Sunday, June 15, 2008

Wham: Daytime Bright Lighting and Melatonin a Benefit to Dementia Patients

A lot of new research is going on in the area of natural treatments for dementia. Recently, the use of daytime bright lighting to improve the circadian rhythm of elderly persons was seen to be associated with a modest improvement in these adults' symptoms of dementia. It was interesting to see how the researchers also found that the use of melatonin supplements resulted in improved sleep. This research was reported in the June 11 issue of the journal of the American Medical Association, JAMA.

“In elderly patients with dementia, cognitive decline is frequently accompanied by disturbances of mood, behavior, sleep, and activities of daily living, which increase the caregiver burden and a risk of institutionalization,” the authors write. These symptoms have been associated with disturbances in circadian rhythm -- another word for our biological clock, that which gets us up in the morning and tells us its OK to be energetic in the daytime or sleepy at night.

Rixt F. Riemersma-van der Lek, M.D., of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, and colleagues conducted a trial at 12 elderly group care facilities in the Netherlands that evaluated the effects of up to 3.5 years of daily supplementation of bright light and/or melatonin on a number of health outcomes, including symptoms of dementia and sleep disturbances. The study included 189 facility residents, average age 85.8 years; 90 percent were female and 87 percent had dementia.

Six of the facilities had bright lighting installed in ceiling-mounted fixtures. Lights were on daily between approximately 9 a.m. to 6 p.m. Participants were randomized to receive evening melatonin (2.5 mg) or placebo and participated an average of 15 months (maximum period of 3.5 years) in the study. The researchers found that these bright lights lessened cognitive deterioration by 5 percent, and more significantlly reduced depressive symptoms by 19 percent. As you might imagine, lessening depressive symptoms in an elderly person has a lot to do with having less downstream ailments. The bright lights also slowed the onset of functional difficulties for these elderly patients by 53 percent.

Melatonin reduced the time to fall asleep by 19 percent and increased total sleep duration by 6 percent, but adversely affected caregiver ratings of withdrawn behavior and mood expressions. The addition of bright light turned around the adverse effect on mood. In combination with the bright light program, melatonin reduced aggressive behavior by 9 percent.


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