Dementia Enlightened?! A Systematic Literature Review of the Influence of Indoor Environmental Light on the Health of Older Persons with Dementia in Long-Term Care Facilities

Abstract

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.

Supporting dementia care by monitoring indoor environmental quality in a nursing home

“…63 Older people with dementia staying in low illuminance environments could show more signs of a negative mood, thus impacting their well-being. 64 A comfortable indoor light environment compensates for the deteriorating eyesight of older people and benefits the quality of life, such as regulating circadian rhythm and decreasing depression. The suggested ambient light environment of care facilities is 500 lux and can be subdivided according to specific spaces.…”

Feasibility of Deploying Home-Based Digital Technology, Environmental Sensors, and Web-Based Surveys for Assessing Behavioral Symptoms and Identifying Their Precipitants in Older Adults: Longitudinal, Observational Study

“…The Awair Omni device was chosen because it measures multiple physical environmental variables that may be associated with apathy, depression, and anxiety in older adults. Light may reduce depressive symptoms in older adults and improve their quality of life [ 37 ]. Noise is associated with more severe anxiety [ 38 ].…”

Effect of Ambient Bright Light on Behavioral and Psychological Symptoms in People With Dementia: A Systematic Review

“…Over the past two decades, research has tested the impact of bright light (BL) on BPSD ( Missotten et al, 2019 ). Evidence suggests that poor sleep, circadian disruption, short daylight exposures, and BPSD are associated with interior daylight conditions, with the most robust evidence concerning depressive symptoms and agitation ( Figueiro et al, 2014 ; Goudriaan et al, 2021 ; Grace, 2002 ). Persons living with dementia have degenerative changes in the suprachiasmatic nuclei (SCN) of the hypothalamus, which is responsible for generating a circadian rhythm ( Figueiro, 2017 ).…”

“…A few systematic reviews have been published to report the impact of BL on persons with dementia ( Goudriaan et al, 2021 ; Kim et al, 2003 ; Mitolo et al, 2018 ). However, most reviews combined evidence of all kinds of BL with light delivery methods varying from portable desktop-type lightboxes to room-based ambient lighting ( Mitolo et al, 2018 ).…”