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

Mariana G Figueiro,1 Barbara A Plitnick,1 Anna Lok,1 Geoffrey E Jones,1 Patricia Higgins,2,3 Thomas R Hornick,3,4 Mark S Rea1 1Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA; 2School of Nursing, 3School of Medicine, Case Western Reserve University, 4Geriatric Research Educ...

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Autores principales: Figueiro MG, Plitnick BA, Lok A, Jones GE, Higgins P, Hornick TR, Rea MS
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Lenguaje:EN
Publicado: Dove Medical Press 2014
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Acceso en línea:https://doaj.org/article/4740c77983574e06a5057fa88e625786
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spelling oai:doaj.org-article:4740c77983574e06a5057fa88e6257862021-12-02T05:13:41ZTailored lighting intervention improves measures of sleep, depression, and agitation in persons with Alzheimer’s disease and related dementia living in long-term care facilities1178-1998https://doaj.org/article/4740c77983574e06a5057fa88e6257862014-09-01T00:00:00Zhttps://www.dovepress.com/tailored-lighting-intervention-improves-measures-of-sleep-depression-a-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Mariana G Figueiro,1 Barbara A Plitnick,1 Anna Lok,1 Geoffrey E Jones,1 Patricia Higgins,2,3 Thomas R Hornick,3,4 Mark S Rea1 1Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA; 2School of Nursing, 3School of Medicine, Case Western Reserve University, 4Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USABackground: 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. Keywords: sleep disorders, light therapy, circadian rhythms, ADRDFigueiro MGPlitnick BALok AJones GEHiggins PHornick TRRea MSDove Medical PressarticleAlzheimer's diseasesleep disordersagitationlight therapycircadian rhythmshigh correlated color temperatureGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1527-1537 (2014)
institution DOAJ
collection DOAJ
language EN
topic Alzheimer's disease
sleep disorders
agitation
light therapy
circadian rhythms
high correlated color temperature
Geriatrics
RC952-954.6
spellingShingle Alzheimer's disease
sleep disorders
agitation
light therapy
circadian rhythms
high correlated color temperature
Geriatrics
RC952-954.6
Figueiro MG
Plitnick BA
Lok A
Jones GE
Higgins P
Hornick TR
Rea MS
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
description Mariana G Figueiro,1 Barbara A Plitnick,1 Anna Lok,1 Geoffrey E Jones,1 Patricia Higgins,2,3 Thomas R Hornick,3,4 Mark S Rea1 1Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA; 2School of Nursing, 3School of Medicine, Case Western Reserve University, 4Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USABackground: 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. Keywords: sleep disorders, light therapy, circadian rhythms, ADRD
format article
author Figueiro MG
Plitnick BA
Lok A
Jones GE
Higgins P
Hornick TR
Rea MS
author_facet Figueiro MG
Plitnick BA
Lok A
Jones GE
Higgins P
Hornick TR
Rea MS
author_sort Figueiro MG
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Dove Medical Press
publishDate 2014
url https://doaj.org/article/4740c77983574e06a5057fa88e625786
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