Light therapy for managing cognitive, sleep, functional, behavioural, or psychiatric disturbances in dementia

被引:56
作者
Forbes, Dorothy [1 ]
Culum, Ivan [2 ]
Lischka, Andrea R. [2 ]
Morgan, Debra G. [3 ]
Peacock, Shelley [4 ]
Forbes, Jennifer [5 ]
Forbes, Sean [6 ]
机构
[1] Univ Western Ontario, Arthur Labatt Family Sch Nursing, London, ON N6A 5C1, Canada
[2] Univ Western Ontario, Elborn Coll, London, ON N6A 5C1, Canada
[3] Univ Saskatchewan, Canadian Ctr Hlth & Safety Agr, Saskatoon, SK S7N 0W0, Canada
[4] Univ Alberta, Fac Nursing, Saskatoon, SK, Canada
[5] Univ Alberta, Sch Phys Therapy, Fac Rehabil Med, Edmonton, AB, Canada
[6] Univ Florida, Dept Phys Therapy, Gainesville, FL USA
来源
COCHRANE DATABASE OF SYSTEMATIC REVIEWS | 2009年 / 04期
关键词
Phototherapy; Affect; Cognition Disorders [etiology; therapy; Dementia [complications; Depression [etiology; Psychomotor Agitation [etiology; Randomized Controlled Trials as Topic; Sleep Disorders [etiology; Aged; Humans; CIRCADIAN REST-ACTIVITY; ACTIVITY RHYTHM DISTURBANCES; BRIGHT-LIGHT; ALZHEIMERS-DISEASE; INSTITUTIONALIZED PATIENTS; ACTIVITY DISRUPTION; NEUROPSYCHIATRIC INVENTORY; CLINICAL-DIAGNOSIS; WAKE DISTURBANCES; MELATONIN;
D O I
10.1002/14651858.CD003946.pub3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Back ground Rest-activity and sleep-wake cycles are controlled by the endogenous circadian rhythm generated by the suprachiasmatic nuclei (SCN) of the hypothalamus. Degenerative changes in the SCN appear to be a biological basis for circadian disturbances in people with dementia, and might be reversed by stimulation of the SCN by light. Objectives The review assesses the evidence of effectiveness of light therapy in managing cognitive, sleep, functional, behavioural, or psychiatric disturbances associated with dementia. Search strategy The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 4 March 2008 using the terms: "bright light*", "light box*", "light visor*", "dawn-dusk*", phototherapy, "photo therapy", "light therapy" "light treatment", light*. The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources. Selection criteria All relevant, randomized clinical trials in which light therapy, at any intensity and duration, was compared with a control group for the effect on managing cognition, sleep, function, behavioural, or psychiatric disturbances (as well as changes in institutionalization rates or cost of care) in people with dementia of any type and degree of severity. Three reviewers independently assessed the retrieved articles for relevance and methodological quality, and extracted data from the selected studies. Statistically significant differences in outcomes between the treatment and control groups at end of treatment and follow-up were examined. Each study was summarized using a measure of effect (e.g. mean difference). Main results Eight trials met the inclusion criteria. However, three of the studies could not be included in the analyses because of inappropriate reported study analyses or inability to retrieve the required data from the investigators. This review revealed no adequate evidence of the effectiveness of light therapy in managing cognition, sleep, function, behaviour, or psychiatric disturbances associated with dementia. Authors' conclusions There is insufficient evidence to assess the value of light therapy for people with dementia. Most of the available studies are not of high methodological quality and further research is required.Data collection and analysis
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页数:91
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