Dementia is such an awful disease. It can be utterly harrowing to see the loss of self and independence of a loved one. I find it such a sad illness. So I was interested to read this piece of research from JAMA today.
One of the most difficult problems for dementia sufferers and their carers is the disruption of the normal circadian rhythms, so these researchers tried two interventions which might make a difference – melatonin and light. The patients who were treated with melatonin did experience improvement in their sleep but their mood deteriorated and they became withdrawn. Bright lights were fitted to the care homes and kept on throughout the day. Residents who lived with the brighter light AND who took melatonin showed the greatest benefits in both cognitive function and in reduction of depressive symptoms. The authors conclude by recommending the light plus melatonin regime, but point out that increased light alone made a difference and that melatonin without increased light should not be recommended because of the adverse effects on mood.
This is a nice study. Very simple intervention which apparently can make a useful difference.
Heroes Not Zombies 
Bob, thanks for sharing this. Do you know what kind of light individuals could use at home – the lights that are used to help with SAD for example?
Joanna
Joanna, yes, I wondered about this. They don’t specify in the paper – just say bright lights with a higher “lumen” value than usual. In the Homeopathic Hospital we use “daylight spectrum” lightbulbs in all our lights and the light boxes you can buy for SAD have special bulbs. It seems with this study that the important thing is the brightness rather than the spectrum. You know, one thing this makes me wonder about is the design of homes and hospitals and care homes. I wonder how much attention is paid to light?
I must find out about these higher lumen bulbs. Someone in my family has dementia and this idea may help.
Here’s a quote from the original paper – “Light exposure was manipulated by installing a large number of ceiling-mounted fixtures with Plexiglas diffusers containing an equal amount of Philips TLD 840 and 940 fluorescent tubes (Philips Lighting BV, Eindhoven, the Netherlands) in the common living room. Lights were on daily between approximately 9 AM and 6 PM. The aim was an exposure of ± 1000 lux, measured before the eyes in the gaze direction. This intensity is technically feasible and has in previous studies been confirmed to synchronize circadian rhythms in healthy people in temporal isolation 31 and to improve circadian activity rhythm disturbances in elderly patients with moderate to severe dementia” (This was a Dutch research team!)
The previous study they refer to is “Van Someren EJW, Kessler A, Mirmiran M, Swaab DF. Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients. Biol Psychiatry. 1997;41(9):955–963.”
Bob, thanks very much for digging into this further and helping to translate it for us.
Joanna
Any time Joanna, I’m always happy to do things like this
Using a blue based light rather than a yellow traditional based light in the home is far closer to sunlight than regular artificial light. You can buy these light bulbs at B and Q or Wicks in the UK and Home Depot or Lowes in the US.
This is great for those who suffer from everything from SAD to Migraines. There is quite a lot of research about this. I use only blue lights in my home. It makes a big difference for me.
I hadn’t thought about it though for Dementia sufferers. That is outstanding! I did notice marked improvement when my uncle (who suffers from Alzheimer’s) recently came to visit me in California where it was sunny every single day as opposed to Boston, Mass where he lives. His mood was great, he had alot more energy and awareness and my Aunt kept commenting on how well he was doing. Makes much more sense now.
Amber, yes, your point about the blue lights is a good one. But it’s interesting that the researchers in this particular study didn’t bother about that. So there’s the idea for the next experiment I reckon…….are bright blue lights better than bright yellow ones in achieving an effect on cognition in dementia patients? My hunch is the answer would be yes, because of the well known effect they have on mood.
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