title: Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study.
abstract: BACKGROUND
  An important parallel exists between patients with seasonal affective disorder and institutionalized older adults. Many older patients, as a result of global physical decline and immobility, are confined to their rooms, experiencing little natural sunlight. Thus, institutionalized older adults are at risk for chronic light deprivation. Testing the hypothesis that chronic light deprivation might be responsible, at least in part, for some depression among institutionalized older adults, the aim of this study was to investigate the efficacy of morning bright light treatment on depression among older adults residing in a long-term care facility.
  
  
  METHODS
  In a placebo controlled, crossover design, participants (N = 10, six women and four men; M age = 83.8) received each of the following: (i) 1 week (5 days) of 10,000 lux (therapeutic dose); (ii) 1 week (5 days) of 300 lux (placebo); or 1 week of no treatment (control). Each week of light treatment was 5 consecutive days, 30 minutes daily, with a wash-out period consisting of 1 week between conditions.
  
  
  RESULTS
  Geriatric Depression Scale (GDS) scores at baseline during all treatment conditions were positively correlated (r = .81, p < .01) with months of institutionalization, where participants with higher GDS scores experienced more time institutionalized. Scores on the GDS remained unchanged during the placebo and control conditions, but depression scores decreased significantly during the 10,000 lux treatment (pretest GDS M = 15 vs posttest GDS M = 11, p < .01). After the 10,000 lux treatment, 50% of the participants no longer scored in the depressed range. Improvement during the 10,000 lux condition was positively correlated (r = .62, p < .05) to baseline GDS scores, where participants with higher GDS scores experienced greater improvement following the 10,000 lux treatment.
  
  
  CONCLUSIONS
  The results of the present study suggest that bright light treatment may be effective among institutionalized older adults, providing nonpharmacological intervention in the treatment of depression. Furthermore, the length of institutionalization may play an important role in determining the efficacy of bright light treatment for older adults in the nursing-home setting.
authors.affiliation: Laboratory of Psychobiochemistry, University of Texas at El Paso, USA. icsumaya@utep.edu
authors.forename: I C
authors.initials: IC
authors.lastname: Sumaya
authors.forename: B M
authors.initials: BM
authors.lastname: Rienzi
authors.forename: J F
authors.initials: JF
authors.lastname: Deegan
authors.forename: D E
authors.initials: DE
authors.lastname: Moss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D003863:Depression / Q000523:psychology / Q000628:therapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008029:Lighting; D008297:Male; D009735:Nursing Homes; D010789:Phototherapy; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D013472:Sunlight; D016896:Treatment Outcome
chemical_list: D010919:Placebos