Tailored lighting intervention improves measures of sleep, depression, and agitation in persons with Alzheimer’s disease and related dementia living in long-term care facilities
Open accessAbstract
BACKGROUND: Light therapy has shown great promise as a nonpharmacological method to improve symptoms associated with Alzheimer's disease and related dementias (ADRD), with preliminary studies demonstrating that appropriately timed light exposure can improve nighttime sleep efficiency, reduce nocturnal wandering, and alleviate evening agitation. Since the human circadian system is maximally sensitive to short-wavelength (blue) light, lower, more targeted lighting interventions for therapeutic purposes, can be used. METHODS: The present study investigated the effectiveness of a tailored lighting intervention for individuals with ADRD living in nursing homes. Low-level "bluish-white" lighting designed to deliver high circadian stimulation during the daytime was installed in 14 nursing home resident rooms for a period of 4 weeks. Light-dark and rest-activity patterns were collected using a Daysimeter. Sleep time and sleep efficiency measures were obtained using the rest-activity data. Measures of sleep quality, depression, and agitation were collected using standardized questionnaires, at baseline, at the end of the 4-week lighting intervention, and 4 weeks after the lighting intervention was removed. RESULTS: The lighting intervention significantly (P<0.05) decreased global sleep scores from the Pittsburgh Sleep Quality Index, and increased total sleep time and sleep efficiency. The lighting intervention also increased phasor magnitude, a measure of the 24-hour resonance between light-dark and rest-activity patterns, suggesting an increase in circadian entrainment. The lighting intervention significantly (P<0.05) reduced depression scores from the Cornell Scale for Depression in Dementia and agitation scores from the Cohen-Mansfield Agitation Inventory. CONCLUSION: A lighting intervention, tailored to increase daytime circadian stimulation, can be used to increase sleep quality and improve behavior in patients with ADRD. The present field study, while promising for application, should be replicated using a larger sample size and perhaps using longer treatment duration.
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Personalized blue light exposure raised activity levels during daytime hours and increased sleep at nighttime in a long-term care facility for patients with Alzheimer's disease and related dementia.
“Personalized blue light exposure raised activity levels during daytime hours and increasing sleep at nighttime in a long‐term care facility for patients with Alzheimer's disease and related dementia 35.”
From The inner clock-Blue light sets the human rhythm (2019) · cites this paper as [35]
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- Authors
- Figueiro, M., Plitnick, B., Lok, A., Jones, G., Higgins, P., Hornick, T., & Rea, M.
- Affiliations
- Rensselaer Polytechnic Institute (US)
- Case Western Reserve University (US)
- Louis Stokes Cleveland VA Medical Center (US)
- Corresponding author
- Figueiro, Mariana
- Venue
- Clinical Interventions in Aging
- Publisher
- Informa UK Limited
- Published
- 2014-09
- Volume
- 9
- Pages
- 1527
- ISSN
- 1176-9092 (ISSN-L)
- 1178-1998
- PMC
- PMC4168854
- OpenAlex
- W2038035975
- Cited by
- 211
- References
- 41
- Citations by year
- 2026: 15 · 2025: 14 · 2024: 14 · 2023: 22 · 2022: 21 · 2021: 30 · 2020: 17 · 2019: 22 · 2018: 17 · 2017: 15 · 2016: 9 · 2015: 15
- FWCI
- 6.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Interventions in Aging (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- National Institute on Aging (R01AG034157)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- phototherapy, circadian lighting, Alzheimer's disease and related dementias, nursing home residents, sleep quality, sleep efficiency, depression, agitation, nocturnal wandering, circadian entrainment, blue light, rest-activity patterns, non-pharmacological treatment
- MeSH terms
- Activities of Daily Living, Aged, 80 and over, Alzheimer Disease, Circadian Rhythm, Dementia, Depression, Female, Humans, Male, Mental Status Schedule, Nursing Homes, Phototherapy, Psychomotor Agitation, Surveys and Questionnaires, Sleep Wake Disorders, Treatment Outcome
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