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Light Therapy for Managing Sleep, Behaviour, and Mood Disturbances in Dementia (Review) Open Access

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Author or creator
Forbes, D.
Morgan, D.G.
Bangma, J.
Peacock, S.
Adamson, J.
Additional contributors
Subject/Keyword
Dementia (complications)
Phototherapy
Sleep disorders (etiology; therapy)
Cognition disorders (etiology; therapy)
Affect
Depression (etiology; therapy)
Psychomotor agitation (etiology; therapy)
Randomized controlled trials as topic
Type of item
Review
Language
English
Place
Time
Description
Background Rest-activity and sleep-wake cycles are controlled by the endogenous circadian rhythmgenerated by the suprachiasmatic nuclei (SCN) of the hypothalamus. Degenerative changes in the SCN appear to be a biological basis for circadian disturbances in people with dementia, and might be reversed by stimulation of the SCN by light. Objectives The review assesses the evidence of efficacy of bright light therapy (BLT) inmanaging sleep, behaviour,mood, and cognitive disturbances associated with dementia. Search strategy The trials were identified from a search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 5 December 2005 using the terms “bright light*”, “light box*”, “light visor*”, “dawn-dusk*”, phototherapy (MESH), phototherapy, “photo therapy”, “light therapy” “light treatment”, light*. Selection criteria All relevant, randomized controlled trials in which BLT, at any intensity and duration, was compared with a control group for the effect on managing sleep, behavioural, mood, or cognitive disturbances (as well as changes in institutionalization rates or cost of care) on people with dementia of any degree of severity. Data collection and analysis Three reviewers independently assessed the retrieved articles for relevance and methodological quality, and extracted data from the selected studies. Statistically significant differences in changes in outcomes from baseline to end of treatment and from baseline to follow-up, between the light therapy and control groups, were examined. Each study was summarized using a measure of effect (e.g. mean difference). Owing to lack of homogeneity between studies, their results were not combined. Main results Five studies met the inclusion criteria. However, only three were included in the analyses because of inappropriate reported study analyses or inability to retrieve the required data from the investigators. This review revealed no adequate evidence of the effectiveness of BLT in managing sleep, behaviour, cognitive, or mood disturbances associated with dementia. Authors’ conclusions There is insufficient evidence to assess the value of BLT for people with dementia. The available studies are of poor quality and further research is required. P L A I N L A N G U A G E S U M M A R Y There is insufficient evidence to determine whether bright light therapy is effective in the management of sleep, behaviour, mood, or cognitive disturbances in dementia. Rest-activity and sleep-wake cycles are controlled by the endogenous circadian rhythm generated by the suprachiasmatic nuclei (SCN) of the hypothalamus. Degenerative changes in the SCN appear to be a biological basis for circadian disturbances in people with dementia, and might be reversed by stimulation of the SCN by light. The light sources in the included studies were: a light box placed approximately one metre away from the subjects at a height within their visual fields; a light visor worn on their heads; or a more acceptable ’naturalistic’ light therapy, known as dawn-dusk simulation that mimics outdoor twilight transitions. Five studies met the inclusion criteria. However, only three were included in this analysis because of inappropriately reported analyses or inability to retrieve the required data from the original investigators. The three studies included in the analysis were of poor quality and revealed no adequate evidence of the effectiveness of bright light therapy (BLT) in managing sleep, behaviour, or mood disturbances associated with dementia.
Date created
2004
DOI
doi:10.7939/R3N29PD5X
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© 2004 The Cochrane Collaboration for John Wiley & Sons, Ltd. This version of this article is open access and can be downloaded and shared. The original author(s) and source must be cited.
Citation for previous publication
Forbes D, Morgan DG, Bangma J, Peacock S, Adamson J. (2004). Light Therapy for Managing Sleep, Behaviour, and Mood Disturbances in Dementia (Review). Cochrane Database of Systematic Reviews, Issue 2, Art. No.: CD003946. DOI: 10.1002/14651858.CD003946.pub2.
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File title: Light Therapy for Managing Sleep, Behaviour, and Mood Disturbances in Dementia
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