title: Senior living environments: evidence-based lighting design strategies.
abstract: OBJECTIVE
  To review from an architectural lighting perspective the effects of indoor lighting on the health and well-being of people in senior living environments.
  
  
  BACKGROUND
  The role of circadian rhythms in people with chronic disorders continues to be a focus of laboratory research and clinical trials. Beneficial, evidence-based indoor lighting design strategies are being considered for senior living environments, particularly for residents who have limited access to natural bright light.
  
  
  METHODS
  Articles published 2002-2012 reporting the results of prospective, randomized, controlled clinical trials (RCTs) were accessed using the U.S. National Library of Medicine PubMed site using the following search terms: "light, sleep, circadian, randomized, controlled, nursing home" and "light, sleep, circadian, randomized, controlled, elderly."
  
  
  RESULTS
  The search resulted in 48 citations, of which 18 meet our pre-search criteria. Data from these RCTs indicate options such as programmable, 24-hour lighting algorithms that may involve light intensity, lighting duration, spectra (wavelength) and lighting timing sequences
  
  
  CONCLUSIONS
  Valid and actionable data are available about circadian rhythms, sleep, and human health and well-being that can inform the design of lighting for long-term care. Evidence-based architectural design of a 24-hour light/dark environment for residents may mitigate symptoms of circadian disruption; evidence-based management of darkness is as important as evidence-based management of light. Further research is needed into the long-term circadian health needs of night staff members in order to understand the effects of shift work while, at the same time providing the highest level of care.
  
  
  BACKGROUND
  Design process, elderly, evidence-based design, lighting, literature review.
authors.affiliation: CORRESPONDING AUTHOR: Michael D. White, mwhite@schulershook.com; (612) 339-5958.
authors.forename: Michael D
authors.initials: MD
authors.lastname: White
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Richard R
authors.initials: RR
authors.lastname: Wilson