Missotten Pierre, Farag Laurent, Delye Sam, Muller Adeline, Grotz Catherine, Adam Stéphane
Unité de psychologie de la sénescence, Université de Liège (ULiège), Belgique.
Intercommunale de soins spécialisés de liège (ISoSL) - Les Cliniques de Soins Spécialisés Valdor-Pèrî, Liège, Belgique.
Geriatr Psychol Neuropsychiatr Vieil. 2019 Mar 1;17(1):83-91. doi: 10.1684/pnv.2019.0786.
Given the relatively modest therapeutic benefits of drug treatments (and their associated costs) in dementia, there is a growing interest in non pharmacological approaches, including light therapy (light based therapy, LBT). Although various literature reviews exist, little attention has been given to the effects of these therapies (according to their modalities of application) on parameters related to both circadian rhythm and clinical parameters associated with dementia.
To provide an overview of available studies using LBT as non-pharmacological approach for managing persons with dementia and to make recommendations for its use.
Systematic searches in Medline and PsycINFO were carried out, from their inception to February 2017, by means of the combination of key words including dementia and light therapy.
Forty-two articles were reviewed with particular attention to the subjects' characteristics and the modalities of the therapy. The effect of LBT has been considered as a mean of intervention to entrain the circadian rhythm as well as in a clinical approach to reduce behavioral disorders, to reduce cognitive decline or loss of independence, and so on. Depending on the parameters and modalities, the effect of LBT is partially or non-significant.
Based on this literature review, some recommendations were formulated: prioritizing 'naturalistic' devices, setting a minimum threshold of 2,000 lux light intensity peak, testing the modulation of the light intensity during the day and finally, assessing the adequacy between the type of light (color) and the desired therapeutic objective (relaxing or stimulating effect).
鉴于药物治疗在痴呆症治疗中的益处相对有限(以及其相关成本),人们对非药物治疗方法的兴趣与日俱增,其中包括光疗法(基于光的疗法,LBT)。尽管已有各种文献综述,但对于这些疗法(根据其应用方式)对与昼夜节律相关的参数以及与痴呆症相关的临床参数的影响,关注甚少。
概述使用LBT作为管理痴呆症患者的非药物方法的现有研究,并为其使用提出建议。
从创刊至2017年2月,通过结合包括痴呆症和光疗法在内的关键词,在Medline和PsycINFO中进行系统检索。
共审查了42篇文章,特别关注受试者的特征和治疗方式。LBT的效果被视为一种干预手段,用于调节昼夜节律,以及在临床方法中减少行为障碍、减少认知衰退或独立性丧失等。根据参数和方式的不同,LBT的效果部分显著或不显著。
基于这篇文献综述,制定了一些建议:优先选择“自然主义”设备,设定光强度峰值的最低阈值为2000勒克斯,测试白天光强度的调制,最后,评估光的类型(颜色)与期望的治疗目标(放松或刺激效果)之间的适配性。