However, many physicians believe that some of these symptoms may be related to changes in the natural time clock of the brain that changes mood, behavior, and sleeping patterns, a clock called the “circadian pacemaker.” This time-keeping system is sensitive to outside light. For this reason, many people from Northern latitudes (for example Alaska, Canada, and Northern states) have a condition called light deprivation, often with severe depression, and these individuals improve after undergoing light therapy.
An important study was recently published by Dr. Rixt Riemersma-Van Der Lek and co-workers from the Netherlands Institute for Neuroscience (JAMA, Volume 299, page 2642, 2008). These authors treated 189 elderly patients in group care facilities between 1999 and 2004 with either whole day bright light exposure, evening melatonin, the combination, or just inactive placebos. They treated patients for an average of 15 months (some patients for up to 3.5 years).
The results were very impressive! The natural history of dementia with progressive reduction in mental functioning was improved with daylight exposure by 5%. Mental deterioration was reduced by 5% on exposure to whole day bright light. Also, light reduced depression by 19%. The patients had a 53% improvement in functional activity according to nurses if they were exposed to light. Melatonin increased sleep duration by 6%, but also increased depression, but not if patients also were exposed to light in addition to the melatonin. The combined treatment of light and melatonin reduced aggressive behaviors by 9% and increased sleep efficiency by 3.5%.
These studies have very important conclusions for all of us. We will either suffer ourselves from dementia as we grow older, or we may currently be caring for family and/or friends who are suffering from early or advanced dementia. At one time or another, it affects all families and people!
The more we know about the symptoms of dementia, the standard treatments of this problem, and the supportive measures that can benefit such individuals, the more that each of us can recognize people who should be tested, and the better we are able to help them get the best care from their doctors.
Therefore, we should learn from this important article that exposure to light and use of mild treatment with melatonin can be highly beneficial. We should suggest that caregivers discuss these findings with physicians who are caring for those individuals. Also, when choosing a chronic care facility for patients with dementia or Alzheimer’s disease, reviewing daylight exposure activities with the staff is important to make certain that these patients are afforded the benefits of daylight exposure. Continuing care of these individuals can result in improved relationships with family and friends, if the severity of symptoms and progression of symptoms are minimized.