Brighter atmosphere good for dementia patients
Relatively simple adjustments in lighting and melatonin may ease some of the behavioural problems associated with dementia.
Relatively simple adjustments in lighting and melatonin may ease some of the behavioural problems associated with dementia. Melatonin is a hormone that plays a role in the sleep-wake cycle.
Dementia patients not only experience memory and other problems with cognition, they often end up with mood, behaviour, sleep and functional disturbances. A recent study found that anti-psychotic medications often prescribed for behavioural problems such as aggression and agitation can increase the risk of hospitalisation and even death. Unfortunately, alternatives to these drugs are limited.
To find out whether bright light and melatonin help dementia patients, researchers from Netherlands studied 189 residents of 12 group-care facilities, 87 percent of whom suffered from dementia. The mean age of the participants was 86 years. The participants were randomly assigned to receive either long-term daily treatment with bright or dim light and to receive 2.5 milligrams of melatonin in the evening or a placebo for up to 3.5 years. Half of the facilities involved had bright lighting mounted in the ceiling, which was on from about 9 a.m. to 6 p.m. every day.
It was observed that bright light reduced cognitive deficits in the participants by 5 percent, cut symptoms of depression by 19 percent and decreased the gradual increase in functional limitations by 53 percent, relative to the dim-light group. The results on melatonin hormone were mixed: while given in combination with bright light, it reduced the time needed by participants to fall asleep by 19 percent, increased mean duration of uninterrupted sleep by 25 percent, and decreased agitated behaviour by 9 percent.
A brighter atmosphere and optimum dosage of melatonin reflected better results than Aricept, which are commonly prescribed to limit cognitive decline in Alzheimer's patients.
The researchers noted that the sleep-cycle and deregulation of the sleep cycles are important contributors to behavioural problems in Alzheimer's patients, especially in later stages of the disease, so if there is an environmental intervention like light that can help tackling behavioural problems in dementia patients.
Journal of the American Medical Association
June 2008
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