Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia
Open accessAbstract
BACKGROUND: Rest-activity and sleep-wake cycles are controlled by the endogenous circadian rhythm generated by the suprachiasmatic nuclei (SCN) of the hypothalamus. Degenerative changes in the SCN appear to be a biological basis for circadian disturbances in people with dementia, and might be reversed by stimulation of the SCN by light. OBJECTIVES: The review examines the effectiveness of light therapy in improving cognition, activities of daily living (ADLs), sleep, challenging behaviour, and psychiatric symptoms associated with dementia. SEARCH METHODS: ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 20 January 2014 using the terms: "bright light*", "light box*", "light visor*", "dawn-dusk*", phototherapy, "photo therapy", "light therapy" "light treatment", light* . The CDCIG Specialized Register contains records from all major healthcare databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources. SELECTION CRITERIA: All relevant, randomized controlled trials were included in which light therapy, at any intensity and duration, was compared with a control group for the effect of improving cognition, ADLs, sleep, challenging behaviour, and psychiatric symptoms associated with dementia (as well as institutionalization rates or cost of care). Included were people with dementia of any type and degree of severity. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the retrieved articles for relevance, and four review authors independently assessed the selected studies for risk of bias and extracted the data. Statistically significant differences in outcomes between the treatment and control groups at the end of treatment and follow-up were examined. Each study was summarized using a measure of effect (for example mean difference). MAIN RESULTS: Eleven trials (13 articles) met the inclusion criteria. However, three of the studies could not be included in the analyses either because the reported data could not be used in the meta-analysis or we were unable to retrieve the required data from the authors.This updated review found no effect of light therapy on cognitive function, sleep, challenging behaviour (for example agitation), or psychiatric symptoms associated with dementia. Reduction in the development of ADL limitations was reported in one study, at three of five time points, and light therapy was found to have an effect after six weeks and two years but not after one year. AUTHORS' CONCLUSIONS: There is insufficient evidence to justify the use of bright light therapy in dementia. Further research should concentrate on replicating the suggested effect on ADLs, and establishing the biological mechanism for how light therapy improves these important outcomes.
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Current practice shows positive results in ocular light exposure interventions based on bright white light, intensities ranging from 2,500 to 10,000 lux for 30 minutes to two hours daily, sustained over two to four weeks.
“Current practice shows positive results in ocular light exposure interventions based on a set of factors: bright 'white' light, intensities ranging from 2,500 to 10,000 lux for 30 minutes to two hours daily, sustained over two to four weeks [46, 63].”
From Ocular light exposure interventions for sleep, circadian rhythms, rest-activity cycles, mood, and cognitive function in older adults: An Overview of Cochrane and non-Cochrane Systematic Reviews (2025) · cites this paper as [46]
The Cognition section describes trials using 2,500–10,000 lux for 30 minutes to two hours, and the Methods section describes a four-week, 10,000-lux regimen. But the Discussion does not endorse that combination as producing positive results: it finds no significant benefit for most outcomes, notes one positive finding for activities of daily living after six weeks and two years, and says there were too few trials to identify the most beneficial intensity and duration. The review also includes light sources other than bright white light. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAt present, there is considerable heterogeneity in methods across studies regarding light exposure parameters, and in reporting them, with mixed findings.
“At present, there is considerable heterogeneity in methods across studies regarding these parameters, and in reporting them [45], with mixed findings [46, 47].”
A seed review validation process was applied to ensure the robustness of the search strategy and its ability to capture relevant literature, using three established systematic reviews as benchmarks.
“Additionally, we applied a seed review validation process to ensure the robustness of our search strategy and its ability to capture relevant literature.”
