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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 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]
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“At present, there is considerable heterogeneity in methods across studies regarding these parameters, and in reporting them [45], with mixed findings [46, 47].”
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“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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Background
Metadata
- 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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