This study aims to investigate the effect of a dynamic lighting intervention on sleep
      quality, circadian activity rhythms, and mood in older adults with dementia living in
      long-term care facilities. The dynamic lighting intervention is designed to create an ambient
      illumination that provides a high level of circadian stimulation in the morning and
      circadian-neutral lighting in the evenings through delivering varying light intensity and
      spectrum.

Lighting for Older Adults With Dementia

Sleep

Mood

Light is the most important environmental element that is not only necessary to fulfill
      visual tasks but also is the main stimulus that regulates circadian rhythms. Daily exposure
      to proper lighting at the right time is reported as an effective non-pharmacological
      treatment to improve sleep disorders in various age groups including older adults. Several
      clinical studies have demonstrated the benefits of bright light therapy to improve sleep
      duration and sleep efficiency at night and reduce daytime sleepiness and behavioral
      disturbance (i.e., agitation, depression) in older adults. In most of these studies, lighting
      intervention includes a lightbox that exposes participants to an extra lighting source with
      specific characteristics (i.e., blue-enriched bright light) for only a few hours without
      considering the impacts of other lighting sources that individuals are exposed to throughout
      the day. A significant impediment to administrating bright light therapy for older adults
      with dementia is that these individuals typically require reminders to remain seated and
      awake in front of a lightbox long enough to benefit from the bright light exposure. An
      alternative way to deliver bright light is through providing circadian-effective ambient
      lighting. The circadian system responds best to high-intensity short-wavelength light (peak
      wavelength of 480 nm). However, the lighting design in long-term care facilities does not
      necessarily provide adequate intensity and spectrum to stimulate circadian rhythms in elder
      residences. Studies reported poor lighting conditions in nursing homes. According to these
      studies, daytime lighting in these institutions is not even sufficient to fulfill older
      adults' visual needs, while light at night is relatively often excessive. Thus, this study
      will be carried out to achieve the following aims:

      Aim1: Investigate the effect of a dynamic lighting condition on circadian activity rhythms
      and selected sleep parameters in older adults with dementia.

      Aim2: Evaluate the effect of a dynamic lighting condition on mood.

      Findings from this study will provide initial guidance to the designers and administration of
      memory care facilities as to the lighting design recommendations of greatest benefits to the
      sleep, mood, and well-being of institutionalized older adults diagnosed with dementia.

      The participants will be recruited from two memory care facilities from the greater Phoenix
      area, based on the recommendation of the managers at the memory care facilities.

      Environment: In this study, the human-lighting interaction will occur in the common areas of
      the selected memory care facilities where older adults with dementia spend most of the
      daytime hours under the supervision of facility caregivers. Research personnel will install
      experimental luminaires in the memory care facility's common area. During this visit,
      research personnel will also give a number of actigraphs and light trackers (which will be
      used for data collection throughout the study) to caregivers and instruct them on how to use
      these devices on participants. Participants will also be instructed (by caregivers) on how to
      use each device.

      Week 1 (Baseline): Patterns of sleep, moods, and light exposure will be monitored ad libitum
      for one week. The experimental luminaires will remain off during Week 1. Placing luminaires
      in the common area of the facility prior to the use of lighting interventions during Weeks 2
      to 7 will minimize environmental variations between baseline and intervention measurements
      (e.g., new luminaires in the room) and decrease the bias resulting from the Hawthorne effect
      on collected data.

      Weeks 2-7 (Intervention): The intervention period will start right after the baseline and
      continue for six constructive weeks. There are two lighting interventions, each of which is
      three weeks long. We will randomly assign one of the residences to start with (Dynamic >
      Placebo) lighting intervention while the other start with (Placebo > Dynamic) lighting
      intervention. Actigraphy will be conducted only on the last 7 days of each condition. Light
      spectrum and intensity will be tracked continuously throughout the waking hours (Blue Iris
      mobile sensor). Moreover, caregivers will complete CSDD and CMAI every seven days to assess
      the short and long-term effects of each condition on mood and agitation of older adult
      participants.

Dynamic Lighting

Placebo Lighting

Effects of Dynamic Lighting on Improving Sleep and Mood in Older Adults With Dementia.

Nocturnal Sleep Duration (in minutes) will be measured by Actigraphy. Longer sleep duration corresponds to improved sleep outcomes.

Percent Sleep Efficiency will be measured by actigraphy. Higher percentage corresponds to higher sleep quality.

Minutes of wake after sleep onset will be measured by actigraphy. Lower number indicates better sleep pattern and sleep outcomes.

Depression level is assessed using CSDD every 7 days throughout the 7-week protocol based on caregivers' observations of the participants' behavior during the week prior. Lower scores in CSDD indicates lower depression and better mood outcomes.

Agitation level is assessed using CMAI every 7 days throughout the 7-week protocol based on caregivers' observations of the participants' behavior during the week prior. A lower score indicates lower levels of agitations and an improvement in mood.

Assistant Professor

Each lighting condition will last for three weeks (Weeks 2-4 or 5-7). The order of conditions will be randomized. Sleep data will be collected only on the last 7 days of each condition using actigraphy. Light spectrum and intensity will be tracked continuously throughout the waking hours (wearable light tracker). Moreover, caregivers will complete two questionnaires (CSDD and CMAI) every seven days to assess the short and long-term effects of each condition on mood and agitation of older adult participants.

Lighting for Older Adults With Dementia

About this trial

Study ID

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Type

Phase

Placebo

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Not accepting

Trial Timing

What is this trial about?

What are the Participation Requirements?

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