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Research works printed but not linked: 5
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- creutzfeldt or jcd or cjd).mp. 17. huntington*.mp. 18. binswanger*.mp. 19. korsako*.mp. 20. or/1-19 21. light*.ti,ab. 22. Phototherapy/ 23. phototherapy.ti,ab. 24. "photo therapy".ti,ab. 25. "dawn-dusk*".ti,ab. 26. or/21-25 27. randomized controlled trial.pt. 28. controlled clinical trial.pt. 29. randomi?ed.ab. Nov 2012: 107 Jan 2014: 25 Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews 30. placebo.ab. 31. randomly.ab. 32. trial.ab. 33. groups.ab. 34. or/27-33 35. (animals not (humans and animals)).sh. 36. 34 not 35 37. 20 and 26 and 36
- W H A T ' S N E W Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cited by
Sorted by citations
Dementia prevention, intervention, and care
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31363-6 · Cited by 6,072 · see citing works
Mechanisms linking circadian clocks, sleep, and neurodegeneration
Musiek, E. S., & Holtzman, D. M. (2016) · Science · doi:10.1126/science.aah4968 · Cited by 878 · see citing works
Association between circadian rhythms and neurodegenerative diseases
Leng, Y., Musiek, E. S., Hu, K., Cappuccio, F. P., & Yaffe, K. S. (2019) · The Lancet Neurology · doi:10.1016/s1474-4422(18)30461-7 · Cited by 660 · see citing works
Abraha, I., Rimland, J. M., Trotta, F. M., Dell'Aquila, G., Cruz-Jentoft, A., Petrovic, M., Gudmundsson, A., Soiza, R., O'Mahony, D., Guaita, A., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-012759 · Cited by 557 · see citing works
“Evidence suggests that circadian rhythm disturbances may be reversed by stimulation of the SCN with light.(67) Four reviews considered the use of bright light therapy to treat behavioural problems in patients with dementia.”
BackgroundMelanopsin retinal ganglion cell loss in A lzheimer disease
Morgia, C. L., Ross‐Cisneros, F. N., Koronyo, Y., Hannibal, J., Gallassi, R., Cantalupo, G., Sambati, L., Pan, B. X., Tozer, K. R., Barboni, P., et al. (2015) · Annals of Neurology · doi:10.1002/ana.24548 · Cited by 389 · see citing works
“The understanding of the mRGC–hypothalamic contribution to circadian dysfunction in AD is particularly important for the development of future strategies aimed at counteracting circadian derangement in AD patients, such as a specifically designed light therapy.(73) This is relevant considering that there is evidence t…”
BackgroundThe effects of light therapy on sleep problems: A systematic review and meta-analysis
van Maanen, A., Meijer, A. M., van der Heijden, K. B., & Oort, F. J. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.08.009 · Cited by 372 · see citing works
Sleep Disturbance, Cognitive Decline, and Dementia: A Review
Wu, M. N., Rosenberg, P. B., Spira, A. P., & Wennberg, A. M. V. (2017) · Seminars in Neurology · doi:10.1055/s-0037-1604351 · Cited by 310 · see citing works
Scales, K., Zimmerman, S. I., & Miller, S. (2017) · The Gerontologist · doi:10.1093/geront/gnx167 · Cited by 297 · see citing works
“One recent review found insufficient evidence to recommend light therapy for reducing sleep disturbance or other BPSDs, such as agitation (Forbes et al., 2014); another review found low-strength evidence showing that bright light therapy is similar to standard light in managing agitation and…”
Laver, K., Dyer, S. M., Whitehead, C., Clemson, L. M., & Crotty, M. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010767 · Cited by 162 · see citing works
Neurodegeneration and the Circadian Clock
Hood, S., & Amir, S. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00170 · Cited by 150 · see citing works
“For example, studies evaluating light exposure have varied markedly in the intensity of light used; the timing of light exposure; and clinical characteristics of the participants (Forbes et al., 2014).”
BackgroundCanevelli, M., Valletta, M., Trebbastoni, A., Sarli, G., D’Antonio, F., Tariciotti, L., de Lena, C., & Bruno, G. (2016) · Frontiers in Medicine · doi:10.3389/fmed.2016.00073 · Cited by 125 · see citing works
“Accordingly, in a recent Cochrane systematic review on the topic, authors concluded that there is insufficient evidence to justify the use of bright light therapy for improving cognition, activities of daily living, sleep, challenging behaviors, and psychiatric disturbances in dementia (44).”
BackgroundBehavioral and psychological symptoms in Alzheimer's dementia and vascular dementia
Deardorff, W. J., & Grossberg, G. T. (2019) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64012-3.00002-2 · Cited by 124 · see citing works
Mitolo, M., Tonon, C., Morgia, C. L., Testa, C. M., Carelli, V., & Lodi, R. (2018) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000494921 · Cited by 120 · see citing works
Clinical management of sleep disturbances in Alzheimer's disease: current and emerging strategies
Urrestarazu, E., & Iriarte, J. (2016) · Nature and Science of Sleep · doi:10.2147/nss.s76706 · Cited by 116 · see citing works
“In spite of these positive reports, the Cochrane systematic review carried out by Forbes et al 108 concluded that there is insufficient evidence of its effectiveness.”
