Effect of Increased Time Spent Outdoors on Individuals with Dementia Residing in Nursing Homes

Abstract

There is growing evidence that exposure to bright light may improve circadian rhythms in individuals with dementia residing in shared residential settings. The vast majority of this research uses electric bright light boxes. However, the outdoor environment not only provides exposure to bright light but to natural elements which have been shown to have a restorative effect across a broad range of situations. Previous research that sought to explore the impact of time spent outdoors on sleep and/or agitation in individuals with dementia was hampered by low time spent outdoors. This project, conducted in three nursing homes (n = 17), used actigraphy, validated proxy measures of sleep and agitation and direct observation to explore the impact of increased time outdoors on sleep and agitation. The repeated measures design assessed residents with dementia under four conditions: winter/no activity, winter/inside activity, summer/no activity and summer/outside activity. Re-Margaret Calkins, PhD, is President, IDEAAS Inc. and Board Chair, IDEAS Institute,

‘We have different routes for different reasons’: Exploring the purpose of walks for carers of people with dementia

“…Previous literature has emphasized that outdoor activities can reinforce self-worth, identity, and social inclusion in people with dementia (Duggan, Blackman, Martyr, & Van Schaik, 2008;Olsson, Lampic, Skovdahl, & Engstro¨m, 2013) and that physical activity can be a way of preserving links with the past (Cedervall, Torres, & Aberg, 2015). Unlike studies focused on the role of walking and physical activity in preventing, slowing, or mitigating the effects of dementia (Aarsland, Sardahaee, Anderssen, & Ballard, 2010;Calkins, Szmerekovsky, & Biddle, 2007;Kemoun et al, 2010), the scholarship mentioned above elucidates the importance of walking in maintaining the agency and selfhood of people with dementia.…”

Effects of spending time outdoors in daylight on the psychosocial well-being of older people and their family carers: a systematic review

“…11 The method of randomization was not reported in one trial. 35 Two trials did not utilize randomization.…”

“…21,36 More than 80% of the participants were followed up in four trials. 11,[34][35][36] The criteria for inclusion in the sample were clearly described in all studies.…”

“…For older people living with dementia, increasing the amount of time spent outdoors in daylight is associated with lessened behavioral disturbances. [11][12][13] These outcomes were associated with the ability of daylight to regulate the body's circadian rhythm. 14 Older people with cognitive impairment are likely to spend less time outdoors in daylight.…”

What are the effects of spending time outdoors in daylight on the physical health of older people and family carers: a systematic review protocol

“…21 The use of artificial light has significant practical limitations as they require the user to sit in front of a light box for one to two hours daily and are costly, especially in comparison to natural light. 22 It has been reported that manipulating the amount of natural or artificial light in indoor environments can improve physical health in older people. 23 This has been an area of intensive research, especially in residential accommodation.…”