Zoekresultaten

Dementia Enlightened?!

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

Protocol for a prospective, multicentre, cross-sectional cohort study to assess personal light exposure

Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (experience sampling implementing Karolinska Sleepiness Scale, KSS ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals’ light exposure. We will implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Ghana, Netherlands, Spain, Sweden, and Turkey (minimum n = 15, target n = 30 per site, minimum n = 90, target n = 180 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.

Ambient bright light in dementia: Effects on behaviour and circadian rhythmicity

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.

City logistics: light and electric

Shedding a light on phototherapy studies with people having dementia

Light therapy is applied to older people with dementia as a treatment to reset the biological clock, to improve the cognitive functioning, and to reduce behavioral symptoms. Although the methodological quality of light therapy studies is essential, many aspects concerning the description of the lighting applied are missing. This study reviewed light therapy studies concerning the effects on people with dementia as a way to check the methodological quality of the description of light from a light engineering perspective. Twelve studies meeting the inclusion criteria were chosen for further analysis. Each study was scored on a list of aspects relevant to a proper description of lighting aspects. The overview demonstrates that the overall quality of the methodologies is poor. The studies describe the lighting insufficiently and not in the correct metrics. The robustness of light therapy studies can be improved by involving a light engineer or specialist.

Personal Lighting Conditions to Obtain More Evidence in Light Effect Studies

Research demonstrated a large variety regarding effects of light (e.g. health, performance, or comfort effects). Since human health is related to each individual separately, the lighting conditions around these individuals should be analysed individually as well. This paper provides, based on a literature study, an overview identifying the currently used methodologies for measuring lighting conditions in light effect studies. 22 eligible articles were analysed and this resulted in two overview tables regarding the light measurement methodologies. In 70% of the papers, no measurement details were reported. In addition, light measurements were often averaged over time (in 84% of the papers) or location level (in 32% of the papers) whereas it is recommended to use continuous personal lighting conditions when light effects are being investigated. Conclusions drawn in light effect studies based on personal lighting conditions may be more trusting and valuable to be used as input for an effect-driven lighting control system.