Figueiro, M. G., Plitnick, B., Roohan, C., Sahin, L., Kalsher, M. J., & Rea, M. S. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8078 · Cited by 116 · see citing works
“…to mild [< 25] dementia) or a Brief Interview for Mental Status (BIMS) 21 score between 3 and 12 points (indicating severe [ ≤ 7] to moderate [8 – 12] cognitive impairment), depending on the particular facility ’ s evaluation procedures; and a score > 5 (indicating sleep disturbance) on the…”
Treatment of Sleep Disorders in Dementia
Ooms, S. J., & Ju, Y. S. (2016) · Current Treatment Options in Neurology · doi:10.1007/s11940-016-0424-3 · Cited by 112 · see citing works
Faulkner, S., Bee, P., Meyer, N., Dijk, D., & Drake, R. (2019) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2019.04.012 · Cited by 111 · see citing works
Cammisuli, D. M., Danti, S., Bosinelli, F., & Cipriani, G. (2016) · European Geriatric Medicine · doi:10.1016/j.eurger.2016.01.002 · Cited by 105 · see citing works
Sekiguchi, H., Iritani, S., & Fujita, K. (2017) · Psychogeriatrics · doi:10.1111/psyg.12233 · Cited by 91 · see citing works
Tailored lighting intervention for persons with dementia and caregivers living at home
Figueiro, M. G., Hunter, C. M., Higgins, P. A., Hornick, T. R., Jones, G. E., Plitnick, B., Brons, J. A., & Rea, M. S. (2015) · Sleep Health · doi:10.1016/j.sleh.2015.09.003 · Cited by 89 · see citing works
Landry, G. J., & Liu-Ambrose, T. (2014) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2014.00325 · Cited by 84 · see citing works
Lynn, J. D., Rondón-Sulbarán, J., Quinn, E., Ryan, A., McCormack, B., & Martin, S. (2019) · Dementia · doi:10.1177/1471301217733649 · Cited by 83 · see citing works
Dance for People with Alzheimer’s Disease: A Systematic Review
Ruiz‐Muelle, A., & López‐Rodriguez, M. M. (2019) · Current Alzheimer Research · doi:10.2174/1567205016666190725151614 · Cited by 77 · see citing works
Hjetland, G. J., Pallesen, S., Thun, E., Kolberg, E., Nordhus, I. H., & Flo, E. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101310 · Cited by 74 · see citing works
Koren, T., Fisher, E., Webster, L., Livingston, G., & Rapaport, P. (2023) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101782 · Cited by 67 · see citing works
“There are, however, currently no treatments with conclusive effectiveness for sleep disturbances in dementia (Forbes et al., 2014; Gibson et al., 2016; Kinnunen et al., 2017; McCleery et al., 2014; Tewary et al., 2016). f This is reflected in our study as the prevalence of sleep disturbances did…”
BackgroundNa, R., Yang, J.-H., Yeom, Y., Kim, Y. J., Byun, S., Kim, K., & Kim, K. W. (2019) · Psychiatry Investigation · doi:10.30773/pi.2019.02.11.2 · Cited by 70 · see citing works
Herke, M., Fink, A. M., Langer, G., Wustmann, T., Watzke, S., Hanff, A.-M. R., & Burckhardt, M. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011542.pub2 · Cited by 66 · see citing works
A Comprehensive Overview of the Neural Mechanisms of Light Therapy
Huang, X., Tao, Q., & Ren, C. (2023) · Neuroscience Bulletin · doi:10.1007/s12264-023-01089-8 · Cited by 71 · see citing works
“In humans, brighter illumination during the day improves cognitive performance [4–8], and bright light therapy appears to attenuate cognitive deterioration in early-stage dementia [22, 80].”
BackgroundMethodLight, Sleep and Circadian Rhythms in Older Adults With Alzheimer’s Disease and Related Dementias
Figueiro, M. G. (2017) · Neurodegenerative Disease Management · doi:10.2217/nmt-2016-0060 · Cited by 69 · see citing works
“in their latest Cochrane review [77] analyzed studies that used a variety of light therapy approaches.”
