Tailored lighting intervention for persons with dementia and caregivers living at home

Abstract

Objectives Light therapy has shown promise as a nonpharmacological treatment to help regulate abnormal sleep-wake patterns and associated behavioral issues prevalent among individuals diagnosed with Alzheimer’s disease and related dementia (ADRD). The present study investigated the effectiveness of a lighting intervention designed to increase circadian stimulation during the day using light sources that have high short-wavelength content and high light output. Methods Thirty-five persons with ADRD and 34 caregivers completed the 11-week study. During week 1, subjective questionnaires were administered to the study participants. During week 2, baseline data were collected using Daysimeters and actigraphs. Researchers installed the lighting during week 3, followed by 4 weeks of the tailored lighting intervention. During the last week of the lighting intervention, Daysimeter, actigraph and questionnaire data were again collected. Three weeks after the lighting intervention was removed, a third data collection (post-intervention assessment) was performed. Results The lighting intervention significantly increased circadian entrainment, as measured by phasor magnitude and sleep efficiency, as measured by actigraphy data, and significantly reduced symptoms of depression in the participants with ADRD. The caregivers also exhibited an increase in circadian entrainment during the lighting intervention; a seasonal effect of greater sleep efficiency and longer sleep duration was also found for caregivers. Conclusions An ambient lighting intervention designed to increase daytime circadian stimulation can be used to increase sleep efficiency in persons with ADRD and their caregivers, and may also be effective for other populations such as healthy older adults with sleep problems, adolescents, and veterans with traumatic brain injury.

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

“…Since the SCN of patients with severe AD is likely to be more degenerated, and the circadian activity rhythms deteriorate as the disease progresses, it is still possible that patients with mild or moderate AD would benefit from light treatment more than those with severe AD. For example, Figueiro et al [37] treated a group of 35 patients with mild or moderate dementia for 4 weeks with a tailored lighting intervention and, differently from previous studies, they showed a significant reduction of depressive symptoms. 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.…”

“…Figueiro et al [36, 37] also obtained an improvement in sleep parameters (e.g., increased total sleep time and sleep efficiency) using a tailored lighting intervention with bright light, from 6 or 8 am to 6 pm, in a group of patients diagnosed with AD and related dementia; however, these authors did not show any effect on the IS and IV parameters. Similar results were also found by Sloane et al [38] who, after a tailored lighting intervention, did not find any significant changes in the actigraph measures (i.e., IS and IV scores); light stimulation levels achieved in this study seem to have some effect on sleep pattern, albeit minor and not statistically significant.…”

“…In fact, successful BLT studies showed more marked beneficial effects during winter, when the external light cues are compromised, than during summer [48, 37]. Therefore, it is suggested that to obtain more beneficial effects, light must be turned on no earlier than the autumn equinox, and turned off not later than the spring equinox [48].…”

“…Patients living at home may still be mobile and can have activities outside the house, while those living in nursing homes have fewer opportunities to spend time outdoors. Therefore, a lighting intervention in a more controlled environment, such as nursing homes, will give the opportunity to receive the lighting intervention in a homogenously lighted and controlled environment and therefore may be more effective than the same intervention at home [37]. …”

User-experience in design and use: enhancing the experience of media content with programmable surround lighting

“…This is because brightlight therapy in an ADRD population significantly improves night time sleep [17] and reduces cognitive decline [25]. Furthermore, pain is strongly linked to depression, and either condition can be cause or effect of the other [19].…”