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Posted: June 17, 2008

Bright Lighting Reduces Dementia Symptoms: Study

Exposure to several hours of bright lighting during daytime hours had about the same effect as Alzheimer’s medications in reducing symptoms and improving brain function in dementia patients, according to newly published research.

The study of elderly Dutch nursing home patients showed that about nine hours of such lighting daily slowed the pace at which patients lost their ability to carry out ordinary tasks including bathing, dressing and eating by more than 50%, compared with those exposed to dim light. Meanwhile, memory problems were reduced by 5%, according to the findings published in the Journal of the American Medical Association.

The researchers, from the Royal Netherlands Academy of Arts and Sciences in Amsterdam, reported that their study was the first controlled trial to determine how various lighting affects mental functioning in dementia patients.


Interestingly, they said, the results of several hours of lighting were similar to the effects gained when patients used the common Alzheimer’s drugs, Aricept and Exelon.


“On the whole, light treatment could have clinically beneficial effects,' the authors wrote in the medical journal. “The long-term application of whole-day bright light did not have adverse effects, on the contrary, and could be considered for use in care facilities for elderly individuals with dementia.'


The researchers also noted their findings’ benefit for caregivers of dementia patients. "In elderly patients with dementia, cognitive decline is frequently accompanied by disturbances of mood, behavior, sleep, and activities of daily living, which increase caregiver burden and the risk of institutionalization," they said. These symptoms have been associated with disturbances of the body clock, known as circadian rhythm. "The circadian timing system is highly sensitive to environmental light and the hormone melatonin and may not function optimally in the absence of their synchronizing effects. In elderly patients with dementia, synchronization may be [diminished] if light exposure and melatonin production are reduced."


The research team used melatonin on subjects in their study to see how sleep would be affected, even with the use of daytime lighting. Melatonin reduced the time to fall asleep by a relative 19% and increased total sleep duration by 6% -- a boon to caregivers. In combination with bright light, melatonin reduced aggressive behavior by a relative 9%, they said.


The team, led by Dr. Rixt F. Riemersma-van der Lek, of the Royal Netherlands Academy of Arts and Sciences, conducted the testing at 12 elderly group care facilities in the Netherlands and evaluated the effects of up to 3.5 years of daily supplementation of bright light and/or melatonin on a number of health outcomes, including symptoms of dementia and sleep disturbances. The study included 189 facility residents, with an average age 85.8 years; 90% were female and 87% had dementia.


Six of the facilities had bright lighting installed in ceiling-mounted fixtures. Lights were on daily between approximately 9 a.m. to 6 p.m. Participants were randomized to receive evening melatonin (2.5 mg) or placebo and took part in testing for an average of 15 months, with a maximum period of 3.5 years.


"The simple measure of increasing the illumination level in group care facilities [improved] symptoms of disturbed cognition, mood, behavior, functional abilities, and sleep," the researchers conclude.


"Melatonin improved sleep, but its long-term use by elderly individuals can only be recommended in combination with light to suppress adverse effects on mood.”

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