Ó’Caoimh, R., Mannion, H., Sezgin, D., O’Donovan, M. R., Liew, A., & Molloy, D. W. (2019) · Maturitas · doi:10.1016/j.maturitas.2019.06.007 · Cited by 66 · see citing works
Non-pharmacological Management of Behavioral Symptoms in Frontotemporal and Other Dementias
Barton, C., Ketelle, R., Merrilees, J. J., & Miller, B. L. (2016) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-015-0618-1 · Cited by 66 · see citing works
Yao, Y., Ying, Y., Deng, Q., Zhang, W., Zhu, H., Lin, Z., Zhang, S., Ma, J., & Zhao, Y. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00294 · Cited by 59 · see citing works
Figueiro, M. G., Sahin, L., Kalsher, M. J., Plitnick, B., & Rea, M. S. (2020) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-200212 · Cited by 61 · see citing works
“In this regard, a 2014 Cochrane review [52] of the effectiveness of light therapy for treating dementia symptoms reported results from three studies [56–59] showing that 2–10 weeks of treatment did not significantly increase sleep effi-ciency values (measured via wrist actigraphy), which led the…”
BackgroundResultLin, F., Su, Y., Weng, Y., Lin, X., Weng, H., Cai, G., & Cai, G. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.03.035 · Cited by 62 · see citing works
Konis, K. (2018) · Building and Environment · doi:10.1016/j.buildenv.2018.03.007 · Cited by 57 · see citing works
Dautovich, N. D., Schreiber, D. R., Imel, J. L., Tighe, C. A., Shoji, K. D., Cyrus, J. W. W., Bryant, N., Lisech, A., O'Brien, C., & Dzierzewski, J. M. (2018) · Sleep Health · doi:10.1016/j.sleh.2018.09.006 · Cited by 58 · see citing works
Livingston, G., Barber, J. A., Kinnunen, K. M., Webster, L., Kyle, S. D., Cooper, C., Espie, C. A., Hallam, B., Horsley, R., Pickett, J., et al. (2019) · International Psychogeriatrics · doi:10.1017/s1041610218000753 · Cited by 55 · see citing works
“Other studies incorporating sleep hygiene and light therapy have been too small for definitive results (McCurry et al., 2009; Forbes et al., 2014; Kinnunen et al., 2017).”
Biodynamic lighting effects on the sleep pattern of people with dementia
Dal, E. V. L.-V., Snaphaan, L. J. A. E., & Bongers, I. M. B. (2019) · Building and Environment · doi:10.1016/j.buildenv.2019.01.010 · Cited by 54 · see citing works
“Forbes and colleagues [23] and Van Hoof and colleagues [24] both conclude in their review articles that there is limited statistic proof for the health e ff ects of daylight.”
BackgroundSoilemezi, D., Drahota, A., Crossland, J., & Stores, R. (2017) · Dementia · doi:10.1177/1471301217692130 · Cited by 54 · see citing works
Hu, K., der Lek, R. F. R., Patxot, M., Li, P., Shea, S. A., Scheer, F. A. J. L., & Someren, E. J. W. V. (2016) · Scientific Reports · doi:10.1038/srep27742 · Cited by 51 · see citing works
Tan, J., Cheng, L. J., Chan, E., Lau, Y., & Lau, S. T. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.01.013 · Cited by 50 · see citing works
Wu, W., Zhao, Y., Cheng, X. R., Xie, X., Zeng, Y., Tao, Q., Yang, Y., Xiao, C., Zhang, Z., Pang, J., et al. (2025) · Nature Communications · doi:10.1038/s41467-024-55678-w · Cited by 53 · see citing works
Circadian Disruption Associated with Alzheimer’s Disease
Saeed, Y., & Abbott, S. M. (2017) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-017-0745-y · Cited by 50 · see citing works
The Treatment of Sleep Dysfunction in Neurodegenerative Disorders
Voysey, Z. J., Barker, R. A., & Lázár, A. S. (2020) · Neurotherapeutics · doi:10.1007/s13311-020-00959-7 · Cited by 47 · see citing works
Sleep physiology and disorders in aging and dementia
Benca, R. M., & Teodorescu, M. C. (2019) · Handbook of clinical neurology · doi:10.1016/b978-0-12-804766-8.00026-1 · Cited by 45 · see citing works
Soufineyestani, M., Khan, A. A., & Sufineyestani, M. (2021) · Neurology International · doi:10.3390/neurolint13010001 · Cited by 45 · see citing works
“Some popular non-pharmacological therapies are pet therapy [3], robot therapy [4], reminiscence therapy [5], aromatherapy [6], occupational therapy [7], massage and touch therapy [8], doll therapy [9], light therapy [10], and creative arts therapies (music, dance-movement, and drama) [11].”
