Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Middin, Care Organization for People with Intellectual Disabilities, Rijswijk, The Netherlands.
J Intellect Disabil Res. 2021 Apr;65(4):361-372. doi: 10.1111/jir.12822. Epub 2021 Feb 16.
Light exposure affects mood and sleep regulation. Sleep problems and mood complaints are common in elderly with intellectual disabilities (ID) living in care facilities. Insufficient light exposure is hypothesised to contribute to the high prevalence of these problems. The current study is the first to describe the personal light exposure pattern during the waking day in elderly with ID.
The study sample consists of 82 elderly with ID (aged 62.3 ± 9.4 years) living in 16 residential homes of three care organisations in the Netherlands. Personal light exposure was measured continuously for 7-10 days using a HOBO data logger light sensor, measuring illuminance at chest height. Participants wore a wrist-worn accelerometer (Actiwatch or Geneactiv) to indicate the bedtimes to determine the waking day.
The variation in illuminance is small during the waking day. Elderly with ID spend most of their waking day (mean duration = 14:32:43 h) in dim light (1-500 lux) environment and spend a median of 32 min in light > 1000 lux. Within participants, the threshold associated with better sleep (>50 min of light > 1000 lux) was reached for 34% of the days, and the threshold associated with less depressive symptoms (>30 min of light > 1000 lux) was reached in 46% of the days. Exposure > 1000 lux was lower during weekends than during weekdays.
Elderly with ID spend most of their waking day in low light levels and did not meet the proposed values associated with better sleep and mood. Given the importance of adequate light exposure for regulation of sleep and mood, and the prevalence of sleep and mood problems in elderly with ID, the current study suggests that the lit environment for this already frail population should be given more attention.
光照会影响情绪和睡眠调节。在居住在护理机构中的老年智障人士（ID）中，睡眠问题和情绪抱怨很常见。光照不足被认为是导致这些问题高发的原因之一。目前的研究首次描述了老年 ID 患者在白天清醒时的个人光照暴露模式。
研究样本包括 82 名居住在荷兰三个护理机构的 16 个住宅中的老年 ID 患者（年龄 62.3±9.4 岁）。使用霍博（HOBO）数据记录器光传感器连续测量 7-10 天的个人光照暴露情况，该传感器在胸部高度测量光照强度。参与者佩戴腕戴式加速度计（Actiwatch 或 Geneactiv）以指示睡眠时间，以确定清醒时间。
白天光照强度的变化很小。老年 ID 患者在大部分清醒时间（平均时长为 14:32:43 小时）处于微光（1-500 勒克斯）环境中，中位数有 32 分钟处于光照强度>1000 勒克斯的环境中。在个体参与者中，达到更好睡眠相关阈值（>50 分钟光照强度>1000 勒克斯）的天数比例为 34%，达到与较少抑郁症状相关的阈值（>30 分钟光照强度>1000 勒克斯）的天数比例为 46%。周末的光照强度>1000 勒克斯的天数低于工作日。
老年 ID 患者在大部分清醒时间处于低光照水平，未达到与更好睡眠和情绪相关的建议值。鉴于光照对睡眠和情绪调节的重要性，以及老年 ID 中睡眠和情绪问题的普遍性，本研究表明，应更加关注这一已经脆弱人群的光照环境。
