Behavioural and psychological symptoms, such as nocturnal restlessness and wandering, are seen in 90% of patients with dementia at some point in their course. Non-pharmacologic interventions, such as high-intensity lighting, can play an important role in managing these behavioural and psychological symptoms by impacting both the visual and the circadian system. In order to assess the effects of prolonged exposure to high-intensity light (about 1800 lx horizontal on table level) on behaviour and circadian rhythmicity of institutionalised older adults with dementia, ceiling-mounted luminaires emitting bluish (6500 K) and yellowish (2700 K) light were installed in an intervention group that was compared to a control group of traditional dim lighting equipment. The study was performed from May to August 2006. Effects of the lighting intervention were assessed by the Dutch Behaviour Observation Scale for Intramural Psychogeriatrics (GIP), and tympanic temperature measurements. In the bluish light scenario, a significant improvement in restless behaviour was observed in the intervention group, as well as a significant increase in the range of tympanic temperature. These effects were not found in the yellowish light scenario. Further evidence is found that high-intensity bluish light may play a role in managing restless behaviour and improving circadian rhythmicity in institutionalised older adults with dementia.
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Long-term care facilities are currently installing dynamic lighting systems with the aim to improve the well-being and behaviour of residents with dementia. The aim of this study was to investigate the implementation of dynamic lighting systems from the perspective of stakeholders and the performance of the technology. Therefore, a questionnaire survey was conducted with the management and care professionals of six care facilities. Moreover, light measurements were conducted in order to describe the exposure of residents to lighting. The results showed that the main reason for purchasing dynamic lighting systems lied in the assumption that the well-being and day/night rhythmicity of residents could be improved. The majority of care professionals were not aware of the reasons why dynamic lighting systems were installed. Despite positive subjective ratings of the dynamic lighting systems, no data were collected by the organizations to evaluate the effectiveness of the lighting. Although the care professionals stated that they did not see any large positive effects of the dynamic lighting systems on the residents and their own work situation, the majority appreciated the dynamic lighting systems more than the old situation. The light values measured in the care facilities did not exceed the minimum threshold values reported in the literature. Therefore, it seems illogical that the dynamic lighting systems installed in the researched care facilities will have any positive health effects.
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De interesse in licht is de afgelopen jaren enorm toegenomen. In het bijzonder betreft dit de invloed van licht op onze gezondheid, prestatie en andere, niet direct visueel gerelateerde aspecten. Het laatste heeft bijvoorbeeld tot gevolg gehad dat basisscholen momenteel op grote schaal uitgerust worden met dynamisch verlichting die de concentratie van scholieren zou verhogen, verlichting in kantoren die de prestatie van medewerkers moet verbeteren en verlichting voor ouderen met dementie die hun verstoorde slaapwaakritme kan stabiliseren. Maar de vraag is nu: hebben we wetenschappelijk bewijs dat deze systemen ook de beoogde claims halen? Dit artikel vraagt aandacht voor de feiten op het gebied van dynamische verlichting voor mensen met dementie en probeert deze van de fictie te onderscheiden.
