Light Treatment for Neuropsychiatric Behaviors in Alzheimer's Disease

Abstract

Neuropsychiatric behaviors are common in people with Alzheimer's disease (AD) and make both professional and lay caregiving difficult. Light therapy has been somewhat successful in ameliorating disruptive behaviors. This randomized trial tested the effects of morning or afternoon bright light exposure compared with usual indoor light on the presence, frequency, severity, and occupational disruptiveness of neuropsychiatric behaviors in nursing home residents with AD. Light was administered for 1 hr daily (Monday-Friday) for 10 weeks. The Neuropsychiatric Inventory-Nursing Home was used to assess behavior at baseline and end of the intervention. Analyses revealed statistically significant differences between groups on agitation/aggression, depression/dysphoria, aberrant motor behavior, and appetite/eating disorders. The magnitude of change was small and may not represent clinically significant findings. Agitation/aggression and nighttime behaviors commonly occurred and were highly correlated with occupational disruptiveness. Interventions that decrease the presence and/or severity of neuropsychiatric behaviors have the potential to significantly decrease caregiver burden.

Effects of Light Treatment on Sleep, Cognition, Mood, and Behavior in Alzheimer’s Disease: A Systematic Review

“…Barrick et al [56] showed that ambient bright light is not effective in reducing agitation in institutionalized persons with dementia and may exacerbate this behavioral symptom in severely demented patients. Another study that described a light treatment in nursing home residents with AD showed small changes in neuropsychiatric behaviors (e.g., aggression, depression, eating disorders); however, the authors concluded that the magnitude of these changes do not represent clinically significant findings [57]. Onega et al [58] showed that bright light exposure was associated with significant improvement in depression and agitation, while participants receiving low-intensity light displayed no significant changes or higher levels of depression and agitation.…”

Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes. A systematic review

“…Thirty-one RCTs met the inclusion criteria [40][41][42][43][44] and five main intervention categories emerged (Table 1): psychoeducational [13][14][15][16][17][18][19][20][21], physical activity [22][23][24][25], sensorial [26][27][28][29][30][31][32][33][34], staff-focused [35,36,37,38,40] and complex [41][42][43][44] (Table 2). Nineteen studies were two-arm RCTs [14,15,[17][18][19][21][22][23]25,26,[29][30][...…”

“…Nineteen studies were two-arm RCTs [14,15,[17][18][19][21][22][23]25,26,[29][30][31][32]35,38,40,41,43] and 12 were three-arm or more [13,16,20,24,27,28,33,34,36,37,42,44].…”

“…We identified four therapy types: light [26][27][28][29], music [30,31], multi-sensory stimuli [32], and therapeutic touch [33,34]. Nine trials met the inclusion criteria.…”

“…Four RCTs tested the effect of Bright Light Therapy (BLT) on behavioral symptoms [26][27][28][29]. Two 3-arm RCTs compared the effect of morning BLT and afternoon/evening BLT with normal light [27,28]. The other two compared one single type of BLT with usual light [26,29].…”