BackgroundKim, S.-J., Lee, S. H., Suh, I. B., Jang, J., Jhoo, J. H., & Lee, J. H. (2021) · Scientific Reports · doi:10.1038/s41598-021-89521-9 · Cited by 44 · see citing works
Kolberg, E., Hjetland, G. J., Thun, E., Pallesen, S., Nordhus, I. H., Husebo, B. S., & Flo, E. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03376-y · Cited by 44 · see citing works
“The FAST score was added as a predetermined covariate to all analyses in order to control for dementia severity, following recommendations by previous authors [34].”
MethodBehavioural determinants of physiologically-relevant light exposure
Biller, A. M., Balakrishnan, P., & Spitschan, M. (2024) · Communications Psychology · doi:10.1038/s44271-024-00159-5 · Cited by 39 · see citing works
“Historically, BLT has been used for the treatment of seasonal affective disorders (SAD) and its subclinical counterpart (sSAD), depression, bipolar disorder, sleep and circadian-related disorders as well as jet lag prevention or reduction 24,113 – 117 .”
Research Note: A self-luminous light table for persons with Alzheimer’s disease
Figueiro, M. G., Plitnick, B., & Rea, M. S. (2015) · Lighting Research & Technology · doi:10.1177/1477153515603881 · Cited by 41 · see citing works
Nonpharmacological interventions to improve sleep in nursing home residents: A systematic review
Shang, B., Yin, H., Jia, Y., Zhao, J., Meng, X., Chen, L., & Liu, P. (2019) · Geriatric Nursing · doi:10.1016/j.gerinurse.2019.01.001 · Cited by 39 · see citing works
Sani, T. P., Bond, R. L., Marshall, C. R., Hardy, C. J. D., Russell, L. L., Moore, K. M., Slattery, C. F., Paterson, R. W., Woollacott, I., Wendi, I. P., et al. (2019) · eNeurologicalSci · doi:10.1016/j.ensci.2019.100212 · Cited by 39 · see citing works
Duan‐Porter, W., Ullman, K. E., Rosebush, C. E., McKenzie, L. G., Ensrud, K. E., Ratner, E. R., Greer, N. L., Shippee, T. P., Gaugler, J. E., & Wilt, T. J. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-019-05568-5 · Cited by 39 · see citing works
Sex differences and sex bias in human circadian and sleep physiology research
Spitschan, M., Santhi, N., Ahluwalia, A., Fischer, D. R., Hunt, L., Karp, N. A., Lévi, F., Pineda‐Torra, I., Vidafar, P., & White, R. (2022) · eLife · doi:10.7554/elife.65419 · Cited by 39 · see citing works
West, A. S., Simonsen, S. A., Jennum, P., Hansen, N. C., Schønsted, M., Zielinski, A. H., Sander, B., & Iversen, H. K. (2019) · Neurorehabilitation · doi:10.3233/nre-192752 · Cited by 38 · see citing works
Jøranson, N., Olsen, C., Calogiuri, G., Ihlebæk, C., & Pedersen, I. (2020) · International Psychogeriatrics · doi:10.1017/s1041610220001787 · Cited by 38 · see citing works
“, 2018), while another Cochrane study reported no significant effect of bright-light therapy on sleep disorders in people with dementia (Forbes et al., 2014).”
BackgroundTherapy for Insomnia and Circadian Rhythm Disorder in Alzheimer Disease
Ferini‐Strambi, L., Galbiati, A., Casoni, F. M., & Salsone, M. (2020) · Current Treatment Options in Neurology · doi:10.1007/s11940-020-0612-z · Cited by 37 · see citing works
Effect of Bright Light Exposure on Depression and Agitation in Older Adults with Dementia
Onega, L. L., Pierce, T. W., & Epperly, L. (2016) · Issues in Mental Health Nursing · doi:10.1080/01612840.2016.1183736 · Cited by 36 · see citing works
“Forbes et al. (2014) conducted a meta-analysis of trials evaluating the effects of bright light exposure on older adults with dementia and found that depression and agitation were not significantly reduced.”
BackgroundInfluentialComorbid Sleep Disturbances in Neurologic Disorders
Ju, Y. S., Videnović, A., & Vaughn, B. V. (2017) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000501 · Cited by 36 · see citing works
Cha, H. K., Chung, S., Lim, H. Y., Jung, J., & Son, G. H. (2019) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2018.00496 · Cited by 36 · see citing works
Simulated presence therapy for dementia.
