Research project: Bright light treatment of patients with dementia

A full-scale research project on the effects of bright light therapy for dementia patients is now being carried out in Bergen, Norway. About 70 nursing home patients receive treatment with artificial daylight in the dark winter months.

The study is conducted at the University of Bergen, and is called the DEM.LIGHT project. The project is led by Associate Professor Elisabeth Flo at the University’s department of clinical psychology. She explains the background of the study: 
“Symptoms of dementia are often treated with drugs that have little beneficial effects, and often cause substantial side effects. However, there is evidence for the effectiveness of non-pharmacological treatment. Among those, bright light therapy is one of the most promising.” she says.

The project started out in October 2017 and will last till March 2018, a period when the days are short and little daylight comes through the windows. The study comprises eight nursing homes and about 70 patients with dementia as well as the employees in the nursing homes.

Bright light treatment
In traditional bright light therapy, the patient is repeatedly exposed to light with high intensity (e.g. 10 000 lux) from a table-mounted light source for a short interval, at a specific time of day. This requires behavioral compliance, and the methodology does not lend itself well to dementia patients. The light used in the DEM.LIGHT project allows patients to be treated using normal ceiling lighting where light exposure is increased.

Therapy light rooms
The Earth's natural light cycle has higher light intensity and cooler light in the middle of the day. The light in the DEM.LIGHT study will mimic daylight in this respect. The patients' living space at the nursing homes is turned into light therapy rooms, where participants with dementia and employees are exposed to light for long periods of the day.

Comprehensive testing
The patients participating undergo a series of tests during and after treatment.
"There are physical tests such as body temperature, blood pressure and pulse, but also observations and mapping of sleep, agitation, depression, quality of life, pain and other conditions," Flo says.
The evaluations of nursing staff include alertness, sleep, fatigue, depression and anxiety. The research project is carried out by Flo and a team of senior researchers (Professor Ståle Pallesen and Professor Inger Hilde Nordhus), postdoctoral scholarship holders, doctoral candidates and assistants. Glamox has provided the lighting for the project.

Multiple objectives
The DEM.LIGHT project is based on the hypothesis that the use of light which compensates for lack of daylight will significantly decrease behavioral and psychological symptoms, and improve sleep and daily living functionality in nursing home patients with dementia. The study also has other objectives, including the effects on nursing home staff, and the possibility for commercialization and development of home-based treatment.
Professor Flo has great goals for the outcome of the study: “Our vision is to improve the quality of the public-sector treatments with novel rehabilitating solutions for nursing home patients,” she says. “Hopefully these solutions can be transferred to a homecare setting, prolonging the time persons with dementia may stay at home. This will reduce the costs for the society and improve the lives of patients, relatives, and healthcare staff.”

About dementia

Dementia is a terminal condition affecting over 47 million people worldwide. As the world population is aging, the number of people affected is expected to rise. The progressive nature of dementia results in cognitive decline, loss of function and independence.

Behavioural and psychological symptoms of dementia (BPSD) and sleep problems are common. BPSD include behaviours such as aggression, screaming, restlessness, and agitation, and psychological symptoms which include anxiety and depression, hallucinations and delusions. Noticeably, both sleep and BPSD are related to a disturbed circadian rhythm. Behavioural problems tend to intensify in the early evening, a phenomenon referred to as sundowning. 

BPSD and sleep problems are also distressing for the caregivers of people with dementia, both family and healthcare staff. The symptoms are often the “last straw” leading to institutionalization, which is reflected by the nursing home population. Dementia care has been linked to nursing home staff burnout, sick leave, turnover, and increased financial costs.