[Symptomatic treatment in patients with dementia: light, but not melatonin, is probably worthwhile].
A recent study in the JAMA described the effects of long-term daily treatment with whole-day bright light in elderly patients with dementia, with or without the addition of melatonin (2.5 mg daily), on cognition, mood, behavioural symptoms, activities of daily living and sleep. It was concluded that light has a modest benefit in improving some cognitive and non-cognitive symptoms of dementia. The effects of melatonin were negligible. Despite the small effects found of this study, the outcomes can be used in clinical practice since other small studies also show a trend towards positive effects of bright light in dementia patients. Since current pharmacotherapy for behavioural problems in dementia has very modest effects at the risk of serious adverse effects, non-pharmacological interventions must be encouraged. Increasing light intensity in the living rooms of patients with dementia is an easy and cheap intervention with possible positive effects on at least some patients.
van Marum
R J
RJ
Universitair Medisch Centrum Utrecht, afd. Geriatrie, Postbus 85.500, 3508 GA Utrecht. r.j.vanmarum@umcutrecht.nl
D000339:Affect / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D003704:Dementia / Q000517:prevention & control / Q000628:therapy*; D003863:Depression / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000009:adverse effects / Q000627:therapeutic use*; D010789:Phototherapy / Q000379:methods*; D012893:Sleep Wake Disorders / Q000517:prevention & control
D008550:Melatonin