Abraha, I., Rimland, J., Lozano-Montoya, I., Dell’Aquila, G., Vélez-Díaz-Pallarés, M., Trotta, F., Cruz-Jentoft, A., & Cherubini, A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011882.pub2 · Cited by 2 · see citing works
Guu, T., Aarsland, D., & Ffytche, D. H. (2022) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5712 · Cited by 33 · see citing works
“Most of the BPSD studies focus on visible light, especially bright light over 1000 lux and in the blue to green light spectrum, as a treatment or an environmental condition influencing IF and NIF functioning to enhance daytime alertness and modify sleep quality.(41) However, a”
BackgroundTreatment for depression comorbid with dementia
Baruch, N., Burgess, J. L., Pillai, M., & Allan, C. L. (2019) · Evidence-Based Mental Health · doi:10.1136/ebmental-2019-300113 · Cited by 32 · see citing works
“In addition, degenerative changes in the suprachiasmatic nucleus of the hypothalamus may result in reduced regulation of circadian rhythms.(28) Hickman et al found BLT led to a reduction in depressive symptoms in women but an increase in men, and overall did not support BLT as a treatment for depression in dementia.”
BackgroundNon-pharmacological interventions for sleep disturbances in people with dementia
Wilfling, D., Calo, S., Dichter, M. N., Meyer, G., Möhler, R., & Köpke, S. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011881.pub2 · Cited by 59 · see citing works
Goudriaan, I., van Boekel, L. C., Verbiest, M. E. A., van Hoof, J., & Luijkx, K. G. (2021) · Clinical Interventions in Aging · doi:10.2147/cia.s297865 · Cited by 31 · see citing works
“A Cochrane review on the effects of light therapy on persons with dementia included only one study with indoor environmental light.(31) Their conclusions were based on studies where the light sources (light boxes, light visors, light fixtures) differed to such an extent that the results might not be comparable.”
Rapaport, P., Webster, L., Horsley, R., Kyle, S. D., Kinnunen, K. M., Hallam, B., Pickett, J., Cooper, C., Espie, C. A., & Livingston, G. (2018) · Dementia · doi:10.1177/1471301218789559 · Cited by 29 · see citing works
When is audit and feedback effective in dementia care? A systematic review
Sykes, M. J., McAnuff, J., & Kolehmainen, N. (2018) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.10.013 · Cited by 19 · see citing works
“The search strategy was adapted from previous reviews (Ivers et al., 2012; Forbes et al., 2014).”
MethodAmbient bright lighting in the morning improves sleep disturbances of older adults with dementia
Liu, C.-R., Liou, Y. M., & Jou, J. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.10.011 · Cited by 28 · see citing works
Cremascoli, R., Sparasci, D., Giusti, G., Cattaldo, S., Prina, E., Roveta, F., Bruno, F., Ghezzi, C., Cerri, S., Picascia, M., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2021.755322 · Cited by 28 · see citing works
López‐Soto, P. J., Manfredini, R., Smolensky, M. H., & Rodríguez‐Borrego, M. A. (2014) · Chronobiology International · doi:10.3109/07420528.2014.987295 · Cited by 28 · see citing works
“Thus, the role of these and other circadian rhythms, or of disruption of key circadian rhythms due to absence of strong synchronizing time cues as a consequence of abnormal day and nighttime lighting and lack of sufficient diurnal socializing common in many nursing homes and other longterm healthcare institutions that…”
BackgroundThe effect of lens aging and cataract surgery on circadian rhythm
Yan, S.-S., & Wang, W. (2016) · International Journal of Ophthalmology · doi:10.18240/ijo.2016.07.21 · Cited by 26 · see citing works
Chiu, H., Chan, P.-T., Chu, H., Hsiao, S. S., Liu, D., Lin, C., & Chou, K. (2017) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14990 · Cited by 28 · see citing works
“The current study subgroup findings suggest that light therapy with an intensity of 2,500 lux or more was more effective for cognitively impaired persons than a lower intensity; this finding is generally consistent with those of previous studies, which suggested that an intensity of 2,500 to 10,000 lux may be greater…”
ResultInteraction between the progression of Alzheimer's disease and fractal degradation
Li, P., Yu, L., Yang, J., Lo, M., Hu, C., Buchman, A. S., Bennett, D. A., & Hu, K. (2019) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2019.08.023 · Cited by 26 · see citing works
Application of light therapy in older adults with cognitive impairment: a systematic review
Cibeira, N., Maseda, A., Lorenzo-López, L., Rodríguez-Villamil, J. L., López-López, R., & Millán-Calenti, J. C. (2020) · Geriatric Nursing · doi:10.1016/j.gerinurse.2020.07.005 · Cited by 25 · see citing works
“Additionally, there is wide methodological heterogeneity with regard to the light intensity, frequency, interval, time of the day, and length of the intervention among the studies.(18)”
BackgroundInfluentialZang, L., Liu, X., Li, Y., Liu, J., Lu, Q., Zhang, Y., & Meng, Q. (2023) · PLoS ONE · doi:10.1371/journal.pone.0293977 · Cited by 25 · see citing works
“In patients with AD, reduced light input due to reduced outdoor exposure and poor sensitivity to light stimuli owing to neuropathic damage can lead to decreased circadian rhythm stability [10].”
