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Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia (Review) Open Access

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Author or creator
Forbes, D.
Culum, I.
Lischka, A.R.
Morgan, D.G.
Peacock, S.
Forbes, J.
Forbes, S.
Additional contributors
Subject/Keyword
Randomized controlled trials as topic
Depression (etiology; therapy)
Affect
Phototherapy
Cognition disorders (etiology; therapy)
Psychomotor agitation (etiology; therapy)
Sleep disorders (etiology; therapy)
Dementia (complications)
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 effectiveness of light therapy in managing cognitive, sleep, functional, behavioural, or psychiatric disturbances associated with dementia. Search methods The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library,MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 4 March 2008 using the terms: “bright light*”, “light box*”, “light visor*”, “dawn-dusk*”, phototherapy, “photo therapy”, “light therapy” “light treatment”, light* . The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources. Selection criteria All relevant, randomized clinical trials in which light therapy, at any intensity and duration, was compared with a control group for the effect on managing cognition, sleep, function, behavioural, or psychiatric disturbances (as well as changes in institutionalization rates or cost of care) in people with dementia of any type and 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 outcomes between the treatment and control groups at end of treatment and follow-up were examined. Each study was summarized using a measure of effect (e.g. mean difference). Main results Eight trials met the inclusion criteria. However, three of the studies could not be 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 light therapy in managing cognition, sleep, function, behaviour, or psychiatric disturbances associated with dementia. Authors’ conclusions There is insufficient evidence to assess the value of light therapy for people with dementia. Most of the available studies are not of high methodological 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 light therapy is effective in the management of cognitive, sleep, functional, behavioural or psychiatric 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 participants at a height within their visual fields; a light visor worn on their heads; ceiling mounted light fixtures; or dawn-dusk simulation that mimics outdoor twilight transitions. Eight studies met the inclusion criteria. However, three trials were not included in the analyses because of inappropriately reported analyses or inability to retrieve the required data from the original investigators. The studies included in the analyses revealed no adequate evidence of the effectiveness of light therapy in managing cognitive, sleep, functional, behavioural, or psychiatric disturbances associated with dementia.
Date created
2009
DOI
doi:10.7939/R3445HK25
License information
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© 2009 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, Culum I, Lischka AR, Morgan DG, Peacock S, Forbes J, Forbes S. (2009). Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia (Review). Cochrane Database of Systematic Reviews, Issue 4, Art. No.: CD003946. DOI: 10.1002/14651858.CD003946.pub3.
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File title: Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia
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