quality of community-dwelling older people. Methods: This study had a pragmatic uncontrolled beforeafter design, including participants during a period of 8 months if they (i) were aged at least 65 years, (ii) ambulated independently at night, and (iii) had no cognitive or audiovisual impairments obstructing outcome measurement. Automated LED strips (Gight TM ) were installed in the participants' homes. The primary outcome measure was overnight FOF on a scale of 0-10. Secondary outcome measures included sleep quality on a scale of 0-10 and fall rate. Additionally, a sample of participants was interviewed about their experiences with Gight. Results: Sixty-four participants were included (mean age: 80.8 ± 8.1 years; 89% living independently). Mean study length was 118 days (range: 30-231). In the intention-to-treat analysis, overnight FOF declined from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001), and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012). The fall rate during the study was too low to detect changes. Participants appreciated Gight (8.4 ± 0.8 on a scale of 10), and the majority (57%) reported a subjective decrease in FOF. Conclusion: Gight shows promising results for overnight FOF and sleep quality, but the effect of lighting interventions on fall rate should be evaluated further before widespread implementation.

Effectiveness of Information and Communication Technology (ICT) Interventions in Elderly’s Sleep Disturbances: A Systematic Review and Meta-Analysis

“…A study on applying guiding nightlight, an intervention method for the elderly’s fear of falling (FOF) and improving sleep quality, presents the following results. The study on night FOF and sleep quality by installing automatic LED strips in 64 participants’ homes showed that FOF fell from 5.5 ± 3.0 to 3.8 ± 3.2 ( p = 0.001) and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 ( p = 0.012) [ 20 ].…”

“…A study on applying guiding nightlight, an intervention method for the elderly's fear of falling (FOF) and improving sleep quality, presents the following results. The study on night FOF and sleep quality by installing automatic LED strips in 64 participants' homes showed that FOF fell from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001) and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012) [20]. Quality of Life-Mental Component Score (QoL-MCS) Meta-analysis results showed significant improvement in QoL-MCS for the CBT-I group compared to the control group (5.75 (1.64, 9.87), p = 0.006, I 2 = 0%) (see Figure 3E).…”

Fear of Falling and Environmental Factors: A Scoping Review

“…In this sense, four studies evaluated or performed intervention of aspects related to the housing environment through validated scales or checklists. 31 , 32 , 35 , 48 ) On the other hand, six of these studies were dedicated to measuring or intervening aspects of the neighborhood environment through various instruments assessing perception in terms of discomfort, accessibility, or use of different neighborhood elements. 35 , 38 , 40 - 42 , 49 ) Finally, three studies that assessed both aspects of the built environment (home and neighborhood) using different instruments were identified.…”

“…Only one pragmatic CT demonstrated the results of a modification of the living environment. The authors assessed the effectiveness of nighttime automated LED lighting on the path from the bedroom to the bathroom 31 ) in reducing the fear of falling and improving sleep in older adults. Intention-to-treat analysis showed a significantly decreased nighttime fear of falling, from a score of 5.5±3.0 to 3.8±3.2 (on a 1–10-point scale) at the end of the study (z=-3.31, p=0.001, r=0.30).…”

Development and validation of the fall risk perception questionnaire for patients in acute care hospitals

“…The Personal‐chronic condition subfactor assesses aspects including poor vision (Ehrlich et al, 2019; Najafpour et al, 2019), poor hearing (Lin & Ferrucci, 2012), dizziness (Alyono, 2018) and medications (de Jong et al, 2013; Najafpour et al, 2019). The Environmental subfactor assesses aspects including disorganised surroundings (Miake‐Lye et al, 2013; Najafpour et al, 2019), moisture on the floor (Miake‐Lye et al, 2013) and poor lighting (Thölking et al, 2020).…”