BackgroundPhototherapy for Cognitive Function in Patients With Dementia: A Systematic Review and Meta-Analysis
Zhu, G., Tong, Q., Ye, X., Li, J., Zhou, L., Sun, P., Liang, F., Zhong, S., Cheng, R., & Zhang, J. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.936489 · Cited by 24 · see citing works
Precision Light for the Treatment of Psychiatric Disorders
Kaladchibachi, S., & Fernandez, F. (2018) · Neural Plasticity · doi:10.1155/2018/5868570 · Cited by 24 · see citing works
“No doubt other case studies can be made for other disorders, such as Alzheimer’s disease or major depressive disorder in aging individuals.”
BackgroundGupta, A., Prakash, N. B., & Sannyasi, G. (2021) · Indian Journal of Psychological Medicine · doi:10.1177/02537176211033316 · Cited by 25 · see citing works
Aini, N., Chen, R., Chu, H., Chang, C., Lin, H., Jen, H., Liu, D., Lee, T., & Chou, K. (2023) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.12.010 · Cited by 23 · see citing works
Subhadeep, D., Srikumar, B. N., Rao, B. S. S., & Kutty, B. M. (2020) · Journal of Neuroscience Research · doi:10.1002/jnr.24601 · Cited by 23 · see citing works
Gallagher, D., & Herrmann, N. (2015) · Neurodegenerative Disease Management · doi:10.2217/nmt.14.46 · Cited by 23 · see citing works
Zhang, M., Wang, Q., Pu, L., Tang, H., Chen, M., Wang, X., Li, Z., Zhao, D., & Xiong, Z. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.10.008 · Cited by 22 · see citing works
Cho, E., Lee, J. Y., Yang, M., Jang, J., Cho, J., & Kim, M. J. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104866 · Cited by 21 · see citing works
Phototherapy improves cognitive function in dementia: A systematic review and meta‐analysis
Lu, X., Liu, C., & Shao, F. (2023) · Brain and Behavior · doi:10.1002/brb3.2952 · Cited by 19 · see citing works
“It is important to note that this RCT was included in several meta-analyses and systematic reviewswhich focused on phototherapy (Forbes et al., 2009, 2014; F IGURE 5 The total sleep time.”
BackgroundResultInfluentialShedding a Light on Phototherapy Studies with People having Dementia
Aarts, M. M., Aries, M. M., Diakoumis, A., & van Hoof, J. (2016) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317515628046 · Cited by 21 · see citing works
Fong, K. N., Ge, X., Ting, K., Wei, M., & Cheung, H. (2023) · American Journal of Alzheimer's Disease & Other Dementias® · doi:10.1177/15333175231160682 · Cited by 20 · see citing works
“In a single group study by Figueiro et al., 55 a tailored lighting intervention using low-level “ bluish-white ” lighting during the daytime for 4 weeks in nursing homes could increase sleep quality (sleep time and sleep ef fi ciency) and reduce depression and agitation in PwD. 55 However, Dowling et al. 27 study parti…”
BackgroundResultInfluentialBaandrup, L., & Jennum, P. (2021) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2021.100067 · Cited by 20 · see citing works
“…Cochrane review investigating the effectiveness of light therapy to improve cognition, activities of daily living, sleep, challenging behavior, and psychiatric symptoms associated with dementia found insufficient evidence to justify the use of bright light therapy in dementia (Forbes et al., 2014).”