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Light therapy for older persons with dementia is often administered with light boxes, even though indoor ambient light may more comfortably support the diverse lighting needs of this population. Our objective is to investigate the influence of indoor daylight and lighting on the health of older adults with dementia living in long-term care facilities. A systematic literature search was performed within PubMed, CINAHL, PsycINFO, Web of Science and Scopus databases. The included articles (n=37) were published from 1991 to 2020. These articles researched the influence of existing and changed indoor light conditions on health and resulted in seven categories of health outcomes. Although no conclusive evidence was found to support the ability of indoor light to decrease challenging behaviors or improve circadian rhythms, findings of two studies indicate that exposure to (very) cool light of moderate intensity diminished agitation. Promising effects of indoor light were to reduce depressive symptoms and facilitate spatial orientation. Furthermore, there were indications that indoor light improved one’s quality of life. Despite interventions with dynamic lighting having yielded little evidence of its efficacy, its potential has been insufficiently researched among this study population. This review provides a clear and comprehensive description of the impact of diverse indoor light conditions on the health of older adults with dementia living in long-term care facilities. Variation was seen in terms of research methods, (the description of) light conditions, and participants’ characteristics (types and severity of dementia), thus confounding the reliability of the findings. The authors recommend further research to corroborate the beneficial effects of indoor light on depression and to clarify its role in supporting everyday activities of this population. An implication for practice in long-term care facilities is raising the awareness of the increased lighting needs of aged residents. Original article at: https://doi.org/10.2147/CIA.S297865
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Over 40% of nursing home residents in the Netherlands are estimated to have visual impairments. In this study, light conditions in Dutch nursing homes were assessed in terms of horizontal and vertical illuminances and colour temperature. Results showed that in the seven nursing homes vertical illuminances in common rooms fell significantly below the 750 lx reference value in at least 65% of the measurements. Horizontal illuminance measurements in common rooms showed a similar pattern. At least 55% of the measurements were below the 750 lx threshold. The number of measurements at the window zone was significantly higher than the threshold level of 750 lx. Illuminances in the corridors fell significantly below the 200 lx threshold in at least three quarters of the measurements in six of the seven nursing homes. The colour temperature of light fell significantly below the reference value for daylight of 5000 K with median scores of 3400 to 4500 K. A significant difference in colour temperature was found between recently constructed nursing homes and some older homes. Lighting conditions of the examined nursing homes were poor. With these data, nursing home staff have the means to improve the lighting conditions, for instance, by encouraging residents to be seated next to a window when performing a task or during meals.
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Studies among people with dementia demonstrated that the sleep quality and rhythm improves significantly when people are exposed to ambient bright light. Since almost half of the healthy older people also indicate to suffer from chronic sleep disorders, the question arises whether ambient bright light can be beneficial to healthy older people. Particularly the effect on sleep/wake rhythm in relation to the exposure to natural light is the focus. It was hypothesised that the sleep quality would be worse in winter due to a lower daylight dose than in summer due to the lower illuminance and exposure duration. A field study was conducted to examine the relationship between daylight exposure and sleep quality in 14 healthy older adults living independently in their own dwellings in the Netherlands. All participants were asked to take part of the study both during the summer period as well as during the winter period. Therefore, they had to wear an actigraph for five consecutive days which measured sleep, activity and light exposure. Results confirmed that people were significantly longer exposed to high illumination levels (>1000 lx) in summer than in winter. Sleep quality measures, however, did not differ significantly between summer and winter. A significant, positive correlation was found between exposure duration to high illuminance from daylight during the day and the sleep efficiency the following night in summer, implying that being exposed to high illuminance for a longer time period has a positive effect on sleep efficiency for the individual data. There was also a tendency of less frequent napping in case of longer exposure duration to light for both seasons. Sleep quality does not differ between summer and winter but is related to the duration of the exposure to bright light the day prior to the night. CC-BY Original article at http://solarlits.com/jd/5-14 http://dx.doi.org/10.15627/jd.2018.2 https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat
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Light therapy is increasingly administered and studied as a non-pharmacologic treatment for a variety of healthrelated problems, including treatment of people with dementia. Light therapy comes in a variety of ways, ranging from being exposed to daylight, to being exposed to light emitted by light boxes and ambient bright light. Light therapy is an area in medicine where medical sciences meet the realms of physics, engineering and technology. Therefore, it is paramount that attention is paid in the methodology of studies to the technical aspects in their full breadth. This paper provides an extensive introduction for non-technical researchers on how to describe and adjust their methodology when involved in lighting therapy research. A specific focus in this manuscript is on ambient bright light, as it is an emerging field within the domain of light therapy. The paper deals with how to (i) describe the lighting equipment, (ii) describe the light measurements, (iii) describe the building and interaction with daylight. Moreover, attention is paid to the uncertainty in standards and guidelines regarding light and lighting for older adults.
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