BackgroundVilela, V. C., Pacheco, R. L., Latorraca, C. O. C., Pachito, D. V., & Riera, R. (2017) · Sao Paulo Medical Journal · doi:10.1590/1516-3180.2017.0092060617 · Cited by 20 · see citing works
Richardson, K., Savva, G. M., Boyd, P. J., Aldus, C. F., Maidment, I. D., Pakpahan, E., Loke, Y. K., Arthur, A. J., Steel, N., Ballard, C. G., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25010 · Cited by 21 · see citing works
Pilot Study of the Effects of Bright Ambient Therapy on Dementia Symptoms and Cognitive Function
Liu, C.-R., Liou, Y. M., & Jou, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.782160 · Cited by 19 · see citing works
Non-pharmacological interventions for sleep disturbances in people with dementia
Wilfling, D., Junghans, A., Marshall, L., Eisemann, N., Meyer, G., Mohler, R. A., & Köpke, S. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011881 · Cited by 19 · see citing works
Prins, A. J., Scherder, E., van Straten, A., Zwaagstra, Y., & Milders, M. V. (2020) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000509433 · Cited by 18 · see citing works
Zhang, F., Zhong, R., Li, S., Chang, R. C., & Le, W. (2017) · Journal of Neural Transmission · doi:10.1007/s00702-017-1696-9 · Cited by 17 · see citing works
Kim, K.-S., & Lee, J. (2019) · Journal of Korean Academy of Nursing · doi:10.4040/jkan.2019.49.3.225 · Cited by 16 · see citing works
“따라서 약 물치료의 의존도와 약물로 인한 부작용을 감소시키기 위한 보완적인 방법으로 비약물적 요법인 회상요법, 아로마요법, 음악요법, 빛요법, 운동요법 등을 활용하고 있으며 몇몇 연구에서는 치매의 우울증상 개선에 효과가 있었다[17-21].”
Long days enhance recognition memory and increase insulin-like growth factor 2 in the hippocampus
Dellapolla, A., Kloehn, I., Pancholi, H., Callif, B. L., Wertz, D., Rohr, K. E., Hurley, M. M., Baker, K. M., Hattar, S. S., Gilmartin, M. R., et al. (2017) · Scientific Reports · doi:10.1038/s41598-017-03896-2 · Cited by 16 · see citing works
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Yuan, Y., Li, G., Ren, H., & Chen, W. (2021) · Phenomics · doi:10.1007/s43657-021-00010-5 · Cited by 15 · see citing works
Expert Consensus on Cognitive Dysfunction in Diabetes
Yang, Y., Zhao, J., & Yu, X. (2022) · Current Medical Science · doi:10.1007/s11596-022-2549-9 · Cited by 16 · see citing works
Cibeira, N., Maseda, A., Lorenzo‐López, L., González‐Abraldes, I., López‐López, R., Rodríguez-Villamil, J. L., & Millán-Calentí, J. C. (2021) · Healthcare · doi:10.3390/healthcare9081065 · Cited by 14 · see citing works
“This therapy consists of the controlled application of certain levels of light that can be administered in different ways, including outdoor sunlight, light boxes, light visors worn on the head, ceiling lights, or dawn-dusk simulation [20].”
BackgroundPalliative care for people with dementia
Timmons, S., & Fox, S. (2023) · Handbook of clinical neurology · doi:10.1016/b978-0-12-824535-4.00013-6 · Cited by 15 · see citing works
- Authors
- Forbes, D., Blake, C. M., Thiessen, E. J., Peacock, S., & Hawranik, P.
- Affiliations
- University of Alberta (CA)
- Western University (CA)
- University of Saskatchewan (CA)
- Athabasca University (CA)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2014-02-26
- Volume
- 2014
- Issue
- 2
- Pages
- CD003946-CD003946
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC10837684
- OpenAlex
- W2150283528
- Cited by
- 194
- References
- 107
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 14 · 2023: 16 · 2022: 14 · 2021: 20 · 2020: 21 · 2019: 22 · 2018: 17 · 2017: 20 · 2016: 17 · 2015: 12 · 2014: 5
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- phototherapy, dementia, circadian rhythm, suprachiasmatic nucleus, sleep-wake cycle, cognitive function, activities of daily living, behavioral problems, agitation, psychiatric symptoms, institutionalization, cost of care, anxiety, delirium, caregiver burden, risk of bias, risk of overstatement
- MeSH terms
- Affect, Aged, Cognition Disorders, Dementia, Depression, Humans, Phototherapy, Psychomotor Agitation, Sleep Wake Disorders, Randomized Controlled Trials as Topic
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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